{"hospital_name": "Amisub (SFH), Inc.", "last_updated_on": "2026-04-08", "version": "3.0.0", "pid": "1514642804", "rid": "11844", "location_name": ["Saint Francis Hospital - Memphis"], "hospital_address": ["5959 Park Ave, Memphis, TN 38119"], "type_2_npi": ["1952326977"], "license_information": {"license_number": "0000000111", "state": "TN"}, "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": "17-HYDROXY PREGNENOLONE", "code_information": [{"code": "84143", "type": "CPT"}, {"code": "7258414", "type": "CDM"}], "standard_charges": [{"gross_charge": 277.0, "discounted_cash": 207.75, "setting": "both", "billing_class": "facility"}]}, {"description": "3D IMAGING W POSTPROCESS", "code_information": [{"code": "76377", "type": "CPT"}, {"code": "4917637", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 1561.0, "discounted_cash": 1170.75, "setting": "both", "billing_class": "facility"}]}, {"description": "3D IMAGING W POSTPROCESS", "code_information": [{"code": "76377", "type": "CPT"}, {"code": "5017637", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 1652.0, "discounted_cash": 1239.0, "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": 1561.0, "discounted_cash": 1170.75, "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": 1574.0, "discounted_cash": 1180.5, "setting": "both", "billing_class": "facility"}]}, {"description": "3D IMAGING W POSTPROCESS", "code_information": [{"code": "76377", "type": "CPT"}, {"code": "5256377", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 1684.0, "discounted_cash": 1263.0, "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": 607.0, "discounted_cash": 455.25, "setting": "both", "billing_class": "facility"}]}, {"description": "3D RADIOTX W DOSE VOL HST", "code_information": [{"code": "77295", "type": "CPT"}, {"code": "5107295", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 11477.0, "discounted_cash": 8607.75, "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": 1829.0, "discounted_cash": 1371.75, "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": 149.0, "discounted_cash": 111.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AA 15% 2000ML TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5413192", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 1365.0, "discounted_cash": 1023.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AA 15% 500ML TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5413190", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 565.0, "discounted_cash": 423.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AA 15% PER 1ML TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5413194", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 0.53, "discounted_cash": 0.4, "setting": "both", "billing_class": "facility"}]}, {"description": "AA 2.75% D10 EL/CA 1LTPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412017", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 468.0, "discounted_cash": 351.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AA 2.75% D10 ELEC 2L TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412014", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 360.0, "discounted_cash": 270.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AA 2.75% D5 ELEC 1L TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412037", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 295.0, "discounted_cash": 221.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AA 3% ELEC GLYC 1L TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5413025", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 1318.0, "discounted_cash": 988.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AA 4.25% D10 1L TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412018", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 456.0, "discounted_cash": 342.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AA 4.25% D10 2L TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412008", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 509.0, "discounted_cash": 381.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AA 4.25% D5 1L TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412034", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 254.0, "discounted_cash": 190.5, "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": 497.0, "discounted_cash": 372.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AA 5.4% 250ML TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5413210", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AA 6% 500ML TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5413105", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AA 8% HEPATIC 500ML TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5413219", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 1861.0, "discounted_cash": 1395.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AA 8.5% 500ML TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5413120", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 23.0, "discounted_cash": 17.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AB ID LEUKOCYTE AB/3", "code_information": [{"code": "86021", "type": "CPT"}, {"code": "7005996", "type": "CDM"}], "standard_charges": [{"gross_charge": 1109.0, "discounted_cash": 831.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AB ID LEUKOCYTE AB/4", "code_information": [{"code": "86021", "type": "CPT"}, {"code": "7256065", "type": "CDM"}], "standard_charges": [{"gross_charge": 222.0, "discounted_cash": 166.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AB ID LEUKOCYTE AB/5", "code_information": [{"code": "86021", "type": "CPT"}, {"code": "7256069", "type": "CDM"}], "standard_charges": [{"gross_charge": 222.0, "discounted_cash": 166.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AB ID LEUKOCYTE AB/6", "code_information": [{"code": "86021", "type": "CPT"}, {"code": "7256071", "type": "CDM"}], "standard_charges": [{"gross_charge": 222.0, "discounted_cash": 166.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ABACAVIR 20MG/ML 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314005", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ABACAVIR 20MG/ML 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314005", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ABACAVIR 300MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300003", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ABACAVIR 300MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300003", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ABATACEPT PER 10MG IV IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0129", "type": "HCPCS"}, {"code": "5318036", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 235.0, "discounted_cash": 176.25, "setting": "both", "billing_class": "facility"}], "modifiers": "JA"}, {"description": "ABATACEPT PER 10MG IV IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0129", "type": "HCPCS"}, {"code": "5318036", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 235.0, "discounted_cash": 176.25, "setting": "both", "billing_class": "facility"}], "modifiers": "JA"}, {"description": "ABCIXIMAB PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0130", "type": "HCPCS"}, {"code": "5318008", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 8776.0, "discounted_cash": 6582.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ABCIXIMAB PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0130", "type": "HCPCS"}, {"code": "5318008", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 8776.0, "discounted_cash": 6582.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ABD AORTA W/BI LWR EXT", "code_information": [{"code": "75630", "type": "CPT"}, {"code": "4615631", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 38266.0, "discounted_cash": 28699.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ABD AORTA W/BI LWR EXT", "code_information": [{"code": "75630", "type": "CPT"}, {"code": "4915631", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 32934.0, "discounted_cash": 24700.5, "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": 10247.0, "discounted_cash": 7685.25, "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": 9976.0, "discounted_cash": 7482.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ABD ART/VEN FLOW ABD COMP", "code_information": [{"code": "93975", "type": "CPT"}, {"code": "5012017", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 3089.0, "discounted_cash": 2316.75, "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": 3190.0, "discounted_cash": 2392.5, "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": 3037.0, "discounted_cash": 2277.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ABD PARACENTESIS W/IMAGE", "code_information": [{"code": "4919083", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4355.0, "discounted_cash": 3266.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ABD PARACENTESIS W/IMAGE", "code_information": [{"code": "5019083", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3780.0, "discounted_cash": 2835.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ABD PARACENTESIS W/IMAGE", "code_information": [{"code": "5059083", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 18929.0, "discounted_cash": 14196.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ABD PARACENTESIS W/IMAGE", "code_information": [{"code": "5069083", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4939.0, "discounted_cash": 3704.25, "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": 1299.0, "discounted_cash": 974.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ABDOMEN 1 VIEW", "code_information": [{"code": "74018", "type": "CPT"}, {"code": "5014018", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1299.0, "discounted_cash": 974.25, "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": 1353.0, "discounted_cash": 1014.75, "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": 2148.0, "discounted_cash": 1611.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ABDOMEN 2 VIEWS", "code_information": [{"code": "74019", "type": "CPT"}, {"code": "5014019", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2148.0, "discounted_cash": 1611.0, "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": 2148.0, "discounted_cash": 1611.0, "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": 2157.0, "discounted_cash": 1617.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ABDOMEN 3/+ VIEWS", "code_information": [{"code": "74021", "type": "CPT"}, {"code": "5014021", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2157.0, "discounted_cash": 1617.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ABDOMEN 3/+ VIEWS", "code_information": [{"code": "74021", "type": "CPT"}, {"code": "5114021", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2157.0, "discounted_cash": 1617.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ABDOMEN/CHEST DET FORBDY", "code_information": [{"code": "76010", "type": "CPT"}, {"code": "4904030", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 740.0, "discounted_cash": 555.0, "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": 749.0, "discounted_cash": 561.75, "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": 617.0, "discounted_cash": 462.75, "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": 40906.0, "discounted_cash": 30679.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ABLATN RENL TUMORS CRYO", "code_information": [{"code": "5050593", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 40228.0, "discounted_cash": 30171.0, "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": 12.0, "discounted_cash": 9.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "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": 13.0, "discounted_cash": 9.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ACARBOSE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300005", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ACARBOSE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300005", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "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": 16.0, "discounted_cash": 12.0, "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": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETABULR COMP", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8131000", "type": "CDM"}], "standard_charges": [{"gross_charge": 7677.0, "discounted_cash": 5757.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETAMNOPHN QUANT", "code_information": [{"code": "80143", "type": "CPT"}, {"code": "7252003", "type": "CDM"}], "standard_charges": [{"gross_charge": 165.0, "discounted_cash": 123.75, "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": 446.0, "discounted_cash": 334.5, "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": 446.0, "discounted_cash": 334.5, "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": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETAZOLAMIDE 125MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300094", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETAZOLAMIDE 125MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300094", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETC AC/HCTS2%-1%10MLOT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330023", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 223.0, "discounted_cash": 167.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETC AC/HCTS2%-1%10MLOT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330023", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 223.0, "discounted_cash": 167.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETIC AC/AL ACET 60MLOT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330017", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 204.0, "discounted_cash": 153.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETIC AC/AL ACET 60MLOT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330017", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 204.0, "discounted_cash": 153.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETIC ACID 3% 30ML TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334005", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETIC ACID.25% 1L IRR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5414015", "type": "CDM"}, {"code": "270", "type": "RC"}], "standard_charges": [{"gross_charge": 452.0, "discounted_cash": 339.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETONE QUALITATIVE", "code_information": [{"code": "82009", "type": "CPT"}, {"code": "4152007", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "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": 253.0, "discounted_cash": 189.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETONE QUANTITATIVE/2", "code_information": [{"code": "82010", "type": "CPT"}, {"code": "7002015", "type": "CDM"}], "standard_charges": [{"gross_charge": 557.0, "discounted_cash": 417.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETONE QUANTITATIVE/2", "code_information": [{"code": "82010", "type": "CPT"}, {"code": "7252015", "type": "CDM"}], "standard_charges": [{"gross_charge": 557.0, "discounted_cash": 417.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETYLCHOLINE CL SYS1%KT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330045", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 439.0, "discounted_cash": 329.25, "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": 597.0, "discounted_cash": 447.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETYLCYST 2.5GM EFF TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300111", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 146.0, "discounted_cash": 109.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETYLCYST 2.5GM EFF TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300111", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 146.0, "discounted_cash": 109.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETYLCYST 500MG EFF TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300110", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETYLCYST 500MG EFF TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300110", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "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": 59.0, "discounted_cash": 44.25, "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": 168.0, "discounted_cash": 126.0, "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": 93.0, "discounted_cash": 69.75, "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": 282.0, "discounted_cash": 211.5, "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": 965.0, "discounted_cash": 723.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ACHR ANTIBODY", "code_information": [{"code": "83519", "type": "CPT"}, {"code": "7253580", "type": "CDM"}], "standard_charges": [{"gross_charge": 656.0, "discounted_cash": 492.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ACHR ANTIBODY/2", "code_information": [{"code": "83519", "type": "CPT"}, {"code": "7253581", "type": "CDM"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "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": 837.0, "discounted_cash": 627.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ACTH", "code_information": [{"code": "82024", "type": "CPT"}, {"code": "7002024", "type": "CDM"}], "standard_charges": [{"gross_charge": 2119.0, "discounted_cash": 1589.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ACTH", "code_information": [{"code": "82024", "type": "CPT"}, {"code": "7252024", "type": "CDM"}], "standard_charges": [{"gross_charge": 2119.0, "discounted_cash": 1589.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ACTIN SMOOTH MUSCLE AB", "code_information": [{"code": "86015", "type": "CPT"}, {"code": "7250516", "type": "CDM"}], "standard_charges": [{"gross_charge": 825.0, "discounted_cash": 618.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ACTINOMYCES AB/3", "code_information": [{"code": "86602", "type": "CPT"}, {"code": "7256602", "type": "CDM"}], "standard_charges": [{"gross_charge": 89.0, "discounted_cash": 66.75, "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": 2558.0, "discounted_cash": 1918.5, "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": 2275.0, "discounted_cash": 1706.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ACUTE HEPATITIS PANEL", "code_information": [{"code": "80074", "type": "CPT"}, {"code": "4120074", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 123.0, "discounted_cash": 92.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ACUTE HEPATITIS PANEL", "code_information": [{"code": "80074", "type": "CPT"}, {"code": "4150074", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 2603.0, "discounted_cash": 1952.25, "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": 49.0, "discounted_cash": 36.75, "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": 49.0, "discounted_cash": 36.75, "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": 2006.0, "discounted_cash": 1504.5, "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": 2006.0, "discounted_cash": 1504.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ACYCLOVIR 5% 15GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334037", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 671.0, "discounted_cash": 503.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ACYCLOVIR 5% 15GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334037", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 671.0, "discounted_cash": 503.25, "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": 4980.0, "discounted_cash": 3735.0, "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": 4980.0, "discounted_cash": 3735.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ACYCLOVIR 5% 3GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334038", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 312.0, "discounted_cash": 234.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ACYCLOVIR 5% 3GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334038", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 312.0, "discounted_cash": 234.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ACYCLOVIR 800MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300161", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ACYCLOVIR 800MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300161", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "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": 12.0, "discounted_cash": 9.0, "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": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ADALIMUMAB PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0139", "type": "HCPCS"}, {"code": "5318049", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 422.0, "discounted_cash": 316.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ADALIMUMAB PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0139", "type": "HCPCS"}, {"code": "5318049", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 422.0, "discounted_cash": 316.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ADAMTS 13 ACTIVITY", "code_information": [{"code": "85397", "type": "CPT"}, {"code": "7258539", "type": "CDM"}], "standard_charges": [{"gross_charge": 472.0, "discounted_cash": 354.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ADAMTS 13 ACTIVITY/2", "code_information": [{"code": "85397", "type": "CPT"}, {"code": "7258540", "type": "CDM"}], "standard_charges": [{"gross_charge": 990.0, "discounted_cash": 742.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ADAPT FRACTURE TRUNION UNIV", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8133862", "type": "CDM"}], "standard_charges": [{"gross_charge": 5963.0, "discounted_cash": 4472.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ADENOSINE DEAMINASE", "code_information": [{"code": "84311", "type": "CPT"}, {"code": "7256367", "type": "CDM"}], "standard_charges": [{"gross_charge": 168.0, "discounted_cash": 126.0, "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": 12.0, "discounted_cash": 9.0, "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": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ADENOVIRUS AB", "code_information": [{"code": "86603", "type": "CPT"}, {"code": "7006911", "type": "CDM"}], "standard_charges": [{"gross_charge": 535.0, "discounted_cash": 401.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ADHESION BARRIER 3X5 EA", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334050", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 6154.0, "discounted_cash": 4615.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ADHESION BARRIER 3X5 EA", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334050", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 6154.0, "discounted_cash": 4615.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ADHESION BARRIER 5X6 EA", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337247", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1757.0, "discounted_cash": 1317.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ADHESION BARRIER 5X6 EA", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337247", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1757.0, "discounted_cash": 1317.75, "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": 4324.0, "discounted_cash": 3243.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY ADULT LEVEL II", "code_information": [{"code": "2020028", "type": "CDM"}, {"code": "199", "type": "RC"}], "standard_charges": [{"gross_charge": 4324.0, "discounted_cash": 3243.0, "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": 4324.0, "discounted_cash": 3243.0, "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": 4324.0, "discounted_cash": 3243.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY ADULT LEVEL II", "code_information": [{"code": "2160028", "type": "CDM"}, {"code": "199", "type": "RC"}], "standard_charges": [{"gross_charge": 4324.0, "discounted_cash": 3243.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY ADULT LEVEL II", "code_information": [{"code": "2170028", "type": "CDM"}, {"code": "199", "type": "RC"}], "standard_charges": [{"gross_charge": 4324.0, "discounted_cash": 3243.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY ADULT LEVEL II", "code_information": [{"code": "2180028", "type": "CDM"}, {"code": "199", "type": "RC"}], "standard_charges": [{"gross_charge": 4324.0, "discounted_cash": 3243.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY ADULT LEVEL II", "code_information": [{"code": "2190028", "type": "CDM"}, {"code": "199", "type": "RC"}], "standard_charges": [{"gross_charge": 4324.0, "discounted_cash": 3243.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY ADULT LEVEL II", "code_information": [{"code": "2360028", "type": "CDM"}, {"code": "199", "type": "RC"}], "standard_charges": [{"gross_charge": 4324.0, "discounted_cash": 3243.0, "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": 4324.0, "discounted_cash": 3243.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY ADULT LEVEL II", "code_information": [{"code": "2700028", "type": "CDM"}, {"code": "199", "type": "RC"}], "standard_charges": [{"gross_charge": 4324.0, "discounted_cash": 3243.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY ADULT LEVEL II", "code_information": [{"code": "2800028", "type": "CDM"}, {"code": "199", "type": "RC"}], "standard_charges": [{"gross_charge": 4324.0, "discounted_cash": 3243.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY ADULT LEVEL II", "code_information": [{"code": "2810028", "type": "CDM"}, {"code": "199", "type": "RC"}], "standard_charges": [{"gross_charge": 4324.0, "discounted_cash": 3243.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY LEVEL I", "code_information": [{"code": "1990027", "type": "CDM"}, {"code": "169", "type": "RC"}], "standard_charges": [{"gross_charge": 4324.0, "discounted_cash": 3243.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY LEVEL I", "code_information": [{"code": "2020027", "type": "CDM"}, {"code": "169", "type": "RC"}], "standard_charges": [{"gross_charge": 4324.0, "discounted_cash": 3243.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY LEVEL I", "code_information": [{"code": "2120027", "type": "CDM"}, {"code": "169", "type": "RC"}], "standard_charges": [{"gross_charge": 4324.0, "discounted_cash": 3243.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY LEVEL I", "code_information": [{"code": "2150027", "type": "CDM"}, {"code": "169", "type": "RC"}], "standard_charges": [{"gross_charge": 4324.0, "discounted_cash": 3243.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY LEVEL I", "code_information": [{"code": "2160027", "type": "CDM"}, {"code": "169", "type": "RC"}], "standard_charges": [{"gross_charge": 4324.0, "discounted_cash": 3243.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY LEVEL I", "code_information": [{"code": "2170027", "type": "CDM"}, {"code": "169", "type": "RC"}], "standard_charges": [{"gross_charge": 4324.0, "discounted_cash": 3243.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY LEVEL I", "code_information": [{"code": "2180027", "type": "CDM"}, {"code": "169", "type": "RC"}], "standard_charges": [{"gross_charge": 4324.0, "discounted_cash": 3243.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY LEVEL I", "code_information": [{"code": "2190027", "type": "CDM"}, {"code": "169", "type": "RC"}], "standard_charges": [{"gross_charge": 4324.0, "discounted_cash": 3243.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY LEVEL I", "code_information": [{"code": "2360027", "type": "CDM"}, {"code": "169", "type": "RC"}], "standard_charges": [{"gross_charge": 4324.0, "discounted_cash": 3243.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY LEVEL I", "code_information": [{"code": "2500027", "type": "CDM"}, {"code": "169", "type": "RC"}], "standard_charges": [{"gross_charge": 4324.0, "discounted_cash": 3243.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY LEVEL I", "code_information": [{"code": "2700027", "type": "CDM"}, {"code": "169", "type": "RC"}], "standard_charges": [{"gross_charge": 4324.0, "discounted_cash": 3243.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY LEVEL I", "code_information": [{"code": "2800027", "type": "CDM"}, {"code": "169", "type": "RC"}], "standard_charges": [{"gross_charge": 4324.0, "discounted_cash": 3243.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY LEVEL I", "code_information": [{"code": "2810027", "type": "CDM"}, {"code": "169", "type": "RC"}], "standard_charges": [{"gross_charge": 4324.0, "discounted_cash": 3243.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ADPT HIP UNIPOLAR ZIMMER CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012953", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1257.0, "discounted_cash": 942.75, "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": 15509.0, "discounted_cash": 11631.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ADRENAL AB 21 OH", "code_information": [{"code": "83519", "type": "CPT"}, {"code": "7258386", "type": "CDM"}], "standard_charges": [{"gross_charge": 232.0, "discounted_cash": 174.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ADRENAL IMG CORTX/MEDULA", "code_information": [{"code": "78075", "type": "CPT"}, {"code": "5208075", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 1043.0, "discounted_cash": 782.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AFO ANKLE GAUNTLET", "code_information": [{"code": "L1902", "type": "HCPCS"}, {"code": "8130061", "type": "CDM"}], "standard_charges": [{"gross_charge": 860.0, "discounted_cash": 645.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AFO ANT TIB SPIRAL", "code_information": [{"code": "L1951", "type": "HCPCS"}, {"code": "8130136", "type": "CDM"}], "standard_charges": [{"gross_charge": 8747.0, "discounted_cash": 6560.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AFO PLSTC/OTHER PREFAB", "code_information": [{"code": "L1930", "type": "HCPCS"}, {"code": "8130079", "type": "CDM"}], "standard_charges": [{"gross_charge": 2165.0, "discounted_cash": 1623.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AFTLD BRCHYTHRPY 1 CHANL", "code_information": [{"code": "77770", "type": "CPT"}, {"code": "5107785", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 3253.0, "discounted_cash": 2439.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AFTLD BRCHYTHRPY 2-12 CH", "code_information": [{"code": "77771", "type": "CPT"}, {"code": "5107786", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 5155.0, "discounted_cash": 3866.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AFTLD BRCHYTHRPY>12 CHLS", "code_information": [{"code": "77772", "type": "CPT"}, {"code": "5107787", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 5677.0, "discounted_cash": 4257.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AG DETECTION POLYVAL DFA", "code_information": [{"code": "87300", "type": "CPT"}, {"code": "4107300", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 239.0, "discounted_cash": 179.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AG DETECTION POLYVAL DFA", "code_information": [{"code": "87300", "type": "CPT"}, {"code": "7257300", "type": "CDM"}], "standard_charges": [{"gross_charge": 162.0, "discounted_cash": 121.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AGALSIDASE BETA PER1MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0180", "type": "HCPCS"}, {"code": "5318033", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1615.0, "discounted_cash": 1211.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AGALSIDASE BETA PER1MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0180", "type": "HCPCS"}, {"code": "5318033", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1615.0, "discounted_cash": 1211.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AGGLUTININS FEBRIL EA AG/4", "code_information": [{"code": "86000", "type": "CPT"}, {"code": "7256086", "type": "CDM"}], "standard_charges": [{"gross_charge": 240.0, "discounted_cash": 180.0, "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": 28.0, "discounted_cash": 21.0, "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": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AL CARBON 400/5 360ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314150", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 152.0, "discounted_cash": 114.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AL CARBON 400/5 360ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314150", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 152.0, "discounted_cash": 114.0, "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": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AL OH 600/5 360ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314166", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AL OH 600/5 360ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314166", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AL/MG OH 360ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314109", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AL/MG OH 360ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314109", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "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": 53.0, "discounted_cash": 39.75, "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": 53.0, "discounted_cash": 39.75, "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": 11.0, "discounted_cash": 8.25, "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": 11.0, "discounted_cash": 8.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALA DELTA AMINOLVLN ACID/2", "code_information": [{"code": "82135", "type": "CPT"}, {"code": "7252136", "type": "CDM"}], "standard_charges": [{"gross_charge": 1139.0, "discounted_cash": 854.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALA(DELTA AMINOLVLN ACID", "code_information": [{"code": "82135", "type": "CPT"}, {"code": "7002135", "type": "CDM"}], "standard_charges": [{"gross_charge": 1139.0, "discounted_cash": 854.25, "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": 36.0, "discounted_cash": 27.0, "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": 36.0, "discounted_cash": 27.0, "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": 1805.0, "discounted_cash": 1353.75, "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": 1805.0, "discounted_cash": 1353.75, "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": 1894.0, "discounted_cash": 1420.5, "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": 1894.0, "discounted_cash": 1420.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUMIN QUANT OTH SRC", "code_information": [{"code": "82042", "type": "CPT"}, {"code": "7252045", "type": "CDM"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "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": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUMIN QUANT OTH SRC/2", "code_information": [{"code": "82042", "type": "CPT"}, {"code": "4122045", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUMIN QUANT OTH SRC/2", "code_information": [{"code": "82042", "type": "CPT"}, {"code": "7252111", "type": "CDM"}], "standard_charges": [{"gross_charge": 107.0, "discounted_cash": 80.25, "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": 301.0, "discounted_cash": 225.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUMIN SERUM", "code_information": [{"code": "82040", "type": "CPT"}, {"code": "4122040", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUMIN SERUM", "code_information": [{"code": "82040", "type": "CPT"}, {"code": "4152040", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 173.0, "discounted_cash": 129.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUMIN SERUM", "code_information": [{"code": "82040", "type": "CPT"}, {"code": "7252040", "type": "CDM"}], "standard_charges": [{"gross_charge": 107.0, "discounted_cash": 80.25, "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": 55.0, "discounted_cash": 41.25, "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": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUTEROL .5% 20ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330115", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 235.0, "discounted_cash": 176.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUTEROL .5% 20ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330115", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 235.0, "discounted_cash": 176.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUTEROL 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300221", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUTEROL 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300221", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUTEROL 4MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300222", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUTEROL 4MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300222", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "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": 303.0, "discounted_cash": 227.25, "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": 303.0, "discounted_cash": 227.25, "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": 368.0, "discounted_cash": 276.0, "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": 368.0, "discounted_cash": 276.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUTEROL HFA 8GM IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330128", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 179.0, "discounted_cash": 134.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUTEROL HFA 8GM IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330128", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 179.0, "discounted_cash": 134.25, "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": 16.0, "discounted_cash": 12.0, "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": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUTEROL/IPRATR 3ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330123", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 29.0, "discounted_cash": 21.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUTEROL/IPRATR 3ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330123", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 29.0, "discounted_cash": 21.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2618.0, "discounted_cash": 1963.5, "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": 2618.0, "discounted_cash": 1963.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUTEROL/IPRATR DS IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5331229", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 29.0, "discounted_cash": 21.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUTEROL/IPRATR DS IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5331229", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 29.0, "discounted_cash": 21.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUTEROL/IPRATR14.7GMIH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5331235", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1913.0, "discounted_cash": 1434.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUTEROL/IPRATR14.7GMIH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5331235", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1913.0, "discounted_cash": 1434.75, "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": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUTEROL2MG/5ML 10ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314041", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUTEROL2MG/5ML 10ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314041", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALCOHOLS/4", "code_information": [{"code": "80320", "type": "CPT"}, {"code": "7252078", "type": "CDM"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALCOHOLS/7", "code_information": [{"code": "80320", "type": "CPT"}, {"code": "7254603", "type": "CDM"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALDESLEUKIN PER 22MU IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9015", "type": "HCPCS"}, {"code": "5318070", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 7536.0, "discounted_cash": 5652.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALDESLEUKIN PER 22MU IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9015", "type": "HCPCS"}, {"code": "5318070", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 7536.0, "discounted_cash": 5652.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALDOLASE", "code_information": [{"code": "82085", "type": "CPT"}, {"code": "7002085", "type": "CDM"}], "standard_charges": [{"gross_charge": 629.0, "discounted_cash": 471.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALDOLASE", "code_information": [{"code": "82085", "type": "CPT"}, {"code": "7252085", "type": "CDM"}], "standard_charges": [{"gross_charge": 629.0, "discounted_cash": 471.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALDOSTERONE", "code_information": [{"code": "82088", "type": "CPT"}, {"code": "7002087", "type": "CDM"}], "standard_charges": [{"gross_charge": 1460.0, "discounted_cash": 1095.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALDOSTERONE", "code_information": [{"code": "82088", "type": "CPT"}, {"code": "7252087", "type": "CDM"}], "standard_charges": [{"gross_charge": 1460.0, "discounted_cash": 1095.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALDOSTERONE/2", "code_information": [{"code": "82088", "type": "CPT"}, {"code": "7002089", "type": "CDM"}], "standard_charges": [{"gross_charge": 1460.0, "discounted_cash": 1095.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALDOSTERONE/2", "code_information": [{"code": "82088", "type": "CPT"}, {"code": "7252089", "type": "CDM"}], "standard_charges": [{"gross_charge": 1460.0, "discounted_cash": 1095.0, "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": 75.0, "discounted_cash": 56.25, "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": 75.0, "discounted_cash": 56.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALENDRONATE 35MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300232", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 462.0, "discounted_cash": 346.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ALENDRONATE 35MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300232", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 462.0, "discounted_cash": 346.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 194.0, "discounted_cash": 145.5, "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": 194.0, "discounted_cash": 145.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ALGINIC AC/AL/MAG360MLLQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314050", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 62.0, "discounted_cash": 46.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ALGINIC AC/AL/MAG360MLLQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314050", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 62.0, "discounted_cash": 46.5, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALISKIREN 300MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300241", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALISKIREN 300MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300241", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALKALOIDS NOS/2", "code_information": [{"code": "80323", "type": "CPT"}, {"code": "7253887", "type": "CDM"}], "standard_charges": [{"gross_charge": 229.0, "discounted_cash": 171.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALKALOIDS NOS/3", "code_information": [{"code": "80323", "type": "CPT"}, {"code": "7258388", "type": "CDM"}], "standard_charges": [{"gross_charge": 504.0, "discounted_cash": 378.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLODERM PER SQ CM (SKIN SUB)", "code_information": [{"code": "Q4116", "type": "HCPCS"}, {"code": "4020485", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 252.0, "discounted_cash": 189.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLODERM PER SQ CM (SKIN SUB)", "code_information": [{"code": "Q4116", "type": "HCPCS"}, {"code": "4020485", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 252.0, "discounted_cash": 189.0, "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": 6992.0, "discounted_cash": 5244.0, "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": 10185.0, "discounted_cash": 7638.75, "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": 10185.0, "discounted_cash": 7638.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOGRFT BN CELLULAR LYOGRAFT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4020414", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 35658.0, "discounted_cash": 26743.5, "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": 19919.0, "discounted_cash": 14939.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOGRFT FIBER DBM CORT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4020515", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4735.0, "discounted_cash": 3551.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOGRFT PLACENTAL TISSUE DISC", "code_information": [{"code": "C9399", "type": "HCPCS"}, {"code": "4020567", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2533.0, "discounted_cash": 1899.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOGRFT PLACENTAL TISSUE DISC", "code_information": [{"code": "C9399", "type": "HCPCS"}, {"code": "4020567", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 2533.0, "discounted_cash": 1899.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOGRFT SPACER CERVICAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8240497", "type": "CDM"}], "standard_charges": [{"gross_charge": 10435.0, "discounted_cash": 7826.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOGRFT TENFUSE PIP", "code_information": [{"code": "C1762", "type": "HCPCS"}, {"code": "4027060", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12298.0, "discounted_cash": 9223.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOGRFT TISS MATRX FLOW", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "4020588", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 23665.0, "discounted_cash": 17748.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOGRFT TISS MATRX FLOW", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "4020588", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 23665.0, "discounted_cash": 17748.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOPURINOL SOD PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0206", "type": "HCPCS"}, {"code": "5318105", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 59.0, "discounted_cash": 44.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOPURINOL SOD PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0206", "type": "HCPCS"}, {"code": "5318105", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 59.0, "discounted_cash": 44.25, "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": 47.0, "discounted_cash": 35.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOPURINOL150MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300247", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOPURINOL150MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300247", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLRGN SPEC IGE EA/16", "code_information": [{"code": "86003", "type": "CPT"}, {"code": "7006053", "type": "CDM"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLRGN SPEC IGE EA/22", "code_information": [{"code": "86003", "type": "CPT"}, {"code": "7256053", "type": "CDM"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLRGN SPEC IGG EA/3", "code_information": [{"code": "86001", "type": "CPT"}, {"code": "7256064", "type": "CDM"}], "standard_charges": [{"gross_charge": 82.0, "discounted_cash": 61.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ALOGLIPTIN 12.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300262", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 75.0, "discounted_cash": 56.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALOGLIPTIN 12.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300262", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 75.0, "discounted_cash": 56.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALOGLIPTIN 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300263", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 75.0, "discounted_cash": 56.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALOGLIPTIN 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300263", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 75.0, "discounted_cash": 56.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALOGLIPTIN 6.25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300261", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 75.0, "discounted_cash": 56.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALOGLIPTIN 6.25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300261", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 75.0, "discounted_cash": 56.25, "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": 770.0, "discounted_cash": 577.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ALPHA FETO PROTEIN SERUM", "code_information": [{"code": "82105", "type": "CPT"}, {"code": "4122114", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALPHA FETO PROTEIN SERUM", "code_information": [{"code": "82105", "type": "CPT"}, {"code": "7002114", "type": "CDM"}], "standard_charges": [{"gross_charge": 927.0, "discounted_cash": 695.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALPHA FETO PROTEIN SERUM/2", "code_information": [{"code": "82105", "type": "CPT"}, {"code": "7252118", "type": "CDM"}], "standard_charges": [{"gross_charge": 549.0, "discounted_cash": 411.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALPHA FETO PROTN AMN FLD", "code_information": [{"code": "82106", "type": "CPT"}, {"code": "7002113", "type": "CDM"}], "standard_charges": [{"gross_charge": 1071.0, "discounted_cash": 803.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALPHA SUBUNIT", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7252666", "type": "CDM"}], "standard_charges": [{"gross_charge": 520.0, "discounted_cash": 390.0, "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": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "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": 48.0, "discounted_cash": 36.0, "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": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALPRAZOLAM 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300302", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALPRAZOLAM 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300302", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "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": 847.0, "discounted_cash": 635.25, "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": 11.0, "discounted_cash": 8.25, "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": 11.0, "discounted_cash": 8.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 492.0, "discounted_cash": 369.0, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 492.0, "discounted_cash": 369.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALUM SOLUTION STERILE CONC IR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334125", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 360.0, "discounted_cash": 270.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALUMINUM", "code_information": [{"code": "82108", "type": "CPT"}, {"code": "7002110", "type": "CDM"}], "standard_charges": [{"gross_charge": 719.0, "discounted_cash": 539.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALUMINUM", "code_information": [{"code": "82108", "type": "CPT"}, {"code": "7252110", "type": "CDM"}], "standard_charges": [{"gross_charge": 719.0, "discounted_cash": 539.25, "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": 840.0, "discounted_cash": 630.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 840.0, "discounted_cash": 630.0, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMANTADINE 10M/M 10ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314176", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMANTADINE 10M/M 10ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314176", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMANTADINE 10M/M 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314177", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMANTADINE 10M/M 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314177", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMB PROC 1ST 30MIN", "code_information": [{"code": "3603000", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2434.0, "discounted_cash": 1825.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMB PROC EA 15MIN", "code_information": [{"code": "3603005", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 535.0, "discounted_cash": 401.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMB PROC LASER 1ST 30MIN", "code_information": [{"code": "3603022", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4656.0, "discounted_cash": 3492.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMIFOSTINE PER 500MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0207", "type": "HCPCS"}, {"code": "5318130", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 8140.0, "discounted_cash": 6105.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMIFOSTINE PER 500MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0207", "type": "HCPCS"}, {"code": "5318130", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 8140.0, "discounted_cash": 6105.0, "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": 435.0, "discounted_cash": 326.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMIKACIN", "code_information": [{"code": "80150", "type": "CPT"}, {"code": "7022124", "type": "CDM"}], "standard_charges": [{"gross_charge": 445.0, "discounted_cash": 333.75, "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": 16.0, "discounted_cash": 12.0, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMIKACIN/2", "code_information": [{"code": "80150", "type": "CPT"}, {"code": "7252126", "type": "CDM"}], "standard_charges": [{"gross_charge": 445.0, "discounted_cash": 333.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMIKACIN/3", "code_information": [{"code": "80150", "type": "CPT"}, {"code": "7252127", "type": "CDM"}], "standard_charges": [{"gross_charge": 445.0, "discounted_cash": 333.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMINO ACIDS 6+ QNT", "code_information": [{"code": "82139", "type": "CPT"}, {"code": "7008213", "type": "CDM"}], "standard_charges": [{"gross_charge": 919.0, "discounted_cash": 689.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMINO ACIDS 6+ QNT/2", "code_information": [{"code": "82139", "type": "CPT"}, {"code": "7258213", "type": "CDM"}], "standard_charges": [{"gross_charge": 919.0, "discounted_cash": 689.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMINO ACIDS QNT SNGL EA", "code_information": [{"code": "82131", "type": "CPT"}, {"code": "4102127", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 713.0, "discounted_cash": 534.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMINOCAPRO AC 250 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314183", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMINOCAPRO AC 250 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314183", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 9.0, "discounted_cash": 6.75, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 9.0, "discounted_cash": 6.75, "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": 52.0, "discounted_cash": 39.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "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": 138.0, "discounted_cash": 103.5, "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": 138.0, "discounted_cash": 103.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 82.0, "discounted_cash": 61.5, "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": 82.0, "discounted_cash": 61.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMIODARONE", "code_information": [{"code": "80151", "type": "CPT"}, {"code": "7000284", "type": "CDM"}], "standard_charges": [{"gross_charge": 504.0, "discounted_cash": 378.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMIODARONE", "code_information": [{"code": "80151", "type": "CPT"}, {"code": "7250284", "type": "CDM"}], "standard_charges": [{"gross_charge": 504.0, "discounted_cash": 378.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMIODARONE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300624", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMIODARONE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300624", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "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": 95.0, "discounted_cash": 71.25, "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": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMIODARONE 400MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300626", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 126.0, "discounted_cash": 94.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMIODARONE 400MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300626", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 126.0, "discounted_cash": 94.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "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": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMITRIPTYLINE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300650", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMITRIPTYLINE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300650", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "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": 33.0, "discounted_cash": 24.75, "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": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMITRIPTYLINE 12.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300635", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMITRIPTYLINE 12.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300635", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMITRIPTYLINE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300642", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMITRIPTYLINE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300642", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMITRIPTYLINE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300636", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMITRIPTYLINE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300636", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMITRIPTYLINE 75MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300646", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMITRIPTYLINE 75MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300646", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMLODIPINE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300662", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMLODIPINE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300662", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "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": 53.0, "discounted_cash": 39.75, "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": 53.0, "discounted_cash": 39.75, "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": 53.0, "discounted_cash": 39.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "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": 477.0, "discounted_cash": 357.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMMONIA", "code_information": [{"code": "82140", "type": "CPT"}, {"code": "4122140", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "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": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXIC/CLAV250/5 75PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314239", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 531.0, "discounted_cash": 398.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXIC/CLAV250/5 75PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314239", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 531.0, "discounted_cash": 398.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXIC/CLAV400/5 50PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314227", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 292.0, "discounted_cash": 219.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXIC/CLAV400/5 50PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314227", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 292.0, "discounted_cash": 219.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXIC/CLAV400/5 5MLPWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314226", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 25.0, "discounted_cash": 18.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXIC/CLAV400/5 5MLPWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314226", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 25.0, "discounted_cash": 18.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXIC/CLAV600/5 125PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314219", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 592.0, "discounted_cash": 444.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXIC/CLAV600/5 125PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314219", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 592.0, "discounted_cash": 444.0, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "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": 71.0, "discounted_cash": 53.25, "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": 71.0, "discounted_cash": 53.25, "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": "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": 130.0, "discounted_cash": 97.5, "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": 130.0, "discounted_cash": 97.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXICILLIN/CLAV1000MGTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300714", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 75.0, "discounted_cash": 56.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXICILLIN/CLAV1000MGTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300714", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 75.0, "discounted_cash": 56.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXICILLN 125/5 80ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314250", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXICILLN 125/5 80ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314250", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXICILLN 250/5 80ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314257", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 158.0, "discounted_cash": 118.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXICILLN 250/5 80ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314257", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 158.0, "discounted_cash": 118.5, "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": 58.0, "discounted_cash": 43.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 58.0, "discounted_cash": 43.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMP CYCLIC", "code_information": [{"code": "82030", "type": "CPT"}, {"code": "7252030", "type": "CDM"}], "standard_charges": [{"gross_charge": 303.0, "discounted_cash": 227.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPHET/DEXAMPHET 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327113", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPHET/DEXAMPHET 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327113", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPHETAM MIX 10MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327021", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 62.0, "discounted_cash": 46.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPHETAM MIX 10MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327021", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 62.0, "discounted_cash": 46.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPHETAM MIX 20MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327024", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPHETAM MIX 20MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327024", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPHETAM MIX 30MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327026", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPHETAM MIX 30MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327026", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPHETAM MIX 5MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327018", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPHETAM MIX 5MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327018", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPHETAM MIX 5MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327109", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPHETAM MIX 5MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327109", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPHETAM MIX 7.5MG XRTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327013", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPHETAM MIX 7.5MG XRTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327013", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPHETAMINE QUAN 1-2/2", "code_information": [{"code": "80324", "type": "CPT"}, {"code": "7252145", "type": "CDM"}], "standard_charges": [{"gross_charge": 189.0, "discounted_cash": 141.75, "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": 356.0, "discounted_cash": 267.0, "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": 356.0, "discounted_cash": 267.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 468.0, "discounted_cash": 351.0, "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": 468.0, "discounted_cash": 351.0, "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": 283.0, "discounted_cash": 212.25, "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": 283.0, "discounted_cash": 212.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 216.0, "discounted_cash": 162.0, "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": 216.0, "discounted_cash": 162.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPICILLIN 250/5 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314280", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 818.0, "discounted_cash": 613.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPICILLIN 250/5 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314280", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 818.0, "discounted_cash": 613.5, "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": 39.0, "discounted_cash": 29.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPICILLIN 30MG/ML 1MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0290", "type": "HCPCS"}, {"code": "5318268", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPICILLIN 30MG/ML 1MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0290", "type": "HCPCS"}, {"code": "5318268", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPICILLIN PEDI DOSE IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0290", "type": "HCPCS"}, {"code": "5318267", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPICILLIN PEDI DOSE IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0290", "type": "HCPCS"}, {"code": "5318267", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 194.0, "discounted_cash": 145.5, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 194.0, "discounted_cash": 145.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPICILLN 125/5 100ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314274", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPICILLN 125/5 100ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314274", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPICILLN 250/5 100ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314282", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPICILLN 250/5 100ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314282", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMYL NITRITE .3ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330177", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "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": 936.0, "discounted_cash": 702.0, "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": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMYLASE", "code_information": [{"code": "82150", "type": "CPT"}, {"code": "4152150", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 269.0, "discounted_cash": 201.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMYLASE", "code_information": [{"code": "82150", "type": "CPT"}, {"code": "7252150", "type": "CDM"}], "standard_charges": [{"gross_charge": 663.0, "discounted_cash": 497.25, "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": 647.0, "discounted_cash": 485.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMYLASE/2", "code_information": [{"code": "82150", "type": "CPT"}, {"code": "4122151", "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": "4152151", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 471.0, "discounted_cash": 353.25, "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": 101.0, "discounted_cash": 75.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMYLASE/4", "code_information": [{"code": "82150", "type": "CPT"}, {"code": "4122154", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMYLASE/4", "code_information": [{"code": "82150", "type": "CPT"}, {"code": "7252153", "type": "CDM"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "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": 621.0, "discounted_cash": 465.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMYLASE/5", "code_information": [{"code": "82150", "type": "CPT"}, {"code": "7252664", "type": "CDM"}], "standard_charges": [{"gross_charge": 481.0, "discounted_cash": 360.75, "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": 123.0, "discounted_cash": 92.25, "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": 123.0, "discounted_cash": 92.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANAKINRA 100MG/.67ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5318040", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1028.0, "discounted_cash": 771.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANAKINRA 100MG/.67ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5318040", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1028.0, "discounted_cash": 771.0, "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": 145.0, "discounted_cash": 108.75, "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": 145.0, "discounted_cash": 108.75, "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": 3376.0, "discounted_cash": 2532.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANCH BIO-SWVLK C DBL #2 TIGRTL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4010697", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1064.0, "discounted_cash": 798.0, "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": 3067.0, "discounted_cash": 2300.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANCH HEALIX PEEK", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4020640", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3970.0, "discounted_cash": 2977.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANCH LEAD SPINL STIM", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8178125", "type": "CDM"}], "standard_charges": [{"gross_charge": 2725.0, "discounted_cash": 2043.75, "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": 3021.0, "discounted_cash": 2265.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANCH SCRW BIO-INTRAFIX", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131013", "type": "CDM"}], "standard_charges": [{"gross_charge": 7219.0, "discounted_cash": 5414.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANCH SUT FBRTAK W/SUTRTP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4010721", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3625.0, "discounted_cash": 2718.75, "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": 3103.0, "discounted_cash": 2327.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANCH SUT FOOTPRINT ULTRA", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4010709", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3096.0, "discounted_cash": 2322.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANCH SUT HEALIX ADVNC BR", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4010711", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3895.0, "discounted_cash": 2921.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANCH SUT KNOTLESS FIBERTAK", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4010724", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3100.0, "discounted_cash": 2325.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANCH SUT SHORT SFT W/NDL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4010701", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3868.0, "discounted_cash": 2901.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANCH SUT SWVLCK PEEK", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4010705", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 989.0, "discounted_cash": 741.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANCH SUT SWVLK TENODESIS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4010706", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 7166.0, "discounted_cash": 5374.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANCH SUTURE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8170090", "type": "CDM"}], "standard_charges": [{"gross_charge": 1379.0, "discounted_cash": 1034.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANCH/SCRW BN/BN TISS/BN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8240005", "type": "CDM"}], "standard_charges": [{"gross_charge": 158.0, "discounted_cash": 118.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANCH/SCRW BN/BN TISS/BN3", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8240007", "type": "CDM"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANCH/SCRW BN/BN TISS/BN4", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8240014", "type": "CDM"}], "standard_charges": [{"gross_charge": 7355.0, "discounted_cash": 5516.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANCH/SCRW BN/BN TISS/BN5", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8240016", "type": "CDM"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANCH/SCRW BN/BN TISS/BN9", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8240021", "type": "CDM"}], "standard_charges": [{"gross_charge": 1577.0, "discounted_cash": 1182.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANCHOR FLEXBAND EYELET W/DRIVR", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131022", "type": "CDM"}], "standard_charges": [{"gross_charge": 3625.0, "discounted_cash": 2718.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANCHOR TENDON", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4020701", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 17873.0, "discounted_cash": 13404.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANDROSTENEDIONE", "code_information": [{"code": "82157", "type": "CPT"}, {"code": "7002157", "type": "CDM"}], "standard_charges": [{"gross_charge": 1147.0, "discounted_cash": 860.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANDROSTENEDIONE", "code_information": [{"code": "82157", "type": "CPT"}, {"code": "7252157", "type": "CDM"}], "standard_charges": [{"gross_charge": 1147.0, "discounted_cash": 860.25, "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": 1535.0, "discounted_cash": 1151.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANESTHESIA INIT 30 MIN", "code_information": [{"code": "3703560", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 3947.0, "discounted_cash": 2960.25, "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": 26446.0, "discounted_cash": 19834.5, "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": 1829.0, "discounted_cash": 1371.75, "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": 1566.0, "discounted_cash": 1174.5, "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": 11505.0, "discounted_cash": 8628.75, "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": 11161.0, "discounted_cash": 8370.75, "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": 7869.0, "discounted_cash": 5901.75, "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": 8521.0, "discounted_cash": 6390.75, "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": 7549.0, "discounted_cash": 5661.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANGIO IC VERT SEL", "code_information": [{"code": "4916234", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 13085.0, "discounted_cash": 9813.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANGIO INTERNAL MAMMARY", "code_information": [{"code": "75756", "type": "CPT"}, {"code": "4615757", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 6138.0, "discounted_cash": 4603.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANGIO INTERNAL MAMMARY", "code_information": [{"code": "75756", "type": "CPT"}, {"code": "4915757", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 3593.0, "discounted_cash": 2694.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANGIO PELVIC SELECT/SUP", "code_information": [{"code": "75736", "type": "CPT"}, {"code": "4615737", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 3697.0, "discounted_cash": 2772.75, "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": 2697.0, "discounted_cash": 2022.75, "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": 3757.0, "discounted_cash": 2817.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANGIO PULM NON-SEL CATH", "code_information": [{"code": "75746", "type": "CPT"}, {"code": "4915747", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 3481.0, "discounted_cash": 2610.75, "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": 5148.0, "discounted_cash": 3861.0, "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": 5086.0, "discounted_cash": 3814.5, "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": 3374.0, "discounted_cash": 2530.5, "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": 3342.0, "discounted_cash": 2506.5, "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": 2784.0, "discounted_cash": 2088.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANGIO SELECT EA ADD VESL", "code_information": [{"code": "75774", "type": "CPT"}, {"code": "4915775", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2651.0, "discounted_cash": 1988.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANGIO SPINAL SELECTIVE", "code_information": [{"code": "75705", "type": "CPT"}, {"code": "4915706", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 10218.0, "discounted_cash": 7663.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANGIO VISCERAL SEL/SUPSEL", "code_information": [{"code": "75726", "type": "CPT"}, {"code": "4615727", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 5972.0, "discounted_cash": 4479.0, "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": 4847.0, "discounted_cash": 3635.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANGIOPLASTY FIBRIN SHEATH", "code_information": [{"code": "4913799", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 11678.0, "discounted_cash": 8758.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANGIOTENSIN CONV ENZYME", "code_information": [{"code": "82164", "type": "CPT"}, {"code": "7002164", "type": "CDM"}], "standard_charges": [{"gross_charge": 649.0, "discounted_cash": 486.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANGIOTENSIN CONV ENZYME", "code_information": [{"code": "82164", "type": "CPT"}, {"code": "7252164", "type": "CDM"}], "standard_charges": [{"gross_charge": 649.0, "discounted_cash": 486.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANGIOTENSIN CONV ENZYME/2", "code_information": [{"code": "82164", "type": "CPT"}, {"code": "7252165", "type": "CDM"}], "standard_charges": [{"gross_charge": 649.0, "discounted_cash": 486.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANGIPLASTY ART EA ADDL", "code_information": [{"code": "4617247", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1526.0, "discounted_cash": 1144.5, "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": 35119.0, "discounted_cash": 26339.25, "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": 42848.0, "discounted_cash": 32136.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANGIPLASTY VEN EA ADDL", "code_information": [{"code": "4617249", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1377.0, "discounted_cash": 1032.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANGIPLASTY VEN EA ADDL", "code_information": [{"code": "4917249", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 15040.0, "discounted_cash": 11280.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANGIPLASTY VEN INIT+S&I", "code_information": [{"code": "4617248", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 35119.0, "discounted_cash": 26339.25, "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": 39431.0, "discounted_cash": 29573.25, "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": 1174.0, "discounted_cash": 880.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANKLE 2 VIEWS", "code_information": [{"code": "73600", "type": "CPT"}, {"code": "5013600", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1174.0, "discounted_cash": 880.5, "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": 1304.0, "discounted_cash": 978.0, "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": 1647.0, "discounted_cash": 1235.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANKLE 3 VIEWS MINIMUM", "code_information": [{"code": "73610", "type": "CPT"}, {"code": "5013610", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1409.0, "discounted_cash": 1056.75, "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": 1647.0, "discounted_cash": 1235.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANORECTAL MANOMETRY", "code_information": [{"code": "91122", "type": "CPT"}, {"code": "6216023", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 2476.0, "discounted_cash": 1857.0, "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": 2499.0, "discounted_cash": 1874.25, "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": 2499.0, "discounted_cash": 1874.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTI TSH AUTO ANTIBODY", "code_information": [{"code": "83519", "type": "CPT"}, {"code": "7253568", "type": "CDM"}], "standard_charges": [{"gross_charge": 969.0, "discounted_cash": 726.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTI-GLOMERULAR BSMNT", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "7252322", "type": "CDM"}], "standard_charges": [{"gross_charge": 681.0, "discounted_cash": 510.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTI-GLOMERULAR BSMNT", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7002322", "type": "CDM"}], "standard_charges": [{"gross_charge": 681.0, "discounted_cash": 510.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTI-SKELETAL MUSCL AB", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "7006063", "type": "CDM"}], "standard_charges": [{"gross_charge": 956.0, "discounted_cash": 717.0, "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": 996.0, "discounted_cash": 747.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTI-STREPTOLYSN O TITER", "code_information": [{"code": "86060", "type": "CPT"}, {"code": "4126060", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTI-STREPTOLYSN O TITER", "code_information": [{"code": "86060", "type": "CPT"}, {"code": "4156060", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 414.0, "discounted_cash": 310.5, "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": 852.0, "discounted_cash": 639.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIBDY IDENT RBC EA PNL", "code_information": [{"code": "86870", "type": "CPT"}, {"code": "4126024", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 319.0, "discounted_cash": 239.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIBDY IDENT RBC EA PNL", "code_information": [{"code": "86870", "type": "CPT"}, {"code": "7016024", "type": "CDM"}], "standard_charges": [{"gross_charge": 494.0, "discounted_cash": 370.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTICOAG CIT/DEX-B1L IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5419001", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTICOAG CIT/DX SOL-A IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5318319", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIDPRSSNTS CYCLICAL 1-2/10", "code_information": [{"code": "80335", "type": "CPT"}, {"code": "7253904", "type": "CDM"}], "standard_charges": [{"gross_charge": 774.0, "discounted_cash": 580.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIDPRSSNTS CYCLICAL 1-2/2", "code_information": [{"code": "80335", "type": "CPT"}, {"code": "7000228", "type": "CDM"}], "standard_charges": [{"gross_charge": 412.0, "discounted_cash": 309.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIDPRSSNTS CYCLICAL 1-2/2", "code_information": [{"code": "80335", "type": "CPT"}, {"code": "7250228", "type": "CDM"}], "standard_charges": [{"gross_charge": 412.0, "discounted_cash": 309.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIDPRSSNTS CYCLICAL 1-2/5", "code_information": [{"code": "80335", "type": "CPT"}, {"code": "7002138", "type": "CDM"}], "standard_charges": [{"gross_charge": 535.0, "discounted_cash": 401.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIDPRSSNTS CYCLICAL 1-2/5", "code_information": [{"code": "80335", "type": "CPT"}, {"code": "7252138", "type": "CDM"}], "standard_charges": [{"gross_charge": 535.0, "discounted_cash": 401.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIDPRSSNTS CYCLICAL 1-2/7", "code_information": [{"code": "80335", "type": "CPT"}, {"code": "7252629", "type": "CDM"}], "standard_charges": [{"gross_charge": 1187.0, "discounted_cash": 890.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIDPRSSNTS CYCLICAL 1-2/8", "code_information": [{"code": "80335", "type": "CPT"}, {"code": "7252657", "type": "CDM"}], "standard_charges": [{"gross_charge": 750.0, "discounted_cash": 562.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIDPRSSNTS CYCLICAL 1-2/9", "code_information": [{"code": "80335", "type": "CPT"}, {"code": "7253523", "type": "CDM"}], "standard_charges": [{"gross_charge": 535.0, "discounted_cash": 401.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIDPRSSNTS CYCLICAL 6+/2", "code_information": [{"code": "80337", "type": "CPT"}, {"code": "7250377", "type": "CDM"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIDPRSSNTS SRTNRGC 1-2", "code_information": [{"code": "80332", "type": "CPT"}, {"code": "7000301", "type": "CDM"}], "standard_charges": [{"gross_charge": 520.0, "discounted_cash": 390.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIEPILEPTIC NOS 1-3", "code_information": [{"code": "80339", "type": "CPT"}, {"code": "7250292", "type": "CDM"}], "standard_charges": [{"gross_charge": 520.0, "discounted_cash": 390.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTINEURONAL CELL ABS", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7258356", "type": "CDM"}], "standard_charges": [{"gross_charge": 427.0, "discounted_cash": 320.25, "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": 1017.0, "discounted_cash": 762.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTINUCLEAR AB(ANA)", "code_information": [{"code": "86038", "type": "CPT"}, {"code": "4126043", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTINUCLEAR AB(ANA)", "code_information": [{"code": "86038", "type": "CPT"}, {"code": "4156043", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 470.0, "discounted_cash": 352.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTINUCLEAR AB(ANA)/2", "code_information": [{"code": "86038", "type": "CPT"}, {"code": "7256043", "type": "CDM"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTINUCLEAR AB(ANA)/3", "code_information": [{"code": "86038", "type": "CPT"}, {"code": "7256058", "type": "CDM"}], "standard_charges": [{"gross_charge": 293.0, "discounted_cash": 219.75, "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": 251.0, "discounted_cash": 188.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTINUCLEAR AB(ANA)TITER", "code_information": [{"code": "86039", "type": "CPT"}, {"code": "4126041", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIPHOSPHATIDYLSERINE AB", "code_information": [{"code": "86148", "type": "CPT"}, {"code": "7256142", "type": "CDM"}], "standard_charges": [{"gross_charge": 559.0, "discounted_cash": 419.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIPHOSPHATIDYLSERINE AB/2", "code_information": [{"code": "86148", "type": "CPT"}, {"code": "7256143", "type": "CDM"}], "standard_charges": [{"gross_charge": 559.0, "discounted_cash": 419.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIPHOSPHATIDYLSERINE AB/3", "code_information": [{"code": "86148", "type": "CPT"}, {"code": "7256144", "type": "CDM"}], "standard_charges": [{"gross_charge": 559.0, "discounted_cash": 419.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIPHOSPHATIDYLSERINE AB/4", "code_information": [{"code": "86148", "type": "CPT"}, {"code": "7006141", "type": "CDM"}], "standard_charges": [{"gross_charge": 561.0, "discounted_cash": 420.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTITHROMBIN 3 PER 1U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7197", "type": "HCPCS"}, {"code": "5318299", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTITHROMBIN 3 PER 1U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7197", "type": "HCPCS"}, {"code": "5318299", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "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": 725.0, "discounted_cash": 543.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTITHROMBIN III ACTIVITY", "code_information": [{"code": "85300", "type": "CPT"}, {"code": "4125300", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTITHROMBIN III ACTIVITY/2", "code_information": [{"code": "85300", "type": "CPT"}, {"code": "7255309", "type": "CDM"}], "standard_charges": [{"gross_charge": 295.0, "discounted_cash": 221.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTITHYM IG EQU 250MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7504", "type": "HCPCS"}, {"code": "5318317", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5327.0, "discounted_cash": 3995.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTITHYM IG EQU 250MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7504", "type": "HCPCS"}, {"code": "5318317", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 5327.0, "discounted_cash": 3995.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTITRYPSIN ALPHA 1 TOTL", "code_information": [{"code": "82103", "type": "CPT"}, {"code": "7006067", "type": "CDM"}], "standard_charges": [{"gross_charge": 825.0, "discounted_cash": 618.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTITRYPSIN ALPHA 1 TOTL", "code_information": [{"code": "82103", "type": "CPT"}, {"code": "7256067", "type": "CDM"}], "standard_charges": [{"gross_charge": 825.0, "discounted_cash": 618.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTITRYPSIN ALPHA PHENO", "code_information": [{"code": "82104", "type": "CPT"}, {"code": "7002104", "type": "CDM"}], "standard_charges": [{"gross_charge": 720.0, "discounted_cash": 540.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTITRYPSIN ALPHA PHENO", "code_information": [{"code": "82104", "type": "CPT"}, {"code": "7252104", "type": "CDM"}], "standard_charges": [{"gross_charge": 720.0, "discounted_cash": 540.0, "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": 3873.0, "discounted_cash": 2904.75, "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": 3873.0, "discounted_cash": 2904.75, "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": 8676.0, "discounted_cash": 6507.0, "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": 8676.0, "discounted_cash": 6507.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AORTIC VALVE #2", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8141010", "type": "CDM"}], "standard_charges": [{"gross_charge": 53468.0, "discounted_cash": 40101.0, "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": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP 160M/5M 10.15ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314018", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP 160M/5M 10.15ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314018", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "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": 4.0, "discounted_cash": 3.0, "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": 4.0, "discounted_cash": 3.0, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "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": 0.65, "discounted_cash": 0.49, "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": 0.65, "discounted_cash": 0.49, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP 500M/15M 12.5ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314015", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP 500M/15M 12.5ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314015", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "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": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP 650M/25M 25ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314013", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP 650M/25M 25ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314013", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "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": 124.0, "discounted_cash": 93.0, "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": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP 80M/.8M 1ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314022", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP 80M/.8M 1ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314022", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 3.0, "discounted_cash": 2.25, "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": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP/BUTAL/CAF CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300012", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP/BUTAL/CAF CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300012", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "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": 4.0, "discounted_cash": 3.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP/COD 120/12 12ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327009", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP/COD 120/12 12ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327009", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "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": 33.0, "discounted_cash": 24.75, "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": 33.0, "discounted_cash": 24.75, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP/COD 60MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327023", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP/COD 60MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327023", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "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": 55.0, "discounted_cash": 41.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "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": 58.0, "discounted_cash": 43.5, "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": 58.0, "discounted_cash": 43.5, "setting": "both", "billing_class": "facility"}]}, {"description": "APLIGRAF PER SQ CM", "code_information": [{"code": "Q4101", "type": "HCPCS"}, {"code": "8240451", "type": "CDM"}], "standard_charges": [{"gross_charge": 277.0, "discounted_cash": 207.75, "setting": "both", "billing_class": "facility"}]}, {"description": "APOLIPOPROTEIN", "code_information": [{"code": "82172", "type": "CPT"}, {"code": "7002169", "type": "CDM"}], "standard_charges": [{"gross_charge": 337.0, "discounted_cash": 252.75, "setting": "both", "billing_class": "facility"}]}, {"description": "APP SKNSUB F/N/H/G 1ST 100SC", "code_information": [{"code": "6900031", "type": "CDM"}], "standard_charges": [{"gross_charge": 13217.0, "discounted_cash": 9912.75, "setting": "both", "billing_class": "facility"}]}, {"description": "APP SKNSUB F/N/H/G 1ST 25SC", "code_information": [{"code": "6900029", "type": "CDM"}], "standard_charges": [{"gross_charge": 13217.0, "discounted_cash": 9912.75, "setting": "both", "billing_class": "facility"}]}, {"description": "APP SKNSUB GRFT T/A/L 1ST100SC", "code_information": [{"code": "6900027", "type": "CDM"}], "standard_charges": [{"gross_charge": 22840.0, "discounted_cash": 17130.0, "setting": "both", "billing_class": "facility"}]}, {"description": "APP SKNSUB GRFT T/A/L ADL100SC", "code_information": [{"code": "6900028", "type": "CDM"}], "standard_charges": [{"gross_charge": 5149.0, "discounted_cash": 3861.75, "setting": "both", "billing_class": "facility"}]}, {"description": "APP SKNSUB GRFT T/A/L<1ST 25SC", "code_information": [{"code": "6900025", "type": "CDM"}], "standard_charges": [{"gross_charge": 13217.0, "discounted_cash": 9912.75, "setting": "both", "billing_class": "facility"}]}, {"description": "APPLY ML COMPRS ARM/HAND", "code_information": [{"code": "6909892", "type": "CDM"}], "standard_charges": [{"gross_charge": 1141.0, "discounted_cash": 855.75, "setting": "both", "billing_class": "facility"}]}, {"description": "APPLY ML COMPRS LWR LEG", "code_information": [{"code": "6900091", "type": "CDM"}], "standard_charges": [{"gross_charge": 1122.0, "discounted_cash": 841.5, "setting": "both", "billing_class": "facility"}]}, {"description": "APPLY RIGID LEG CAST", "code_information": [{"code": "6900090", "type": "CDM"}], "standard_charges": [{"gross_charge": 2000.0, "discounted_cash": 1500.0, "setting": "both", "billing_class": "facility"}]}, {"description": "APPLY SHORT LEG CAST", "code_information": [{"code": "6900130", "type": "CDM"}], "standard_charges": [{"gross_charge": 2000.0, "discounted_cash": 1500.0, "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": 683.0, "discounted_cash": 512.25, "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": 683.0, "discounted_cash": 512.25, "setting": "both", "billing_class": "facility"}]}, {"description": "APRACLONIDINE 1% .1ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330215", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 162.0, "discounted_cash": 121.5, "setting": "both", "billing_class": "facility"}]}, {"description": "APREPITANT 5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8501", "type": "HCPCS"}, {"code": "5300774", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 146.0, "discounted_cash": 109.5, "setting": "both", "billing_class": "facility"}]}, {"description": "APREPITANT 5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8501", "type": "HCPCS"}, {"code": "5300774", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 146.0, "discounted_cash": 109.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 75.0, "discounted_cash": 56.25, "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": 75.0, "discounted_cash": 56.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "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": 47.0, "discounted_cash": 35.25, "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": 20.0, "discounted_cash": 15.0, "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": 20.0, "discounted_cash": 15.0, "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": 317.0, "discounted_cash": 237.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ARGININE 500MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5300778", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ARGININE 500MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5300778", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": 225.0, "discounted_cash": 168.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 225.0, "discounted_cash": 168.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ARIPIPRAZOLE 15MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300780", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 251.0, "discounted_cash": 188.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ARIPIPRAZOLE 15MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300780", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 251.0, "discounted_cash": 188.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ARIPIPRAZOLE 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300789", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 171.0, "discounted_cash": 128.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ARIPIPRAZOLE 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300789", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 171.0, "discounted_cash": 128.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 318.0, "discounted_cash": 238.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 318.0, "discounted_cash": 238.5, "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": 171.0, "discounted_cash": 128.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 171.0, "discounted_cash": 128.25, "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": 354.0, "discounted_cash": 265.5, "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": 354.0, "discounted_cash": 265.5, "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": 189.0, "discounted_cash": 141.75, "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": 189.0, "discounted_cash": 141.75, "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": 3.0, "discounted_cash": 2.25, "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": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ARIPIPRAZOLE PER1MG XRIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0401", "type": "HCPCS"}, {"code": "5318362", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ARIPIPRAZOLE PER1MG XRIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0401", "type": "HCPCS"}, {"code": "5318362", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ARSENIC", "code_information": [{"code": "82175", "type": "CPT"}, {"code": "7252158", "type": "CDM"}], "standard_charges": [{"gross_charge": 481.0, "discounted_cash": 360.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ARSENIC TRIOXID PER1MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9017", "type": "HCPCS"}, {"code": "5318340", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 255.0, "discounted_cash": 191.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ARSENIC TRIOXID PER1MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9017", "type": "HCPCS"}, {"code": "5318340", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 255.0, "discounted_cash": 191.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ARSENIC/3", "code_information": [{"code": "82175", "type": "CPT"}, {"code": "7002175", "type": "CDM"}], "standard_charges": [{"gross_charge": 481.0, "discounted_cash": 360.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ARSENIC/3", "code_information": [{"code": "82175", "type": "CPT"}, {"code": "7252175", "type": "CDM"}], "standard_charges": [{"gross_charge": 481.0, "discounted_cash": 360.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ARSENIC/4", "code_information": [{"code": "82175", "type": "CPT"}, {"code": "7002186", "type": "CDM"}], "standard_charges": [{"gross_charge": 481.0, "discounted_cash": 360.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTERIOG CAR NKHD SEL", "code_information": [{"code": "4616226", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 8168.0, "discounted_cash": 6126.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTERIOG CAR NKHD SEL", "code_information": [{"code": "4916226", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 17096.0, "discounted_cash": 12822.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTERIOG EXT CAR SEL", "code_information": [{"code": "4616232", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3846.0, "discounted_cash": 2884.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTERIOG EXT CAR SEL", "code_information": [{"code": "4916232", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5373.0, "discounted_cash": 4029.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTERIOG SUBC/INOM", "code_information": [{"code": "4616228", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 10378.0, "discounted_cash": 7783.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTERIOG SUBC/INOM", "code_information": [{"code": "4916228", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 16160.0, "discounted_cash": 12120.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTERIOG VERT SEL", "code_information": [{"code": "4616230", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 11001.0, "discounted_cash": 8250.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTERIOG VERT SEL", "code_information": [{"code": "4916230", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 14999.0, "discounted_cash": 11249.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTERIOGR CAR HD SEL", "code_information": [{"code": "4616224", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6432.0, "discounted_cash": 4824.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTERIOGR CAR HD SEL", "code_information": [{"code": "4916224", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 11203.0, "discounted_cash": 8402.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTERIOGR CAR NK SEL", "code_information": [{"code": "4616222", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6915.0, "discounted_cash": 5186.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTERIOGR CAR NK SEL", "code_information": [{"code": "4916222", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 9299.0, "discounted_cash": 6974.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTEROGRAM ARCH NON SEL", "code_information": [{"code": "4616221", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 12719.0, "discounted_cash": 9539.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTEROGRAM ARCH NON SEL", "code_information": [{"code": "4916221", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 20929.0, "discounted_cash": 15696.75, "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": 3597.0, "discounted_cash": 2697.75, "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": 3597.0, "discounted_cash": 2697.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTICULAR COMPONENT", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8131014", "type": "CDM"}], "standard_charges": [{"gross_charge": 15239.0, "discounted_cash": 11429.25, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "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": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "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": 0.04, "discounted_cash": 0.03, "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": 0.04, "discounted_cash": 0.03, "setting": "both", "billing_class": "facility"}]}, {"description": "ASA 600MG SU", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5338116", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ASA 600MG SU", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5338116", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "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": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "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": 39.0, "discounted_cash": 29.25, "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": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ASA/BUT/CAF/COD 30MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327397", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ASA/BUT/CAF/COD 30MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327397", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ASCORBIC ACID", "code_information": [{"code": "82180", "type": "CPT"}, {"code": "7002180", "type": "CDM"}], "standard_charges": [{"gross_charge": 657.0, "discounted_cash": 492.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ASCORBIC ACID", "code_information": [{"code": "82180", "type": "CPT"}, {"code": "7252180", "type": "CDM"}], "standard_charges": [{"gross_charge": 657.0, "discounted_cash": 492.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ASCORBIC ACID 250MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301057", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ASCORBIC ACID 250MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301057", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "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": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ASENAPINE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301081", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ASENAPINE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301081", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "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": 102.0, "discounted_cash": 76.5, "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": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ASIALO GM1 AB", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7252217", "type": "CDM"}], "standard_charges": [{"gross_charge": 520.0, "discounted_cash": 390.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ASIALO GM1 AB/2", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7253545", "type": "CDM"}], "standard_charges": [{"gross_charge": 520.0, "discounted_cash": 390.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ASP ABS/HEMAT/CYST", "code_information": [{"code": "4910160", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 982.0, "discounted_cash": 736.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ASP ABS/HEMAT/CYST", "code_information": [{"code": "5050160", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 903.0, "discounted_cash": 677.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ASP ABS/HEMAT/CYST", "code_information": [{"code": "5061160", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 903.0, "discounted_cash": 677.25, "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": 2061.0, "discounted_cash": 1545.75, "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": 1977.0, "discounted_cash": 1482.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ASP/INJ RENL CYST/PELVIS", "code_information": [{"code": "4917585", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4089.0, "discounted_cash": 3066.75, "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": 3543.0, "discounted_cash": 2657.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ASPARAG ECOLI PER10KU IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9020", "type": "HCPCS"}, {"code": "5318333", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1103.0, "discounted_cash": 827.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ASPARAG ECOLI PER10KU IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9020", "type": "HCPCS"}, {"code": "5318333", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1103.0, "discounted_cash": 827.25, "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": 347.0, "discounted_cash": 260.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ASPERGILLUS AB", "code_information": [{"code": "86606", "type": "CPT"}, {"code": "4126606", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ASPERGILLUS AB/2", "code_information": [{"code": "86606", "type": "CPT"}, {"code": "7256607", "type": "CDM"}], "standard_charges": [{"gross_charge": 264.0, "discounted_cash": 198.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ASPERGILLUS AB/4", "code_information": [{"code": "86606", "type": "CPT"}, {"code": "7256932", "type": "CDM"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ASPERGILLUS IA", "code_information": [{"code": "87305", "type": "CPT"}, {"code": "7257306", "type": "CDM"}], "standard_charges": [{"gross_charge": 356.0, "discounted_cash": 267.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ASPERGILLUS IA/2", "code_information": [{"code": "87305", "type": "CPT"}, {"code": "7258730", "type": "CDM"}], "standard_charges": [{"gross_charge": 990.0, "discounted_cash": 742.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ASPIR BLADDR W/INS CATH", "code_information": [{"code": "4917460", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 11874.0, "discounted_cash": 8905.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ASPIR BREAST CYST", "code_information": [{"code": "5066650", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 590.0, "discounted_cash": 442.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ASPIR BREAST CYST ADD", "code_information": [{"code": "3071009", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 173.0, "discounted_cash": 129.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ASPIR BREAST CYST ADD", "code_information": [{"code": "5066652", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 433.0, "discounted_cash": 324.75, "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": 1548.0, "discounted_cash": 1161.0, "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": 1969.0, "discounted_cash": 1476.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ASPIR/INJ MAJ JT WO/US", "code_information": [{"code": "5050610", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1548.0, "discounted_cash": 1161.0, "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": 1548.0, "discounted_cash": 1161.0, "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": 1548.0, "discounted_cash": 1161.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ASPIR/INJ THYROID CYST", "code_information": [{"code": "5010019", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2361.0, "discounted_cash": 1770.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ASSAY ORGANIC ACIDS QNT/2", "code_information": [{"code": "83918", "type": "CPT"}, {"code": "7253939", "type": "CDM"}], "standard_charges": [{"gross_charge": 1177.0, "discounted_cash": 882.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ASSAY TOXIN/ANTITOXIN", "code_information": [{"code": "87230", "type": "CPT"}, {"code": "4107077", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 244.0, "discounted_cash": 183.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ASSAY TOXIN/ANTITOXIN", "code_information": [{"code": "87230", "type": "CPT"}, {"code": "4127077", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 62.0, "discounted_cash": 46.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ATAZANAVIR 100MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301120", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 249.0, "discounted_cash": 186.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ATAZANAVIR 100MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301120", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 249.0, "discounted_cash": 186.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ATAZANAVIR 150MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301121", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 194.0, "discounted_cash": 145.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ATAZANAVIR 150MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301121", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 194.0, "discounted_cash": 145.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ATAZANAVIR 200MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301122", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 235.0, "discounted_cash": 176.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ATAZANAVIR 200MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301122", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 235.0, "discounted_cash": 176.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ATENOLOL 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301134", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ATENOLOL 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301134", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ATENOLOL 12.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301133", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ATENOLOL 12.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301133", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 46.0, "discounted_cash": 34.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ATEZOLIZUMAB PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9022", "type": "HCPCS"}, {"code": "5318363", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 566.0, "discounted_cash": 424.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ATEZOLIZUMAB PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9022", "type": "HCPCS"}, {"code": "5318363", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 566.0, "discounted_cash": 424.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ATHERECT ILIAC OPEN PERC", "code_information": [{"code": "4610146", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 17368.0, "discounted_cash": 13026.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ATHERECT ILIAC OPEN PERC", "code_information": [{"code": "4915499", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 78731.0, "discounted_cash": 59048.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ATOMOXETINE 10MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301125", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 82.0, "discounted_cash": 61.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ATOMOXETINE 10MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301125", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 82.0, "discounted_cash": 61.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ATOMOXETINE 18MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301126", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ATOMOXETINE 18MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301126", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ATOMOXETINE 25MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301127", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ATOMOXETINE 25MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301127", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ATOMOXETINE 40MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301128", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ATOMOXETINE 40MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301128", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ATOMOXETINE 60MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301129", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ATOMOXETINE 60MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301129", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "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": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ATORVASTATIN 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301146", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ATORVASTATIN 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301146", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "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": 93.0, "discounted_cash": 69.75, "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": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ATORVASTATIN 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301144", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ATORVASTATIN 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301144", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ATORVASTATIN 80MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301148", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 62.0, "discounted_cash": 46.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ATORVASTATIN 80MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301148", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 62.0, "discounted_cash": 46.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ATOVAQUONE 750/5 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314293", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 229.0, "discounted_cash": 171.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ATOVAQUONE 750/5 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314293", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 229.0, "discounted_cash": 171.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ATRACURIUM10MG/ML 5ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5318368", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 808.0, "discounted_cash": 606.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ATRIAL APPENDGE OCCLUSN", "code_information": [{"code": "4619379", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 32060.0, "discounted_cash": 24045.0, "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": 39.0, "discounted_cash": 29.25, "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": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ATROPINE .4MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301161", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ATROPINE .4MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301161", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ATROPINE 1% 15ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330289", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 274.0, "discounted_cash": 205.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ATROPINE 1% 15ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330289", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 274.0, "discounted_cash": 205.5, "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": 195.0, "discounted_cash": 146.25, "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": 195.0, "discounted_cash": 146.25, "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": "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": 94.0, "discounted_cash": 70.5, "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": 94.0, "discounted_cash": 70.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.29, "discounted_cash": 0.22, "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": 0.29, "discounted_cash": 0.22, "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": 0.52, "discounted_cash": 0.39, "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": 0.52, "discounted_cash": 0.39, "setting": "both", "billing_class": "facility"}]}, {"description": "AUTOLOGOUS BLOOD C/P/S", "code_information": [{"code": "86890", "type": "CPT"}, {"code": "4206891", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1220.0, "discounted_cash": 915.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AV TUNNELER/SCNLN SHEATH", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8201079", "type": "CDM"}], "standard_charges": [{"gross_charge": 1455.0, "discounted_cash": 1091.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AXLE DISTAL FEMORAL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8131030", "type": "CDM"}], "standard_charges": [{"gross_charge": 9343.0, "discounted_cash": 7007.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AXLE OSS STD ZIMMER", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8131031", "type": "CDM"}], "standard_charges": [{"gross_charge": 4868.71, "discounted_cash": 3651.53, "setting": "both", "billing_class": "facility"}]}, {"description": "AZACITIDINE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9025", "type": "HCPCS"}, {"code": "5318413", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 58.0, "discounted_cash": 43.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AZACITIDINE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9025", "type": "HCPCS"}, {"code": "5318413", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 58.0, "discounted_cash": 43.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AZATHIOPRINE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301214", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AZATHIOPRINE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301214", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "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": 52.0, "discounted_cash": 39.0, "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": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AZATHIOPRINE PER100MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7501", "type": "HCPCS"}, {"code": "5318415", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1885.0, "discounted_cash": 1413.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AZATHIOPRINE PER100MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7501", "type": "HCPCS"}, {"code": "5318415", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1885.0, "discounted_cash": 1413.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AZELASTINE NASAL 17ML SP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330334", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 789.0, "discounted_cash": 591.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AZELASTINE NASAL 17ML SP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330334", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 789.0, "discounted_cash": 591.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AZELASTINE NASAL 30ML SP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330330", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 865.0, "discounted_cash": 648.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AZELASTINE NASAL 30ML SP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330330", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 865.0, "discounted_cash": 648.75, "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": 90.0, "discounted_cash": 67.5, "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": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AZITHROMY200/5 22.5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314302", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 583.0, "discounted_cash": 437.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AZITHROMY200/5 22.5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314302", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 583.0, "discounted_cash": 437.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AZITHROMYCIN 1% 2.5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330327", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 779.0, "discounted_cash": 584.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AZITHROMYCIN 1% 2.5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330327", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 779.0, "discounted_cash": 584.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AZITHROMYCIN 1GM PWLQ", "code_information": [{"code": "Q0144", "type": "HCPCS"}, {"code": "5314303", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 411.0, "discounted_cash": 308.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AZITHROMYCIN 1GM PWLQ", "code_information": [{"code": "Q0144", "type": "HCPCS"}, {"code": "5314303", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 411.0, "discounted_cash": 308.25, "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": 172.0, "discounted_cash": 129.0, "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": 172.0, "discounted_cash": 129.0, "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": 205.0, "discounted_cash": 153.75, "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": 205.0, "discounted_cash": 153.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 558.0, "discounted_cash": 418.5, "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": 558.0, "discounted_cash": 418.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 25.0, "discounted_cash": 18.75, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 25.0, "discounted_cash": 18.75, "setting": "both", "billing_class": "facility"}]}, {"description": "B CELLS TOTAL COUNT", "code_information": [{"code": "86355", "type": "CPT"}, {"code": "7258606", "type": "CDM"}], "standard_charges": [{"gross_charge": 128.0, "discounted_cash": 96.0, "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": 1065.0, "discounted_cash": 798.75, "setting": "both", "billing_class": "facility"}]}, {"description": "B-TYP NATRIURETC PEPTIDE", "code_information": [{"code": "83880", "type": "CPT"}, {"code": "4123527", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "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": 264.0, "discounted_cash": 198.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 264.0, "discounted_cash": 198.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BACITRACIN 10000U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5318452", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 284.0, "discounted_cash": 213.0, "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": 76.0, "discounted_cash": 57.0, "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": 76.0, "discounted_cash": 57.0, "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": 177.0, "discounted_cash": 132.75, "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": 266.0, "discounted_cash": 199.5, "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": 266.0, "discounted_cash": 199.5, "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": 94.0, "discounted_cash": 70.5, "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": 94.0, "discounted_cash": 70.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BACITRACIN/POLYB.9GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334300", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BACITRACIN/POLYB.9GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334300", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "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": 77.0, "discounted_cash": 57.75, "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": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BACITRACIN500U/GM3.5GMOO", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330351", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 126.0, "discounted_cash": 94.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BACITRACIN500U/GM3.5GMOO", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330351", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 126.0, "discounted_cash": 94.5, "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": 39.0, "discounted_cash": 29.25, "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": 39.0, "discounted_cash": 29.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "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": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BACLOFEN 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301356", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BACLOFEN 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301356", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BACLOFEN ITKT PER50MCGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0476", "type": "HCPCS"}, {"code": "5318468", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 933.0, "discounted_cash": 699.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BACLOFEN ITKT PER50MCGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0476", "type": "HCPCS"}, {"code": "5318468", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 933.0, "discounted_cash": 699.75, "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": 2587.0, "discounted_cash": 1940.25, "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": 2587.0, "discounted_cash": 1940.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BACTERIUM AB NES/4", "code_information": [{"code": "86609", "type": "CPT"}, {"code": "7006612", "type": "CDM"}], "standard_charges": [{"gross_charge": 571.0, "discounted_cash": 428.25, "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": 88251.0, "discounted_cash": 66188.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BALOON DILATE URETER", "code_information": [{"code": "4910706", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 840.0, "discounted_cash": 630.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BAND ANNULOPLASTY", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8141021", "type": "CDM"}], "standard_charges": [{"gross_charge": 18287.0, "discounted_cash": 13715.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BAR LOCKING TIBIAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131242", "type": "CDM"}], "standard_charges": [{"gross_charge": 1230.0, "discounted_cash": 922.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BAR ORTHO", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8130134", "type": "CDM"}], "standard_charges": [{"gross_charge": 2308.0, "discounted_cash": 1731.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BARBITURATE/3", "code_information": [{"code": "80345", "type": "CPT"}, {"code": "7002203", "type": "CDM"}], "standard_charges": [{"gross_charge": 765.0, "discounted_cash": 573.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BARBITURATE/4", "code_information": [{"code": "80345", "type": "CPT"}, {"code": "7252210", "type": "CDM"}], "standard_charges": [{"gross_charge": 106.0, "discounted_cash": 79.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BARICITINIB 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301365", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 514.0, "discounted_cash": 385.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BARICITINIB 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301365", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 514.0, "discounted_cash": 385.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BARICITINIB 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301366", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 514.0, "discounted_cash": 385.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BARICITINIB 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301366", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 514.0, "discounted_cash": 385.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BARRIER ADH SEPRA GEL", "code_information": [{"code": "C1765", "type": "HCPCS"}, {"code": "8172007", "type": "CDM"}], "standard_charges": [{"gross_charge": 2638.0, "discounted_cash": 1978.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BARRIER ADHENSION 3X4EA", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5334045", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3062.0, "discounted_cash": 2296.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BARRIER ADHENSION 3X4EA", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5334045", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 3062.0, "discounted_cash": 2296.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BARRIER ADHESION 2", "code_information": [{"code": "C1765", "type": "HCPCS"}, {"code": "8240515", "type": "CDM"}], "standard_charges": [{"gross_charge": 4243.0, "discounted_cash": 3182.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BARS ARCH", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8172010", "type": "CDM"}], "standard_charges": [{"gross_charge": 254.0, "discounted_cash": 190.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BARTONELLA AB", "code_information": [{"code": "86611", "type": "CPT"}, {"code": "7006608", "type": "CDM"}], "standard_charges": [{"gross_charge": 511.0, "discounted_cash": 383.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BARTONELLA AB/4", "code_information": [{"code": "86611", "type": "CPT"}, {"code": "7256612", "type": "CDM"}], "standard_charges": [{"gross_charge": 254.0, "discounted_cash": 190.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BARTONELLA AB/5", "code_information": [{"code": "86611", "type": "CPT"}, {"code": "7256613", "type": "CDM"}], "standard_charges": [{"gross_charge": 254.0, "discounted_cash": 190.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BARTONELLA AB/6", "code_information": [{"code": "86611", "type": "CPT"}, {"code": "7256614", "type": "CDM"}], "standard_charges": [{"gross_charge": 254.0, "discounted_cash": 190.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BASE PLT GLENOID WDGE AUG", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8131247", "type": "CDM"}], "standard_charges": [{"gross_charge": 18767.0, "discounted_cash": 14075.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BASE POST MOD GLENOID ZIM CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012958", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9354.0, "discounted_cash": 7015.5, "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": 15548.0, "discounted_cash": 11661.0, "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": 13756.0, "discounted_cash": 10317.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BASE TIB UNCOATD RP CORIN CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013219", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11506.0, "discounted_cash": 8629.5, "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": 10508.0, "discounted_cash": 7881.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BASE TIB UNCT TRIATH STRYK CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013069", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11602.0, "discounted_cash": 8701.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BASE TIB UNCT UNCT PRS ZIM CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013006", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11364.0, "discounted_cash": 8523.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BASE TIBIAL ALL POLY STRYK CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013066", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8274.0, "discounted_cash": 6205.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BASE TIBIAL UNCTD CONFORMIS CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013328", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 14143.0, "discounted_cash": 10607.25, "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": 15760.0, "discounted_cash": 11820.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BASEPLATE MODULAR", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4010899", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 33623.0, "discounted_cash": 25217.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BASEPLATE REVERSE STRYKER CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013032", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11961.0, "discounted_cash": 8970.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BASEPLT AUG REV GLENOID ZIM CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012966", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16208.0, "discounted_cash": 12156.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BASEPLT GLENOID RVS TORNIER CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013501", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11943.0, "discounted_cash": 8957.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BASEPLT GLENOID ZIMMER CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012955", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 17538.0, "discounted_cash": 13153.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BASEPLT GLNOID AUGM TORNIER CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013495", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 18767.0, "discounted_cash": 14075.25, "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": 62307.0, "discounted_cash": 46730.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BASIC METABOL PN ION CA", "code_information": [{"code": "80047", "type": "CPT"}, {"code": "4100047", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 282.0, "discounted_cash": 211.5, "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": 1235.0, "discounted_cash": 926.25, "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": 26.0, "discounted_cash": 19.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BASIC METABOLIC PANEL", "code_information": [{"code": "80048", "type": "CPT"}, {"code": "4150166", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 238.0, "discounted_cash": 178.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BASIC RADIATION DOSIMTRY", "code_information": [{"code": "77300", "type": "CPT"}, {"code": "5107300", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 2154.0, "discounted_cash": 1615.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BCG (LIVE) INTRAVES 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9030", "type": "HCPCS"}, {"code": "5318497", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BCG (LIVE) INTRAVES 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9030", "type": "HCPCS"}, {"code": "5318497", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BCR/ABL 1 MINOR BREAKPNT/2", "code_information": [{"code": "81207", "type": "CPT"}, {"code": "7259203", "type": "CDM"}], "standard_charges": [{"gross_charge": 1732.0, "discounted_cash": 1299.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BCR/ABL1 MAJOR BREAKPNT/2", "code_information": [{"code": "81206", "type": "CPT"}, {"code": "7259202", "type": "CDM"}], "standard_charges": [{"gross_charge": 1732.0, "discounted_cash": 1299.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BECAPLERMIN.01%15GM GL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5334359", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 6042.0, "discounted_cash": 4531.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BECAPLERMIN.01%15GM GL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5334359", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 6042.0, "discounted_cash": 4531.5, "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": 708.0, "discounted_cash": 531.0, "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": 708.0, "discounted_cash": 531.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BECLOMETHASN80MCG8.7GMIH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330383", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1741.0, "discounted_cash": 1305.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BECLOMETHASN80MCG8.7GMIH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330383", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1741.0, "discounted_cash": 1305.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BELIMUMAB PER 10MG IV IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0490", "type": "HCPCS"}, {"code": "5318502", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 343.0, "discounted_cash": 257.25, "setting": "both", "billing_class": "facility"}], "modifiers": "JA"}, {"description": "BELIMUMAB PER 10MG IV IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0490", "type": "HCPCS"}, {"code": "5318502", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 343.0, "discounted_cash": 257.25, "setting": "both", "billing_class": "facility"}], "modifiers": "JA"}, {"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": 83.0, "discounted_cash": 62.25, "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": 109.0, "discounted_cash": 81.75, "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": 48.0, "discounted_cash": 36.0, "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": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BENAZEPRIL 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301429", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BENAZEPRIL 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301429", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BENAZEPRIL 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301432", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BENAZEPRIL 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301432", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BENAZEPRIL 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301433", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BENAZEPRIL 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301433", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "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": 48.0, "discounted_cash": 36.0, "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": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BENDAMUSTINE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9033", "type": "HCPCS"}, {"code": "5318510", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BENDAMUSTINE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9033", "type": "HCPCS"}, {"code": "5318510", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BENDAMUSTINE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9034", "type": "HCPCS"}, {"code": "5318509", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 193.0, "discounted_cash": 144.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BENDAMUSTINE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9034", "type": "HCPCS"}, {"code": "5318509", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 193.0, "discounted_cash": 144.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZALKON 1:750 240ML TS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334361", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 770.0, "discounted_cash": 577.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZALKON 1:750 240ML TS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334361", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 770.0, "discounted_cash": 577.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZO/BUTA/TETR 20GM SP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334394", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 427.0, "discounted_cash": 320.25, "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": 870.0, "discounted_cash": 652.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZOCAIN 10% 5GM MMGL", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334412", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZOCAIN 10% 5GM MMGL", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334412", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "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": 113.0, "discounted_cash": 84.75, "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": 113.0, "discounted_cash": 84.75, "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": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZOCAINE 20% 0.5ML TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334410", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZOCAINE 20% 15ML OT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330397", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 262.0, "discounted_cash": 196.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZOCAINE 20% 15ML OT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330397", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 262.0, "discounted_cash": 196.5, "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": 277.0, "discounted_cash": 207.75, "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": 277.0, "discounted_cash": 207.75, "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": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "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": 86.0, "discounted_cash": 64.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 156.0, "discounted_cash": 117.0, "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": 156.0, "discounted_cash": 117.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZOCAINE20% 30GM GL", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334418", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 134.0, "discounted_cash": 100.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZOCAINE20% 30GM GL", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334418", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 134.0, "discounted_cash": 100.5, "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": 154.0, "discounted_cash": 115.5, "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": 62.0, "discounted_cash": 46.5, "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": 62.0, "discounted_cash": 46.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZODIAZEPINES 1-12/10", "code_information": [{"code": "80346", "type": "CPT"}, {"code": "7252636", "type": "CDM"}], "standard_charges": [{"gross_charge": 1017.0, "discounted_cash": 762.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZODIAZEPINES 1-12/11", "code_information": [{"code": "80346", "type": "CPT"}, {"code": "7254619", "type": "CDM"}], "standard_charges": [{"gross_charge": 1017.0, "discounted_cash": 762.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZODIAZEPINES 1-12/5", "code_information": [{"code": "80346", "type": "CPT"}, {"code": "7252183", "type": "CDM"}], "standard_charges": [{"gross_charge": 106.0, "discounted_cash": 79.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZODIAZEPINES 1-12/6", "code_information": [{"code": "80346", "type": "CPT"}, {"code": "7252185", "type": "CDM"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZODIAZEPINES 1-12/7", "code_information": [{"code": "80346", "type": "CPT"}, {"code": "7252512", "type": "CDM"}], "standard_charges": [{"gross_charge": 1017.0, "discounted_cash": 762.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZOIN TINC SWAB STK EA", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334385", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.52, "discounted_cash": 0.39, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZOIN TINC SWAB STK EA", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334385", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 0.52, "discounted_cash": 0.39, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZOIN TINCTUR STRIP EA", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334441", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 58.0, "discounted_cash": 43.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZOIN TINCTUR STRIP EA", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334441", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 58.0, "discounted_cash": 43.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZOYL PEROX10%42GM GL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334469", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZOYL PEROX10%42GM GL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334469", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZOYL PEROX10%60GM GL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334470", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 299.0, "discounted_cash": 224.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZOYL PEROX10%60GM GL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334470", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 299.0, "discounted_cash": 224.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZTROPINE 0.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301520", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZTROPINE 0.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301520", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "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": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "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": 142.0, "discounted_cash": 106.5, "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": 142.0, "discounted_cash": 106.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BETA 2 GLYCOPROT I AB EA", "code_information": [{"code": "86146", "type": "CPT"}, {"code": "7256115", "type": "CDM"}], "standard_charges": [{"gross_charge": 230.0, "discounted_cash": 172.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BETA 2 GLYCOPROT I AB EA/2", "code_information": [{"code": "86146", "type": "CPT"}, {"code": "7256116", "type": "CDM"}], "standard_charges": [{"gross_charge": 230.0, "discounted_cash": 172.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BETA 2 GLYCOPROT I AB EA/4", "code_information": [{"code": "86146", "type": "CPT"}, {"code": "7006146", "type": "CDM"}], "standard_charges": [{"gross_charge": 230.0, "discounted_cash": 172.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BETA 2 GLYCOPROT I AB EA/4", "code_information": [{"code": "86146", "type": "CPT"}, {"code": "7256146", "type": "CDM"}], "standard_charges": [{"gross_charge": 230.0, "discounted_cash": 172.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BETA-2-MICROGLOBLN", "code_information": [{"code": "82232", "type": "CPT"}, {"code": "7252231", "type": "CDM"}], "standard_charges": [{"gross_charge": 681.0, "discounted_cash": 510.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BETA-2-MICROGLOBLN/2", "code_information": [{"code": "82232", "type": "CPT"}, {"code": "7002232", "type": "CDM"}], "standard_charges": [{"gross_charge": 681.0, "discounted_cash": 510.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BETA-2-MICROGLOBLN/2", "code_information": [{"code": "82232", "type": "CPT"}, {"code": "7252232", "type": "CDM"}], "standard_charges": [{"gross_charge": 681.0, "discounted_cash": 510.75, "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": 160.0, "discounted_cash": 120.0, "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": 160.0, "discounted_cash": 120.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 134.0, "discounted_cash": 100.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 134.0, "discounted_cash": 100.5, "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": 128.0, "discounted_cash": 96.0, "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": 128.0, "discounted_cash": 96.0, "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": 1507.0, "discounted_cash": 1130.25, "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": 1507.0, "discounted_cash": 1130.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 432.0, "discounted_cash": 324.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 432.0, "discounted_cash": 324.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BETAXOLOL .5% 15ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330408", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 487.0, "discounted_cash": 365.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BETAXOLOL .5% 15ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330408", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 487.0, "discounted_cash": 365.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BETAXOLOL .5% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330404", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 574.0, "discounted_cash": 430.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BETAXOLOL .5% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330404", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 574.0, "discounted_cash": 430.5, "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": 19.0, "discounted_cash": 14.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "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": 50.0, "discounted_cash": 37.5, "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": 74.0, "discounted_cash": 55.5, "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": 74.0, "discounted_cash": 55.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 686.0, "discounted_cash": 514.5, "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": 686.0, "discounted_cash": 514.5, "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": 477.0, "discounted_cash": 357.75, "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": 477.0, "discounted_cash": 357.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BEVACIZUMAB-BVZR PER 10MG IJ", "code_information": [{"code": "Q5118", "type": "HCPCS"}, {"code": "5318609", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 398.0, "discounted_cash": 298.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BEVACIZUMAB-BVZR PER 10MG IJ", "code_information": [{"code": "Q5118", "type": "HCPCS"}, {"code": "5318609", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 398.0, "discounted_cash": 298.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BEZLOTOXUMAB PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0565", "type": "HCPCS"}, {"code": "5318611", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 247.0, "discounted_cash": 185.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BEZLOTOXUMAB PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0565", "type": "HCPCS"}, {"code": "5318611", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 247.0, "discounted_cash": 185.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BG FECAL COLLECTION", "code_information": [{"code": "A4330", "type": "HCPCS"}, {"code": "8031126", "type": "CDM"}], "standard_charges": [{"gross_charge": 106.0, "discounted_cash": 79.5, "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": 254.0, "discounted_cash": 190.5, "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": 254.0, "discounted_cash": 190.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BICTEG/EMTRIC/TENOF50/200/25TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301581", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 695.0, "discounted_cash": 521.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BICTEG/EMTRIC/TENOF50/200/25TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301581", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 695.0, "discounted_cash": 521.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BILE ACIDS TOTAL", "code_information": [{"code": "82239", "type": "CPT"}, {"code": "7002241", "type": "CDM"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BILE ACIDS TOTAL/2", "code_information": [{"code": "82239", "type": "CPT"}, {"code": "7252241", "type": "CDM"}], "standard_charges": [{"gross_charge": 577.0, "discounted_cash": 432.75, "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": 3136.0, "discounted_cash": 2352.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BILIARY DUCT STONE EXTR", "code_information": [{"code": "4918200", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5861.0, "discounted_cash": 4395.75, "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": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BILIRUBIN DIRECT", "code_information": [{"code": "82248", "type": "CPT"}, {"code": "4122253", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BILIRUBIN DIRECT", "code_information": [{"code": "82248", "type": "CPT"}, {"code": "4152253", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BILIRUBIN TOTAL", "code_information": [{"code": "82247", "type": "CPT"}, {"code": "4122250", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BILIRUBIN TOTAL", "code_information": [{"code": "82247", "type": "CPT"}, {"code": "4152250", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "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": 269.0, "discounted_cash": 201.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BILIRUBIN TOTL TRNSCTNS", "code_information": [{"code": "88720", "type": "CPT"}, {"code": "4108400", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "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": 980.0, "discounted_cash": 735.0, "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": 980.0, "discounted_cash": 735.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BIODFENCE G3 1.5X2CM PER SQ CM", "code_information": [{"code": "Q4140", "type": "HCPCS"}, {"code": "4020752", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1777.0, "discounted_cash": 1332.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BIODFENCE G3 1.5X2CM PER SQ CM", "code_information": [{"code": "Q4140", "type": "HCPCS"}, {"code": "4020752", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1777.0, "discounted_cash": 1332.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BIODFENCE G3 2CMX3CM PER SQ CM", "code_information": [{"code": "Q4140", "type": "HCPCS"}, {"code": "4020738", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1343.0, "discounted_cash": 1007.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BIODFENCE G3 2CMX3CM PER SQ CM", "code_information": [{"code": "Q4140", "type": "HCPCS"}, {"code": "4020738", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1343.0, "discounted_cash": 1007.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BIODFENCE G3 2CMX4CM PER SQ CM", "code_information": [{"code": "Q4140", "type": "HCPCS"}, {"code": "4020741", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1529.0, "discounted_cash": 1146.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BIODFENCE G3 2CMX4CM PER SQ CM", "code_information": [{"code": "Q4140", "type": "HCPCS"}, {"code": "4020741", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1529.0, "discounted_cash": 1146.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BIODFENCE G3 3CMX6CM PER SQ CM", "code_information": [{"code": "Q4140", "type": "HCPCS"}, {"code": "4020743", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1149.0, "discounted_cash": 861.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BIODFENCE G3 3CMX6CM PER SQ CM", "code_information": [{"code": "Q4140", "type": "HCPCS"}, {"code": "4020743", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1149.0, "discounted_cash": 861.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BIODFENCE G3 4CMX8CM PER SQ CM", "code_information": [{"code": "Q4140", "type": "HCPCS"}, {"code": "4020742", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 382.0, "discounted_cash": 286.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BIODFENCE G3 4CMX8CM PER SQ CM", "code_information": [{"code": "Q4140", "type": "HCPCS"}, {"code": "4020742", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 382.0, "discounted_cash": 286.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BIODFENCE G3 PER SQ CM", "code_information": [{"code": "Q4140", "type": "HCPCS"}, {"code": "4020744", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1655.0, "discounted_cash": 1241.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BIODFENCE G3 PER SQ CM", "code_information": [{"code": "Q4140", "type": "HCPCS"}, {"code": "4020744", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1655.0, "discounted_cash": 1241.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BIODFENCE SENTRY PER SQ CM", "code_information": [{"code": "Q4140", "type": "HCPCS"}, {"code": "4020735", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 453.0, "discounted_cash": 339.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BIODFENCE SENTRY PER SQ CM", "code_information": [{"code": "Q4140", "type": "HCPCS"}, {"code": "4020735", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 453.0, "discounted_cash": 339.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BIOPSY BONE DEEP", "code_information": [{"code": "4917503", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2499.0, "discounted_cash": 1874.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BIOPSY BONE DEEP", "code_information": [{"code": "5010026", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6366.0, "discounted_cash": 4774.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BIOPSY BONE DEEP", "code_information": [{"code": "5057503", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1062.0, "discounted_cash": 796.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BIOPSY BONE SUPERFICIAL", "code_information": [{"code": "5057504", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 531.0, "discounted_cash": 398.25, "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": 2845.0, "discounted_cash": 2133.75, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BISMUTH SUBSALI 240ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314360", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BISMUTH SUBSALI 240ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314360", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 34.0, "discounted_cash": 25.5, "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": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BISOPROLOL 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301606", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BISOPROLOL 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301606", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BISOPROLOL 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301603", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BISOPROLOL 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301603", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BISOPROLOL 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301605", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BISOPROLOL 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301605", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BLASTOMYCES AB", "code_information": [{"code": "86612", "type": "CPT"}, {"code": "4106168", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 505.0, "discounted_cash": 378.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BLASTOMYCES AB", "code_information": [{"code": "86612", "type": "CPT"}, {"code": "7256198", "type": "CDM"}], "standard_charges": [{"gross_charge": 194.0, "discounted_cash": 145.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BLASTOMYCES AB/3", "code_information": [{"code": "86612", "type": "CPT"}, {"code": "7258697", "type": "CDM"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD AUTOSLV INTRA/PSOP", "code_information": [{"code": "86891", "type": "CPT"}, {"code": "3306891", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1590.0, "discounted_cash": 1192.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD CUTTR TURBOHAWK SUPR", "code_information": [{"code": "C1714", "type": "HCPCS"}, {"code": "8172283", "type": "CDM"}], "standard_charges": [{"gross_charge": 22752.0, "discounted_cash": 17064.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD IRRAD RBC", "code_information": [{"code": "P9038", "type": "HCPCS"}, {"code": "4500033", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 340.0, "discounted_cash": 255.0, "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": 402.0, "discounted_cash": 301.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD PLATELET APHERESIS", "code_information": [{"code": "4202300", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 16190.0, "discounted_cash": 12142.5, "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": 2701.0, "discounted_cash": 2025.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD RC PACKED", "code_information": [{"code": "P9021", "type": "HCPCS"}, {"code": "4500014", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 1554.0, "discounted_cash": 1165.5, "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": 86.0, "discounted_cash": 64.5, "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": 11.0, "discounted_cash": 8.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD SMR EXAM W/DIFF", "code_information": [{"code": "85007", "type": "CPT"}, {"code": "4155007", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "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": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD SMR EXAM W/O DIFF", "code_information": [{"code": "85008", "type": "CPT"}, {"code": "4125008", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 11.0, "discounted_cash": 8.25, "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": 550.0, "discounted_cash": 412.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD TYPE ABO", "code_information": [{"code": "86900", "type": "CPT"}, {"code": "4156080", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 180.0, "discounted_cash": 135.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD TYPE ABO", "code_information": [{"code": "86900", "type": "CPT"}, {"code": "7016080", "type": "CDM"}], "standard_charges": [{"gross_charge": 206.0, "discounted_cash": 154.5, "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": 1711.0, "discounted_cash": 1283.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD TYPE ANTIGEN DONOR EA/3", "code_information": [{"code": "86902", "type": "CPT"}, {"code": "7016916", "type": "CDM"}], "standard_charges": [{"gross_charge": 1845.0, "discounted_cash": 1383.75, "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": 504.0, "discounted_cash": 378.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD TYPE RH (D)", "code_information": [{"code": "86901", "type": "CPT"}, {"code": "4156100", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 180.0, "discounted_cash": 135.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD TYPE RH (D)", "code_information": [{"code": "86901", "type": "CPT"}, {"code": "7016100", "type": "CDM"}], "standard_charges": [{"gross_charge": 206.0, "discounted_cash": 154.5, "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": 501.0, "discounted_cash": 375.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD UREA NITROGEN QUAN", "code_information": [{"code": "84520", "type": "CPT"}, {"code": "4124520", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD UREA NITROGEN QUAN", "code_information": [{"code": "84520", "type": "CPT"}, {"code": "4154520", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 193.0, "discounted_cash": 144.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BLEOMYCIN PER 15U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9040", "type": "HCPCS"}, {"code": "5318621", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5043.0, "discounted_cash": 3782.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BLEOMYCIN PER 15U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9040", "type": "HCPCS"}, {"code": "5318621", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 5043.0, "discounted_cash": 3782.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BLINATUMOMAB PER 1MCG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9039", "type": "HCPCS"}, {"code": "5318626", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 752.0, "discounted_cash": 564.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BLINATUMOMAB PER 1MCG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9039", "type": "HCPCS"}, {"code": "5318626", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 752.0, "discounted_cash": 564.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BLISTEX 4.25GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334607", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BLISTEX 4.25GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334607", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BLN COLON DILATION", "code_information": [{"code": "C1726", "type": "HCPCS"}, {"code": "8055090", "type": "CDM"}], "standard_charges": [{"gross_charge": 1601.0, "discounted_cash": 1200.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BLOOD ADMINISTRATION 1-2 UNITS", "code_information": [{"code": "36430", "type": "CPT"}, {"code": "6290011", "type": "CDM"}], "standard_charges": [{"gross_charge": 2378.0, "discounted_cash": 1783.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BLOOD ADMINISTRATION 3-4 UNITS", "code_information": [{"code": "36430", "type": "CPT"}, {"code": "6290012", "type": "CDM"}], "standard_charges": [{"gross_charge": 3963.0, "discounted_cash": 2972.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BLOOD ADMINISTRATION 5-6 UNITS", "code_information": [{"code": "36430", "type": "CPT"}, {"code": "6290013", "type": "CDM"}], "standard_charges": [{"gross_charge": 5719.0, "discounted_cash": 4289.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BLOOD ADMINISTRATION 7-8 UNITS", "code_information": [{"code": "36430", "type": "CPT"}, {"code": "6290014", "type": "CDM"}], "standard_charges": [{"gross_charge": 6564.0, "discounted_cash": 4923.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BLOOD ADMINISTRATION 9-10 UNIT", "code_information": [{"code": "36430", "type": "CPT"}, {"code": "6290015", "type": "CDM"}], "standard_charges": [{"gross_charge": 8720.0, "discounted_cash": 6540.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BLOOD ADMINISTRATION >10 UNITS", "code_information": [{"code": "36430", "type": "CPT"}, {"code": "6290016", "type": "CDM"}], "standard_charges": [{"gross_charge": 9482.0, "discounted_cash": 7111.5, "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": 206.0, "discounted_cash": 154.5, "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": 306.0, "discounted_cash": 229.5, "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": 502.0, "discounted_cash": 376.5, "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": 443.0, "discounted_cash": 332.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BLOOD HEMOGLBN", "code_information": [{"code": "85018", "type": "CPT"}, {"code": "4125018", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BLOOD HEMOGLBN", "code_information": [{"code": "85018", "type": "CPT"}, {"code": "4155018", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 101.0, "discounted_cash": 75.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BLOOD PLASMAPHERESIS", "code_information": [{"code": "4202320", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5098.0, "discounted_cash": 3823.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BLOOD PLATELET CONCNTRAT", "code_information": [{"code": "P9019", "type": "HCPCS"}, {"code": "4500025", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 894.0, "discounted_cash": 670.5, "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": 1188.0, "discounted_cash": 891.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BN CEMENT GV SPECTRUM40", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131319", "type": "CDM"}], "standard_charges": [{"gross_charge": 4472.0, "discounted_cash": 3354.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BN CEMENT INJ HYDROSET XT 15CC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011051", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 24126.0, "discounted_cash": 18094.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BN CHIPS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131275", "type": "CDM"}], "standard_charges": [{"gross_charge": 14245.0, "discounted_cash": 10683.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BN CMT ANT FL DS DPY CAP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011978", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3984.0, "discounted_cash": 2988.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BN CMT PLFL DS DPY CAP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011976", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 858.0, "discounted_cash": 643.5, "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": 8878.0, "discounted_cash": 6658.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BN FILLER", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131276", "type": "CDM"}], "standard_charges": [{"gross_charge": 9547.0, "discounted_cash": 7160.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BN FILLER 2", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131277", "type": "CDM"}], "standard_charges": [{"gross_charge": 22401.0, "discounted_cash": 16800.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BN GEL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8031368", "type": "CDM"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BN GEL/PUTTY 10CC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8031369", "type": "CDM"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BN GEL/PUTTY 1CC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8038143", "type": "CDM"}], "standard_charges": [{"gross_charge": 4928.0, "discounted_cash": 3696.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BN GEL/PUTTY 2.5CC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8031359", "type": "CDM"}], "standard_charges": [{"gross_charge": 4313.0, "discounted_cash": 3234.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BN GEL/PUTTY 20CC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8031364", "type": "CDM"}], "standard_charges": [{"gross_charge": 41723.0, "discounted_cash": 31292.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BN GEL/PUTTY 5CC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8031366", "type": "CDM"}], "standard_charges": [{"gross_charge": 4755.0, "discounted_cash": 3566.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BN GRANUELS 10CC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131281", "type": "CDM"}], "standard_charges": [{"gross_charge": 25397.0, "discounted_cash": 19047.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BN GRANUELS 15CC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131282", "type": "CDM"}], "standard_charges": [{"gross_charge": 2890.0, "discounted_cash": 2167.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BN GRANULES ANY", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131284", "type": "CDM"}], "standard_charges": [{"gross_charge": 47035.01, "discounted_cash": 35276.26, "setting": "both", "billing_class": "facility"}]}, {"description": "BN GRFT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131285", "type": "CDM"}], "standard_charges": [{"gross_charge": 29.0, "discounted_cash": 21.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BN GRFT 2", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131286", "type": "CDM"}], "standard_charges": [{"gross_charge": 4162.0, "discounted_cash": 3121.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BN GRFT 3", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131287", "type": "CDM"}], "standard_charges": [{"gross_charge": 8853.0, "discounted_cash": 6639.75, "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": 43912.0, "discounted_cash": 32934.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BN GRFT INFS MED 4SPNG", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011000", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 41008.0, "discounted_cash": 30756.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BN GRFT INFS SM 4SPNG", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011001", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 31594.0, "discounted_cash": 23695.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BN GRFT INFS XXS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011003", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6785.0, "discounted_cash": 5088.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BN GRFT INJ 10CC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131294", "type": "CDM"}], "standard_charges": [{"gross_charge": 58374.0, "discounted_cash": 43780.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BN GRFT INJ 5CC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131289", "type": "CDM"}], "standard_charges": [{"gross_charge": 36776.0, "discounted_cash": 27582.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BN GRFT INJ PRODENSE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131298", "type": "CDM"}], "standard_charges": [{"gross_charge": 35691.0, "discounted_cash": 26768.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BN GRFT PUTTY IFACTORY", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131296", "type": "CDM"}], "standard_charges": [{"gross_charge": 23885.0, "discounted_cash": 17913.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BN MATRX GRFT MOLDBLE STRP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131307", "type": "CDM"}], "standard_charges": [{"gross_charge": 12693.0, "discounted_cash": 9519.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BN OSTEOFLO SYN HYDROPUTTY", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131279", "type": "CDM"}], "standard_charges": [{"gross_charge": 14075.0, "discounted_cash": 10556.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BN PASTE 1", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8031372", "type": "CDM"}], "standard_charges": [{"gross_charge": 3919.0, "discounted_cash": 2939.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BN PASTE 2", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8031373", "type": "CDM"}], "standard_charges": [{"gross_charge": 7671.0, "discounted_cash": 5753.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BN PLUGS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131290", "type": "CDM"}], "standard_charges": [{"gross_charge": 211.0, "discounted_cash": 158.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BOLT CNNLTD", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131315", "type": "CDM"}], "standard_charges": [{"gross_charge": 3578.0, "discounted_cash": 2683.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BOLT TIBIA N+WAS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131325", "type": "CDM"}], "standard_charges": [{"gross_charge": 3538.0, "discounted_cash": 2653.5, "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": 607.0, "discounted_cash": 455.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BONE AGE STUDIES", "code_information": [{"code": "77072", "type": "CPT"}, {"code": "5016020", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 607.0, "discounted_cash": 455.25, "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": 638.0, "discounted_cash": 478.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BONE CEMENT OSTEOREMEDIES CL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4013370", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3199.0, "discounted_cash": 2399.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BONE DECALCIFICATION/2", "code_information": [{"code": "88311", "type": "CPT"}, {"code": "7050040", "type": "CDM"}], "standard_charges": [{"gross_charge": 602.0, "discounted_cash": 451.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BONE IMAG 3 PHASE STUDY", "code_information": [{"code": "78315", "type": "CPT"}, {"code": "5018315", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 8474.0, "discounted_cash": 6355.5, "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": 2552.0, "discounted_cash": 1914.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BONE IMAGING LIMITED", "code_information": [{"code": "78300", "type": "CPT"}, {"code": "5010304", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 1760.0, "discounted_cash": 1320.0, "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": 2512.0, "discounted_cash": 1884.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BONE IMAGING WHOLE BODY", "code_information": [{"code": "78306", "type": "CPT"}, {"code": "5018307", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 7877.0, "discounted_cash": 5907.75, "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": 2910.0, "discounted_cash": 2182.5, "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": 812.0, "discounted_cash": 609.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BONE MARROW ASPIRATION", "code_information": [{"code": "4305095", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2546.0, "discounted_cash": 1909.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BONE MARROW IMAGING LTD", "code_information": [{"code": "78102", "type": "CPT"}, {"code": "5208102", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 2793.0, "discounted_cash": 2094.75, "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": 4300.0, "discounted_cash": 3225.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BONE MARROW SMEAR INTRP", "code_information": [{"code": "85097", "type": "CPT"}, {"code": "7050033", "type": "CDM"}], "standard_charges": [{"gross_charge": 1755.0, "discounted_cash": 1316.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BONE PUTTY", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8031657", "type": "CDM"}], "standard_charges": [{"gross_charge": 1588.0, "discounted_cash": 1191.0, "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": 1385.0, "discounted_cash": 1038.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BONE SURVEY COMPLETE", "code_information": [{"code": "77075", "type": "CPT"}, {"code": "5016063", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1348.0, "discounted_cash": 1011.0, "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": 1711.0, "discounted_cash": 1283.25, "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": 744.0, "discounted_cash": 558.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BONE VD FILLR 5CC OSTEOREMD CL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4013369", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5971.0, "discounted_cash": 4478.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BONE VD FLLR 10CC OSTEOREMD CL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4013368", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9810.0, "discounted_cash": 7357.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BONE VOID FILLER BIOBEADS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131274", "type": "CDM"}], "standard_charges": [{"gross_charge": 9952.0, "discounted_cash": 7464.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BOOT/SHOE SURGICAL", "code_information": [{"code": "L3260", "type": "HCPCS"}, {"code": "8131331", "type": "CDM"}], "standard_charges": [{"gross_charge": 958.0, "discounted_cash": 718.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BORDETELLA AB", "code_information": [{"code": "86615", "type": "CPT"}, {"code": "7016924", "type": "CDM"}], "standard_charges": [{"gross_charge": 649.0, "discounted_cash": 486.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BORDETELLA AB", "code_information": [{"code": "86615", "type": "CPT"}, {"code": "7256924", "type": "CDM"}], "standard_charges": [{"gross_charge": 649.0, "discounted_cash": 486.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BORDETELLA AB/2", "code_information": [{"code": "86615", "type": "CPT"}, {"code": "7256928", "type": "CDM"}], "standard_charges": [{"gross_charge": 649.0, "discounted_cash": 486.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BORDETELLA AB/3", "code_information": [{"code": "86615", "type": "CPT"}, {"code": "7256929", "type": "CDM"}], "standard_charges": [{"gross_charge": 649.0, "discounted_cash": 486.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BORDETELLA PERTUSSIS DFA", "code_information": [{"code": "87265", "type": "CPT"}, {"code": "7007265", "type": "CDM"}], "standard_charges": [{"gross_charge": 245.0, "discounted_cash": 183.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BORTEZOMIB PER .1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9041", "type": "HCPCS"}, {"code": "5318644", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 402.0, "discounted_cash": 301.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BORTEZOMIB PER .1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9041", "type": "HCPCS"}, {"code": "5318644", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 402.0, "discounted_cash": 301.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BOSENTAN 125MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301641", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1178.0, "discounted_cash": 883.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BOSENTAN 125MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301641", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1178.0, "discounted_cash": 883.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BOSENTAN 62.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301640", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1093.0, "discounted_cash": 819.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BOSENTAN 62.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301640", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1093.0, "discounted_cash": 819.75, "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": 225.0, "discounted_cash": 168.75, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 225.0, "discounted_cash": 168.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BOWEL EVACUANT KIT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5339247", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BOWEL EVACUANT KIT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5339247", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BRACHYTX ISO PLAN CMPLX", "code_information": [{"code": "77318", "type": "CPT"}, {"code": "5107328", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 3455.0, "discounted_cash": 2591.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BRACHYTX ISO PLAN INTRMD", "code_information": [{"code": "77317", "type": "CPT"}, {"code": "5107327", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 3961.0, "discounted_cash": 2970.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BRACHYTX ISO PLAN SIMPLE", "code_information": [{"code": "77316", "type": "CPT"}, {"code": "5107326", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 1766.0, "discounted_cash": 1324.5, "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": 2841.0, "discounted_cash": 2130.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BRENTUXIMAB PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9042", "type": "HCPCS"}, {"code": "5318661", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1172.0, "discounted_cash": 879.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BRENTUXIMAB PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9042", "type": "HCPCS"}, {"code": "5318661", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1172.0, "discounted_cash": 879.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BRETYLIUM 500MG/10ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5318663", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 984.0, "discounted_cash": 738.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BREXPIPRAZOLE 0.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301665", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 258.0, "discounted_cash": 193.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BREXPIPRAZOLE 0.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301665", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 258.0, "discounted_cash": 193.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BREXPIPRAZOLE 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301663", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 258.0, "discounted_cash": 193.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BREXPIPRAZOLE 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301663", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 258.0, "discounted_cash": 193.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BREXPIPRAZOLE 3MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301666", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 274.0, "discounted_cash": 205.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BREXPIPRAZOLE 3MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301666", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 274.0, "discounted_cash": 205.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 616.0, "discounted_cash": 462.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 616.0, "discounted_cash": 462.0, "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": 270.0, "discounted_cash": 202.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 270.0, "discounted_cash": 202.5, "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": 962.0, "discounted_cash": 721.5, "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": 962.0, "discounted_cash": 721.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BRINZOLAMIDE 1% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330443", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 401.0, "discounted_cash": 300.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BRINZOLAMIDE 1% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330443", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 401.0, "discounted_cash": 300.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BRIVARACETAM 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301672", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 120.0, "discounted_cash": 90.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BRIVARACETAM 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301672", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 120.0, "discounted_cash": 90.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BRN IMG PET METABLC EVAL", "code_information": [{"code": "78608", "type": "CPT"}, {"code": "5238608", "type": "CDM"}, {"code": "404", "type": "RC"}], "standard_charges": [{"gross_charge": 3756.0, "discounted_cash": 2817.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BROMFENAC .09% 1.7ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330425", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1086.0, "discounted_cash": 814.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BROMFENAC .09% 1.7ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330425", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1086.0, "discounted_cash": 814.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BROMFENAC .09% 2.5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330456", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 909.0, "discounted_cash": 681.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BROMFENAC .09% 2.5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330456", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 909.0, "discounted_cash": 681.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BROMIDES", "code_information": [{"code": "80299", "type": "CPT"}, {"code": "7250298", "type": "CDM"}], "standard_charges": [{"gross_charge": 456.0, "discounted_cash": 342.0, "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": 70.0, "discounted_cash": 52.5, "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": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BROMOCRIPTINE 5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301681", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 101.0, "discounted_cash": 75.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BROMOCRIPTINE 5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301681", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 101.0, "discounted_cash": 75.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BROMPHEN/PSE 5ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314404", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BROMPHEN/PSE 5ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314404", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BRONCH ASPIRATN INITIAL", "code_information": [{"code": "4400671", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7250.0, "discounted_cash": 5437.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BRONCH ASPIRATN INITIAL", "code_information": [{"code": "5500671", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 11019.0, "discounted_cash": 8264.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BRONCH EVAL W/MULT SPIRO", "code_information": [{"code": "94070", "type": "CPT"}, {"code": "4401180", "type": "CDM"}, {"code": "460", "type": "RC"}], "standard_charges": [{"gross_charge": 1341.0, "discounted_cash": 1005.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BRONCH EVAL W/MULT SPIRO", "code_information": [{"code": "94070", "type": "CPT"}, {"code": "5501180", "type": "CDM"}, {"code": "460", "type": "RC"}], "standard_charges": [{"gross_charge": 2268.0, "discounted_cash": 1701.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BRONCHOSCOPE ASCOPE 4", "code_information": [{"code": "A4649", "type": "HCPCS"}, {"code": "8031429", "type": "CDM"}], "standard_charges": [{"gross_charge": 13187.0, "discounted_cash": 9890.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BRONCHOSCOPY DIAGNOSTIC", "code_information": [{"code": "4400655", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5751.0, "discounted_cash": 4313.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BRONCHOSCOPY DIAGNOSTIC", "code_information": [{"code": "5500655", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 10774.0, "discounted_cash": 8080.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BRONCHOSCOPY W BIOPSY", "code_information": [{"code": "4400660", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7643.0, "discounted_cash": 5732.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BRONCHOSCOPY W BIOPSY", "code_information": [{"code": "5500660", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 12671.0, "discounted_cash": 9503.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BRONCHOSPASM EVAL PRE/PS", "code_information": [{"code": "94060", "type": "CPT"}, {"code": "4401201", "type": "CDM"}, {"code": "460", "type": "RC"}], "standard_charges": [{"gross_charge": 661.0, "discounted_cash": 495.75, "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": 1053.0, "discounted_cash": 789.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BRUCELLA AB", "code_information": [{"code": "86622", "type": "CPT"}, {"code": "7006622", "type": "CDM"}], "standard_charges": [{"gross_charge": 223.0, "discounted_cash": 167.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BRUCELLA AB/2", "code_information": [{"code": "86622", "type": "CPT"}, {"code": "7256628", "type": "CDM"}], "standard_charges": [{"gross_charge": 223.0, "discounted_cash": 167.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BRUCELLA AB/3", "code_information": [{"code": "86622", "type": "CPT"}, {"code": "7256635", "type": "CDM"}], "standard_charges": [{"gross_charge": 223.0, "discounted_cash": 167.25, "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": 12526.0, "discounted_cash": 9394.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BSK RETRV", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8041071", "type": "CDM"}], "standard_charges": [{"gross_charge": 1896.0, "discounted_cash": 1422.0, "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": 194.0, "discounted_cash": 145.5, "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": 679.0, "discounted_cash": 509.25, "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": 1801.0, "discounted_cash": 1350.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1495.0, "discounted_cash": 1121.25, "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": 1495.0, "discounted_cash": 1121.25, "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": 1425.0, "discounted_cash": 1068.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1425.0, "discounted_cash": 1068.75, "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": 49.0, "discounted_cash": 36.75, "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": 49.0, "discounted_cash": 36.75, "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": 83.0, "discounted_cash": 62.25, "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": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BUDESONIDE 200MCG PW IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330441", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 615.0, "discounted_cash": 461.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BUDESONIDE 200MCG PW IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330441", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 615.0, "discounted_cash": 461.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BUDESONIDE 3MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301725", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BUDESONIDE 3MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301725", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BUMETANIDE 0.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301738", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BUMETANIDE 0.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301738", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BUMETANIDE 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301743", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BUMETANIDE 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301743", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "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": 20.0, "discounted_cash": 15.0, "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": 20.0, "discounted_cash": 15.0, "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": 1049.0, "discounted_cash": 786.75, "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": 395.0, "discounted_cash": 296.25, "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": 395.0, "discounted_cash": 296.25, "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": 1.0, "discounted_cash": 0.75, "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": 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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.16, "discounted_cash": 0.12, "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": 0.16, "discounted_cash": 0.12, "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": 14.0, "discounted_cash": 10.5, "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": 14.0, "discounted_cash": 10.5, "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": 0.13, "discounted_cash": 0.1, "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": 0.13, "discounted_cash": 0.1, "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": 0.19, "discounted_cash": 0.14, "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": 0.19, "discounted_cash": 0.14, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPRENOR 10MCG/HR XR TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334636", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 405.0, "discounted_cash": 303.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPRENOR 10MCG/HR XR TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334636", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 405.0, "discounted_cash": 303.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPRENOR 15MCG/HR XR TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334629", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 613.0, "discounted_cash": 459.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPRENOR 15MCG/HR XR TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334629", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 613.0, "discounted_cash": 459.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPRENOR 5MCG/HR XR TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5327200", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 451.0, "discounted_cash": 338.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPRENOR 5MCG/HR XR TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5327200", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 451.0, "discounted_cash": 338.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "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": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPRENORPHINE 8MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301755", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 144.0, "discounted_cash": 108.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPRENORPHINE 8MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301755", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 144.0, "discounted_cash": 108.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPRENORPHINE/3", "code_information": [{"code": "80348", "type": "CPT"}, {"code": "7253963", "type": "CDM"}], "standard_charges": [{"gross_charge": 741.0, "discounted_cash": 555.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 126.0, "discounted_cash": 94.5, "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": 126.0, "discounted_cash": 94.5, "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": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "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": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "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": 49.0, "discounted_cash": 36.75, "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": 49.0, "discounted_cash": 36.75, "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": 49.0, "discounted_cash": 36.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "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": 68.0, "discounted_cash": 51.0, "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": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPROPION 300MG XR24 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301744", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPROPION 300MG XR24 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301744", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "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": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BURR HOLE COVER II", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8172867", "type": "CDM"}], "standard_charges": [{"gross_charge": 272.0, "discounted_cash": 204.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BURR HOLE W/EXT DRAIN", "code_information": [{"code": "4916121", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 547.0, "discounted_cash": 410.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BUSHING DISTAL FEMORAL", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8131342", "type": "CDM"}], "standard_charges": [{"gross_charge": 2732.0, "discounted_cash": 2049.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BUSPIRONE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301761", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BUSPIRONE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301761", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BUSPIRONE 15MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301762", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BUSPIRONE 15MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301762", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BUSPIRONE 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301759", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BUSPIRONE 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301759", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 323.0, "discounted_cash": 242.25, "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": 323.0, "discounted_cash": 242.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BUTT PASTE PEDI CMPD OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334635", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 314.0, "discounted_cash": 235.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BUTT PASTE PEDI CMPD OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334635", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 314.0, "discounted_cash": 235.5, "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": 1095.0, "discounted_cash": 821.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BX ABD/RETROPER PERC NDL", "code_information": [{"code": "5010032", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4384.0, "discounted_cash": 3288.0, "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": 1095.0, "discounted_cash": 821.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BX ABD/RETROPER PERC NDL", "code_information": [{"code": "5067530", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 645.0, "discounted_cash": 483.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BX ABD/RETROPER PERC NDL", "code_information": [{"code": "49180", "type": "CPT"}, {"code": "5010083", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4384.0, "discounted_cash": 3288.0, "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": 11222.0, "discounted_cash": 8416.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BX BRST 1ST LESION US", "code_information": [{"code": "5069183", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7693.0, "discounted_cash": 5769.75, "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": 9482.0, "discounted_cash": 7111.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BX BRST ADD LESION US", "code_information": [{"code": "5069184", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7693.0, "discounted_cash": 5769.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BX BRST NDL UNGUIDED", "code_information": [{"code": "3071003", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1328.0, "discounted_cash": 996.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BX FORCEPS", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8081021", "type": "CDM"}], "standard_charges": [{"gross_charge": 4816.0, "discounted_cash": 3612.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BX LIVER PERC NDL", "code_information": [{"code": "4918215", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1878.0, "discounted_cash": 1408.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BX LIVER PERC NDL", "code_information": [{"code": "5017000", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5033.0, "discounted_cash": 3774.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BX LIVER PERC NDL", "code_information": [{"code": "5058215", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2108.0, "discounted_cash": 1581.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BX LIVER PERC NDL", "code_information": [{"code": "5067520", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1972.0, "discounted_cash": 1479.0, "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": 1812.0, "discounted_cash": 1359.0, "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": 1736.0, "discounted_cash": 1302.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BX MUSCLE PERC NDL", "code_information": [{"code": "5010025", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4291.0, "discounted_cash": 3218.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BX MUSCLE PERC NDL", "code_information": [{"code": "5057511", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 722.0, "discounted_cash": 541.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BX MUSCLE PERC NDL", "code_information": [{"code": "5067515", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 633.0, "discounted_cash": 474.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BX PANCREAS PERC NDL", "code_information": [{"code": "5057512", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1974.0, "discounted_cash": 1480.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BX PANCREAS PERC NDL", "code_information": [{"code": "5067525", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1974.0, "discounted_cash": 1480.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BX RENAL PERC NDL", "code_information": [{"code": "4917514", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2578.0, "discounted_cash": 1933.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BX RENAL PERC NDL", "code_information": [{"code": "5057514", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2206.0, "discounted_cash": 1654.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BX RENAL PERC NDL", "code_information": [{"code": "5067535", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2206.0, "discounted_cash": 1654.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BX SALIVARY GLAND NDL", "code_information": [{"code": "5010017", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3362.0, "discounted_cash": 2521.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BX SALIVARY GLAND NDL", "code_information": [{"code": "5062400", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5623.0, "discounted_cash": 4217.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BX SOFT TISSUE NECK/THOR", "code_information": [{"code": "5058575", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 8295.0, "discounted_cash": 6221.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BX THYROID PERC NDL", "code_information": [{"code": "5017545", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2873.0, "discounted_cash": 2154.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BX THYROID PERC NDL", "code_information": [{"code": "5057509", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1310.0, "discounted_cash": 982.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BX THYROID PERC NDL", "code_information": [{"code": "5067545", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1137.0, "discounted_cash": 852.75, "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": 477.0, "discounted_cash": 357.75, "setting": "both", "billing_class": "facility"}]}, {"description": "C DIFF TOXIN AMP PROBE", "code_information": [{"code": "87493", "type": "CPT"}, {"code": "4127493", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "C DIFF TOXIN AMP PROBE", "code_information": [{"code": "87493", "type": "CPT"}, {"code": "7077493", "type": "CDM"}], "standard_charges": [{"gross_charge": 1809.0, "discounted_cash": 1356.75, "setting": "both", "billing_class": "facility"}]}, {"description": "C DIFF TOXIN DIR OPT", "code_information": [{"code": "87803", "type": "CPT"}, {"code": "4107803", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 664.0, "discounted_cash": 498.0, "setting": "both", "billing_class": "facility"}]}, {"description": "C FUNGI SKIN HAIR NAIL/2", "code_information": [{"code": "87101", "type": "CPT"}, {"code": "7257102", "type": "CDM"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "C-PEPTIDE", "code_information": [{"code": "84681", "type": "CPT"}, {"code": "7003976", "type": "CDM"}], "standard_charges": [{"gross_charge": 1139.0, "discounted_cash": 854.25, "setting": "both", "billing_class": "facility"}]}, {"description": "C-PEPTIDE", "code_information": [{"code": "84681", "type": "CPT"}, {"code": "7253976", "type": "CDM"}], "standard_charges": [{"gross_charge": 1139.0, "discounted_cash": 854.25, "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": 106.0, "discounted_cash": 79.5, "setting": "both", "billing_class": "facility"}]}, {"description": "C-REACTIVE PROTEIN", "code_information": [{"code": "86140", "type": "CPT"}, {"code": "4126021", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "C-REACTIVE PROTEIN/2", "code_information": [{"code": "86140", "type": "CPT"}, {"code": "4106025", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 384.0, "discounted_cash": 288.0, "setting": "both", "billing_class": "facility"}]}, {"description": "C-REACTIVE PROTEIN/2", "code_information": [{"code": "86140", "type": "CPT"}, {"code": "4156025", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 146.0, "discounted_cash": 109.5, "setting": "both", "billing_class": "facility"}]}, {"description": "C/R EXER W/ ECG", "code_information": [{"code": "93798", "type": "CPT"}, {"code": "6010152", "type": "CDM"}, {"code": "943", "type": "RC"}], "standard_charges": [{"gross_charge": 424.0, "discounted_cash": 318.0, "setting": "both", "billing_class": "facility"}]}, {"description": "C/T FACET INJ+IMAGE LV3+", "code_information": [{"code": "4914492", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2212.0, "discounted_cash": 1659.0, "setting": "both", "billing_class": "facility"}]}, {"description": "C/T FACET INJ+IMAGE LVL1", "code_information": [{"code": "4914490", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6309.0, "discounted_cash": 4731.75, "setting": "both", "billing_class": "facility"}]}, {"description": "C/T FACET INJ+IMAGE LVL2", "code_information": [{"code": "4914491", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2349.0, "discounted_cash": 1761.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CA CARB CMPD PED DOSE LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314449", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.17, "discounted_cash": 0.13, "setting": "both", "billing_class": "facility"}]}, {"description": "CA CARB CMPD PED DOSE LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314449", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 0.17, "discounted_cash": 0.13, "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": 36.0, "discounted_cash": 27.0, "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": 36.0, "discounted_cash": 27.0, "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": 17.0, "discounted_cash": 12.75, "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": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CA DISO EDET UPTO 1GM IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0600", "type": "HCPCS"}, {"code": "5320320", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 840.0, "discounted_cash": 630.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CA DISO EDET UPTO 1GM IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0600", "type": "HCPCS"}, {"code": "5320320", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 840.0, "discounted_cash": 630.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CA GLUBIONT1.8/5 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314463", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.47, "discounted_cash": 0.35, "setting": "both", "billing_class": "facility"}]}, {"description": "CA GLUBIONT1.8/5 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314463", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 0.47, "discounted_cash": 0.35, "setting": "both", "billing_class": "facility"}]}, {"description": "CA GLUBIONT1.8/5 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314465", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CA GLUBIONT1.8/5 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314465", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CA GLUBIONT1.8/5 60ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314464", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CA GLUBIONT1.8/5 60ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314464", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "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": 280.0, "discounted_cash": 210.0, "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": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "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": 0.75, "discounted_cash": 0.56, "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": 0.75, "discounted_cash": 0.56, "setting": "both", "billing_class": "facility"}]}, {"description": "CABAZITAXEL PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9043", "type": "HCPCS"}, {"code": "5318771", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 719.0, "discounted_cash": 539.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CABAZITAXEL PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9043", "type": "HCPCS"}, {"code": "5318771", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 719.0, "discounted_cash": 539.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CABERGOLINE .5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301780", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 312.0, "discounted_cash": 234.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CABERGOLINE .5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301780", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 312.0, "discounted_cash": 234.0, "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": 0.27, "discounted_cash": 0.2, "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": 0.27, "discounted_cash": 0.2, "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": 0.11, "discounted_cash": 0.08, "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": 0.11, "discounted_cash": 0.08, "setting": "both", "billing_class": "facility"}]}, {"description": "CADEX IOD PAD 5GM 5BX", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334646", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 197.0, "discounted_cash": 147.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CADEX IOD PAD 5GM 5BX", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334646", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 197.0, "discounted_cash": 147.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CADEXOMER IODIN.9%40GMGL", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334648", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 579.0, "discounted_cash": 434.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CADEXOMER IODIN.9%40GMGL", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334648", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 579.0, "discounted_cash": 434.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CADMIUM", "code_information": [{"code": "82300", "type": "CPT"}, {"code": "7252300", "type": "CDM"}], "standard_charges": [{"gross_charge": 315.0, "discounted_cash": 236.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CAFFEINE 200MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301794", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CAFFEINE 200MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301794", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": 788.0, "discounted_cash": 591.0, "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": 788.0, "discounted_cash": 591.0, "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": 38.0, "discounted_cash": 28.5, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "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": 471.0, "discounted_cash": 353.25, "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": 94.0, "discounted_cash": 70.5, "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": 94.0, "discounted_cash": 70.5, "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": 19.0, "discounted_cash": 14.25, "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": 19.0, "discounted_cash": 14.25, "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": 124.0, "discounted_cash": 93.0, "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": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCIPOTRIENE 60ML TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334668", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1764.0, "discounted_cash": 1323.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCIPOTRIENE 60ML TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334668", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1764.0, "discounted_cash": 1323.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCITONIN", "code_information": [{"code": "82308", "type": "CPT"}, {"code": "7002308", "type": "CDM"}], "standard_charges": [{"gross_charge": 1315.0, "discounted_cash": 986.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCITONIN", "code_information": [{"code": "82308", "type": "CPT"}, {"code": "7252308", "type": "CDM"}], "standard_charges": [{"gross_charge": 1315.0, "discounted_cash": 986.25, "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": 491.0, "discounted_cash": 368.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 491.0, "discounted_cash": 368.25, "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": 7904.0, "discounted_cash": 5928.0, "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": 7904.0, "discounted_cash": 5928.0, "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": 847.0, "discounted_cash": 635.25, "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": 847.0, "discounted_cash": 635.25, "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": 52.0, "discounted_cash": 39.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCITRIOL .5MCG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301793", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCITRIOL .5MCG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301793", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCITRIOL PER 0.1MCG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0636", "type": "HCPCS"}, {"code": "5318805", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCITRIOL PER 0.1MCG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0636", "type": "HCPCS"}, {"code": "5318805", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCITRIOL1MCG/ML 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314470", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 101.0, "discounted_cash": 75.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCITRIOL1MCG/ML 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314470", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 101.0, "discounted_cash": 75.75, "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": 141.0, "discounted_cash": 105.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCIUM", "code_information": [{"code": "82310", "type": "CPT"}, {"code": "4122310", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCIUM", "code_information": [{"code": "82310", "type": "CPT"}, {"code": "4152310", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "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": 0.14, "discounted_cash": 0.11, "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": 0.14, "discounted_cash": 0.11, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCIUM CITRATE 950MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301831", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.48, "discounted_cash": 0.36, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCIUM CITRATE 950MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301831", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 0.48, "discounted_cash": 0.36, "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": 523.0, "discounted_cash": 392.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCIUM IONIZED", "code_information": [{"code": "82330", "type": "CPT"}, {"code": "4122330", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCIUM IONIZED", "code_information": [{"code": "82330", "type": "CPT"}, {"code": "7002330", "type": "CDM"}], "standard_charges": [{"gross_charge": 407.0, "discounted_cash": 305.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCIUM IONIZED", "code_information": [{"code": "82330", "type": "CPT"}, {"code": "7252330", "type": "CDM"}], "standard_charges": [{"gross_charge": 409.0, "discounted_cash": 306.75, "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": 673.0, "discounted_cash": 504.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCIUM URINE QUAN/2", "code_information": [{"code": "82340", "type": "CPT"}, {"code": "4122341", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCULUS QUAN", "code_information": [{"code": "82360", "type": "CPT"}, {"code": "7002360", "type": "CDM"}], "standard_charges": [{"gross_charge": 1250.0, "discounted_cash": 937.5, "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": 10239.0, "discounted_cash": 7679.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CALPROTECTIN FECAL", "code_information": [{"code": "83993", "type": "CPT"}, {"code": "7254001", "type": "CDM"}], "standard_charges": [{"gross_charge": 790.0, "discounted_cash": 592.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CALR EXON 9 VARIANTS", "code_information": [{"code": "81219", "type": "CPT"}, {"code": "7050036", "type": "CDM"}], "standard_charges": [{"gross_charge": 871.0, "discounted_cash": 653.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CAMPHOR/MENTHOL240MLLT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334710", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 160.0, "discounted_cash": 120.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CAMPHOR/MENTHOL240MLLT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334710", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 160.0, "discounted_cash": 120.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CAMPYLOBACTER AB", "code_information": [{"code": "86625", "type": "CPT"}, {"code": "7016625", "type": "CDM"}], "standard_charges": [{"gross_charge": 801.0, "discounted_cash": 600.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CAMPYLOBACTER AB", "code_information": [{"code": "86625", "type": "CPT"}, {"code": "7256625", "type": "CDM"}], "standard_charges": [{"gross_charge": 808.0, "discounted_cash": 606.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CANDIDA AB", "code_information": [{"code": "86628", "type": "CPT"}, {"code": "7256049", "type": "CDM"}], "standard_charges": [{"gross_charge": 328.0, "discounted_cash": 246.0, "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": 258.0, "discounted_cash": 193.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CANNABINOID GC/MS QUANT", "code_information": [{"code": "80349", "type": "CPT"}, {"code": "7258316", "type": "CDM"}], "standard_charges": [{"gross_charge": 269.0, "discounted_cash": 201.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CANNULATION THORACIC DUCT", "code_information": [{"code": "4918794", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1095.0, "discounted_cash": 821.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CAP END FEM/TIB CANAL", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8131509", "type": "CDM"}], "standard_charges": [{"gross_charge": 2296.0, "discounted_cash": 1722.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CAPECITABINE PER 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8522", "type": "HCPCS"}, {"code": "5301919", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CAPECITABINE PER 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8522", "type": "HCPCS"}, {"code": "5301919", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CAPLACIZUMAB-YHDP PER 1MG IJ", "code_information": [{"code": "C9047", "type": "HCPCS"}, {"code": "5318857", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3656.0, "discounted_cash": 2742.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CAPLACIZUMAB-YHDP PER 1MG IJ", "code_information": [{"code": "C9047", "type": "HCPCS"}, {"code": "5318857", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 3656.0, "discounted_cash": 2742.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CAPSAICIN .025% 60GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334728", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 162.0, "discounted_cash": 121.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CAPSAICIN .025% 60GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334728", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 162.0, "discounted_cash": 121.5, "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": 222.0, "discounted_cash": 166.5, "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": 222.0, "discounted_cash": 166.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CAPSAICIN .075% 30GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334731", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 267.0, "discounted_cash": 200.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CAPSAICIN .075% 30GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334731", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 267.0, "discounted_cash": 200.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CAPTOPRIL 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301935", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 62.0, "discounted_cash": 46.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CAPTOPRIL 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301935", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 62.0, "discounted_cash": 46.5, "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": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "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": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CAPTOPRIL 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301927", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 59.0, "discounted_cash": 44.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CAPTOPRIL 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301927", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 59.0, "discounted_cash": 44.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CAPTOPRIL 6.25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301921", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CAPTOPRIL 6.25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301921", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "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": 39.0, "discounted_cash": 29.25, "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": 317.0, "discounted_cash": 237.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBACHOL 3% 15ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330471", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 435.0, "discounted_cash": 326.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBACHOL 3% 15ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330471", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 435.0, "discounted_cash": 326.25, "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": 1381.0, "discounted_cash": 1035.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBAMAZAPINE", "code_information": [{"code": "80156", "type": "CPT"}, {"code": "4122372", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBAMAZAPINE", "code_information": [{"code": "80156", "type": "CPT"}, {"code": "4152372", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 343.0, "discounted_cash": 257.25, "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": 34.0, "discounted_cash": 25.5, "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": 34.0, "discounted_cash": 25.5, "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": 36.0, "discounted_cash": 27.0, "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": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBAMAZEPINE 100MG XRTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301976", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBAMAZEPINE 100MG XRTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301976", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "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": 36.0, "discounted_cash": 27.0, "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": 36.0, "discounted_cash": 27.0, "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": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBAMAZEPINE FREE", "code_information": [{"code": "80157", "type": "CPT"}, {"code": "7250157", "type": "CDM"}], "standard_charges": [{"gross_charge": 178.0, "discounted_cash": 133.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBAMAZEPINE100/5 5MLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314482", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBAMAZEPINE100/5 5MLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314482", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "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": 36.0, "discounted_cash": 27.0, "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": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBAMIDE PEROXID60ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314485", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBAMIDE PEROXID60ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314485", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "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": 90.0, "discounted_cash": 67.5, "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": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBAMIDE PERX6.5%30MLOT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5330491", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 181.0, "discounted_cash": 135.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBAMIDE PERX6.5%30MLOT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5330491", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 181.0, "discounted_cash": 135.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBHYDRT DEFC TRNSFRRN", "code_information": [{"code": "82373", "type": "CPT"}, {"code": "7252373", "type": "CDM"}], "standard_charges": [{"gross_charge": 578.0, "discounted_cash": 433.5, "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": 39.0, "discounted_cash": 29.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBIDOPA/LEVD 12/50 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302029", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBIDOPA/LEVD 12/50 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302029", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "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": 39.0, "discounted_cash": 29.25, "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": 39.0, "discounted_cash": 29.25, "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": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBIDOPA/LEVD25/100XRTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302032", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBIDOPA/LEVD25/100XRTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302032", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 58.0, "discounted_cash": 43.5, "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": 58.0, "discounted_cash": 43.5, "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": 193.0, "discounted_cash": 144.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBON DIOXIDE", "code_information": [{"code": "82374", "type": "CPT"}, {"code": "4122374", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBON DIOXIDE", "code_information": [{"code": "82374", "type": "CPT"}, {"code": "4152374", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBON DIOXIDE/2", "code_information": [{"code": "82374", "type": "CPT"}, {"code": "7252382", "type": "CDM"}], "standard_charges": [{"gross_charge": 284.0, "discounted_cash": 213.0, "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": 227.0, "discounted_cash": 170.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBON MONOXIDE QUAN", "code_information": [{"code": "82375", "type": "CPT"}, {"code": "4122375", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBON PARTICL PUR 5MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5318900", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 432.0, "discounted_cash": 324.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBOPLATIN PER50MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9045", "type": "HCPCS"}, {"code": "5318911", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1531.0, "discounted_cash": 1148.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBOPLATIN PER50MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9045", "type": "HCPCS"}, {"code": "5318911", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1531.0, "discounted_cash": 1148.25, "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": 571.14, "discounted_cash": 428.36, "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": 571.14, "discounted_cash": 428.36, "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": 807.0, "discounted_cash": 605.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CARCINO-EMBRYONIC AG", "code_information": [{"code": "82378", "type": "CPT"}, {"code": "4126151", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CARCINO-EMBRYONIC AG", "code_information": [{"code": "82378", "type": "CPT"}, {"code": "4156151", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 425.0, "discounted_cash": 318.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CARCINO-EMBRYONIC AG", "code_information": [{"code": "82378", "type": "CPT"}, {"code": "7252378", "type": "CDM"}], "standard_charges": [{"gross_charge": 134.0, "discounted_cash": 100.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CARDIAC DOPPLER FU/LTD", "code_information": [{"code": "93321", "type": "CPT"}, {"code": "4603328", "type": "CDM"}, {"code": "483", "type": "RC"}], "standard_charges": [{"gross_charge": 2505.0, "discounted_cash": 1878.75, "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": 2167.0, "discounted_cash": 1625.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CARDIO STRESS TRACE ONLY", "code_information": [{"code": "93017", "type": "CPT"}, {"code": "4633017", "type": "CDM"}, {"code": "482", "type": "RC"}], "standard_charges": [{"gross_charge": 2167.0, "discounted_cash": 1625.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CARDIOLIPIN AB EA IG/2", "code_information": [{"code": "86147", "type": "CPT"}, {"code": "7006382", "type": "CDM"}], "standard_charges": [{"gross_charge": 385.0, "discounted_cash": 288.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CARDIOLIPIN AB EA IG/2", "code_information": [{"code": "86147", "type": "CPT"}, {"code": "7256382", "type": "CDM"}], "standard_charges": [{"gross_charge": 385.0, "discounted_cash": 288.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CARDIOLIPIN AB EA IG/3", "code_information": [{"code": "86147", "type": "CPT"}, {"code": "7006385", "type": "CDM"}], "standard_charges": [{"gross_charge": 408.0, "discounted_cash": 306.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CARDIOLIPIN AB EA IG/3", "code_information": [{"code": "86147", "type": "CPT"}, {"code": "7256385", "type": "CDM"}], "standard_charges": [{"gross_charge": 408.0, "discounted_cash": 306.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CARDIOLIPIN AB EA IG/4", "code_information": [{"code": "86147", "type": "CPT"}, {"code": "7006386", "type": "CDM"}], "standard_charges": [{"gross_charge": 408.0, "discounted_cash": 306.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CARDIOLIPIN AB EA IG/4", "code_information": [{"code": "86147", "type": "CPT"}, {"code": "7256386", "type": "CDM"}], "standard_charges": [{"gross_charge": 408.0, "discounted_cash": 306.0, "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": 1650.0, "discounted_cash": 1237.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CARDIOVERSION", "code_information": [{"code": "92960", "type": "CPT"}, {"code": "6112960", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 3478.0, "discounted_cash": 2608.5, "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": 3630.0, "discounted_cash": 2722.5, "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": 2849.0, "discounted_cash": 2136.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CARDIOVERSION ELECTIVE", "code_information": [{"code": "92960", "type": "CPT"}, {"code": "6292960", "type": "CDM"}], "standard_charges": [{"gross_charge": 3478.0, "discounted_cash": 2608.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CARDIOVERSION INTERNAL", "code_information": [{"code": "92961", "type": "CPT"}, {"code": "4612961", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 3048.0, "discounted_cash": 2286.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CARFILZOMIB 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9047", "type": "HCPCS"}, {"code": "5318922", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 274.0, "discounted_cash": 205.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CARFILZOMIB 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9047", "type": "HCPCS"}, {"code": "5318922", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 274.0, "discounted_cash": 205.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CARIPRAZINE 1.5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302051", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 242.0, "discounted_cash": 181.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CARIPRAZINE 1.5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302051", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 242.0, "discounted_cash": 181.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CARISOPRODOL 350MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302058", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CARISOPRODOL 350MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302058", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CARMUSTINE 7.7MG WAFR IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9999", "type": "HCPCS"}, {"code": "5323455", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 16720.0, "discounted_cash": 12540.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CARMUSTINE 7.7MG WAFR IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9999", "type": "HCPCS"}, {"code": "5323455", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 16720.0, "discounted_cash": 12540.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CARMUSTINE PER100MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9050", "type": "HCPCS"}, {"code": "5318924", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1825.0, "discounted_cash": 1368.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CARMUSTINE PER100MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9050", "type": "HCPCS"}, {"code": "5318924", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1825.0, "discounted_cash": 1368.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CARNITINE", "code_information": [{"code": "82379", "type": "CPT"}, {"code": "7252379", "type": "CDM"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CAROTENE", "code_information": [{"code": "82380", "type": "CPT"}, {"code": "7002380", "type": "CDM"}], "standard_charges": [{"gross_charge": 726.0, "discounted_cash": 544.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CAROTENE", "code_information": [{"code": "82380", "type": "CPT"}, {"code": "7252380", "type": "CDM"}], "standard_charges": [{"gross_charge": 726.0, "discounted_cash": 544.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CARTEOLOL 1% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330493", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 349.0, "discounted_cash": 261.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CARTEOLOL 1% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330493", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 349.0, "discounted_cash": 261.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CARVEDILOL 1.563MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302074", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CARVEDILOL 1.563MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302074", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "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": 64.0, "discounted_cash": 48.0, "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": 64.0, "discounted_cash": 48.0, "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": 60.0, "discounted_cash": 45.0, "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": 60.0, "discounted_cash": 45.0, "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": 59.0, "discounted_cash": 44.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 59.0, "discounted_cash": 44.25, "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": 63.0, "discounted_cash": 47.25, "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": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CASPOFUNGIN PER 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0637", "type": "HCPCS"}, {"code": "5318933", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 868.0, "discounted_cash": 651.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CASPOFUNGIN PER 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0637", "type": "HCPCS"}, {"code": "5318933", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 868.0, "discounted_cash": 651.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATECHOLAMINES FRAC", "code_information": [{"code": "82384", "type": "CPT"}, {"code": "7252384", "type": "CDM"}], "standard_charges": [{"gross_charge": 1093.0, "discounted_cash": 819.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATECHOLAMINES FRAC/2", "code_information": [{"code": "82384", "type": "CPT"}, {"code": "7002020", "type": "CDM"}], "standard_charges": [{"gross_charge": 1400.0, "discounted_cash": 1050.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATECHOLAMINES FRAC/2", "code_information": [{"code": "82384", "type": "CPT"}, {"code": "7252385", "type": "CDM"}], "standard_charges": [{"gross_charge": 177.0, "discounted_cash": 132.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATECHOLAMINES FRAC/3", "code_information": [{"code": "82384", "type": "CPT"}, {"code": "7252386", "type": "CDM"}], "standard_charges": [{"gross_charge": 1093.0, "discounted_cash": 819.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATECHOLAMINES FRAC/4", "code_information": [{"code": "82384", "type": "CPT"}, {"code": "7002386", "type": "CDM"}], "standard_charges": [{"gross_charge": 1093.0, "discounted_cash": 819.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ABL BI-DIR IRRIGATD", "code_information": [{"code": "C2630", "type": "HCPCS"}, {"code": "8055015", "type": "CDM"}], "standard_charges": [{"gross_charge": 9850.0, "discounted_cash": 7387.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ABL BIDRCT THRMCOOL", "code_information": [{"code": "C1732", "type": "HCPCS"}, {"code": "8055003", "type": "CDM"}], "standard_charges": [{"gross_charge": 24259.0, "discounted_cash": 18194.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ABL BLAZER II HTORQ", "code_information": [{"code": "C1733", "type": "HCPCS"}, {"code": "8240637", "type": "CDM"}], "standard_charges": [{"gross_charge": 8856.0, "discounted_cash": 6642.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ABL BLAZER II XP", "code_information": [{"code": "C1733", "type": "HCPCS"}, {"code": "8240638", "type": "CDM"}], "standard_charges": [{"gross_charge": 11109.0, "discounted_cash": 8331.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ABL COOL PATH BRD", "code_information": [{"code": "C2630", "type": "HCPCS"}, {"code": "4031180", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 13938.0, "discounted_cash": 10453.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ABL EP FIX WEBSTER", "code_information": [{"code": "C1730", "type": "HCPCS"}, {"code": "8055024", "type": "CDM"}], "standard_charges": [{"gross_charge": 2234.0, "discounted_cash": 1675.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ABL IRRIG TACTICATH", "code_information": [{"code": "C2630", "type": "HCPCS"}, {"code": "8055011", "type": "CDM"}], "standard_charges": [{"gross_charge": 17311.0, "discounted_cash": 12983.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ABL NAVISTAR DS", "code_information": [{"code": "C1732", "type": "HCPCS"}, {"code": "8240646", "type": "CDM"}], "standard_charges": [{"gross_charge": 16747.0, "discounted_cash": 12560.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ABL PENTARAY NAV", "code_information": [{"code": "C1732", "type": "HCPCS"}, {"code": "8056048", "type": "CDM"}], "standard_charges": [{"gross_charge": 11155.0, "discounted_cash": 8366.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ABL SAFIRE", "code_information": [{"code": "C1733", "type": "HCPCS"}, {"code": "8240028", "type": "CDM"}], "standard_charges": [{"gross_charge": 5966.0, "discounted_cash": 4474.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ABL THERMISTR N-BRD", "code_information": [{"code": "C1733", "type": "HCPCS"}, {"code": "8055012", "type": "CDM"}], "standard_charges": [{"gross_charge": 5693.0, "discounted_cash": 4269.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ABL THERMOCL BI-DIR", "code_information": [{"code": "C2630", "type": "HCPCS"}, {"code": "8055013", "type": "CDM"}], "standard_charges": [{"gross_charge": 11388.0, "discounted_cash": 8541.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ABL THERMOCPL BIDIR", "code_information": [{"code": "C1733", "type": "HCPCS"}, {"code": "8055014", "type": "CDM"}], "standard_charges": [{"gross_charge": 6361.0, "discounted_cash": 4770.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ABL UNI-DIRECT W/CURV", "code_information": [{"code": "C1732", "type": "HCPCS"}, {"code": "8055017", "type": "CDM"}], "standard_charges": [{"gross_charge": 19572.0, "discounted_cash": 14679.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ACCESS BENCHMARK BMX", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8051736", "type": "CDM"}], "standard_charges": [{"gross_charge": 9965.0, "discounted_cash": 7473.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ACCESS DUAL LUMEN", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8056003", "type": "CDM"}], "standard_charges": [{"gross_charge": 1062.0, "discounted_cash": 796.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ACUNAV ULTRSND DIAG", "code_information": [{"code": "C1759", "type": "HCPCS"}, {"code": "8240022", "type": "CDM"}], "standard_charges": [{"gross_charge": 19665.0, "discounted_cash": 14748.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ANG QUICK-CROSS", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8240029", "type": "CDM"}], "standard_charges": [{"gross_charge": 1281.0, "discounted_cash": 960.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ANG TRANSLUM NLSR2", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8240126", "type": "CDM"}], "standard_charges": [{"gross_charge": 1657.0, "discounted_cash": 1242.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ANG TRANSLUM NLSR3", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8240128", "type": "CDM"}], "standard_charges": [{"gross_charge": 2294.0, "discounted_cash": 1720.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ANG TRANSLUM NLSR4", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8240141", "type": "CDM"}], "standard_charges": [{"gross_charge": 4668.0, "discounted_cash": 3501.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ANG TRANSLUMINL LSR", "code_information": [{"code": "C1885", "type": "HCPCS"}, {"code": "8240123", "type": "CDM"}], "standard_charges": [{"gross_charge": 14269.0, "discounted_cash": 10701.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ANG TRANSLUMNL NLSR", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8240125", "type": "CDM"}], "standard_charges": [{"gross_charge": 1365.0, "discounted_cash": 1023.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ANGIO", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8057001", "type": "CDM"}], "standard_charges": [{"gross_charge": 664.0, "discounted_cash": 498.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ANGIO OMNI FLUSH", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056013", "type": "CDM"}], "standard_charges": [{"gross_charge": 1000.0, "discounted_cash": 750.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ANGIOJET RHEO THROM", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8240026", "type": "CDM"}], "standard_charges": [{"gross_charge": 11534.0, "discounted_cash": 8650.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ASPIRATION EXPORTAP", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8056052", "type": "CDM"}], "standard_charges": [{"gross_charge": 2894.0, "discounted_cash": 2170.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ASPIRATION FLASH HTORQ", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8050019", "type": "CDM"}], "standard_charges": [{"gross_charge": 82319.0, "discounted_cash": 61739.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ASPIRATION GDE TRIEVER20", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8056057", "type": "CDM"}], "standard_charges": [{"gross_charge": 105224.0, "discounted_cash": 78918.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ASPIRATION HTORQ INDIGO", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8050017", "type": "CDM"}], "standard_charges": [{"gross_charge": 57069.0, "discounted_cash": 42801.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ASPIRATION XTORQ INDIGO", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8177027", "type": "CDM"}], "standard_charges": [{"gross_charge": 61130.0, "discounted_cash": 45847.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ATHER JETSTREAM G2", "code_information": [{"code": "C1724", "type": "HCPCS"}, {"code": "8056044", "type": "CDM"}], "standard_charges": [{"gross_charge": 30530.0, "discounted_cash": 22897.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ATHER SILVERHAWK", "code_information": [{"code": "C1714", "type": "HCPCS"}, {"code": "8240739", "type": "CDM"}], "standard_charges": [{"gross_charge": 19598.0, "discounted_cash": 14698.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ATHER STEALTH 360", "code_information": [{"code": "C1724", "type": "HCPCS"}, {"code": "8056043", "type": "CDM"}], "standard_charges": [{"gross_charge": 21048.0, "discounted_cash": 15786.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ATHERCTMY HYDROHLC AURYON", "code_information": [{"code": "C1885", "type": "HCPCS"}, {"code": "8056573", "type": "CDM"}], "standard_charges": [{"gross_charge": 32140.0, "discounted_cash": 24105.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ATHERECTOMY DIRECT", "code_information": [{"code": "C1714", "type": "HCPCS"}, {"code": "8056045", "type": "CDM"}], "standard_charges": [{"gross_charge": 30159.0, "discounted_cash": 22619.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ATHR TRANSLUM DIREC", "code_information": [{"code": "C1714", "type": "HCPCS"}, {"code": "8240127", "type": "CDM"}], "standard_charges": [{"gross_charge": 23.0, "discounted_cash": 17.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ATHR TRANSLUM ROTAT", "code_information": [{"code": "C1724", "type": "HCPCS"}, {"code": "8240129", "type": "CDM"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ATTAIN COMND SURVLV", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056426", "type": "CDM"}], "standard_charges": [{"gross_charge": 1910.0, "discounted_cash": 1432.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BAL DIL SINUS", "code_information": [{"code": "C1726", "type": "HCPCS"}, {"code": "8056054", "type": "CDM"}], "standard_charges": [{"gross_charge": 5616.0, "discounted_cash": 4212.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BALLOON BILIARY DILATOR", "code_information": [{"code": "C1726", "type": "HCPCS"}, {"code": "8055095", "type": "CDM"}], "standard_charges": [{"gross_charge": 2537.0, "discounted_cash": 1902.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BI-DIRECTIONAL VARIPULSE", "code_information": [{"code": "C1732", "type": "HCPCS"}, {"code": "8055029", "type": "CDM"}], "standard_charges": [{"gross_charge": 71149.0, "discounted_cash": 53361.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BIDIRECT PFA OTW 170", "code_information": [{"code": "C1733", "type": "HCPCS"}, {"code": "8245501", "type": "CDM"}], "standard_charges": [{"gross_charge": 80891.0, "discounted_cash": 60668.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLLN AGNT PACLITAXEL NTAP", "code_information": [{"code": "C9610", "type": "HCPCS"}, {"code": "8058510", "type": "CDM"}], "standard_charges": [{"gross_charge": 20323.0, "discounted_cash": 15242.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLLN GUIDE CELLO", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056102", "type": "CDM"}], "standard_charges": [{"gross_charge": 11755.0, "discounted_cash": 8816.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLLN GUIDE FLOWGATE", "code_information": [{"code": "C2628", "type": "HCPCS"}, {"code": "8056092", "type": "CDM"}], "standard_charges": [{"gross_charge": 15322.0, "discounted_cash": 11491.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLN CUTTING", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056031", "type": "CDM"}], "standard_charges": [{"gross_charge": 4849.0, "discounted_cash": 3636.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLN CUTTING WOLVERINE", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056066", "type": "CDM"}], "standard_charges": [{"gross_charge": 8646.0, "discounted_cash": 6484.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLN DIL COYOTE OTW", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056072", "type": "CDM"}], "standard_charges": [{"gross_charge": 2203.0, "discounted_cash": 1652.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLN DIL HURRICANERX", "code_information": [{"code": "C1726", "type": "HCPCS"}, {"code": "4031252", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2407.0, "discounted_cash": 1805.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLN DIL METACROSS RX", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056074", "type": "CDM"}], "standard_charges": [{"gross_charge": 1455.0, "discounted_cash": 1091.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLN DIL MINI TREK", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8051726", "type": "CDM"}], "standard_charges": [{"gross_charge": 836.0, "discounted_cash": 627.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLN DIL NC EUPHORA", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056094", "type": "CDM"}], "standard_charges": [{"gross_charge": 911.0, "discounted_cash": 683.25, "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": 1899.0, "discounted_cash": 1424.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLN DIL NONVASCULAR", "code_information": [{"code": "C1726", "type": "HCPCS"}, {"code": "8240074", "type": "CDM"}], "standard_charges": [{"gross_charge": 2770.0, "discounted_cash": 2077.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLN DIL SC EUPHORA", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056093", "type": "CDM"}], "standard_charges": [{"gross_charge": 453.0, "discounted_cash": 339.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLN DIL SPRINTER", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8245164", "type": "CDM"}], "standard_charges": [{"gross_charge": 1051.0, "discounted_cash": 788.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLN DIL STERLNG MR", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "4031256", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1784.0, "discounted_cash": 1338.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLN DIL STERLNG OTW", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8240035", "type": "CDM"}], "standard_charges": [{"gross_charge": 1682.0, "discounted_cash": 1261.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLN DIL TCAR ENFLATE RX", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8058035", "type": "CDM"}], "standard_charges": [{"gross_charge": 2678.0, "discounted_cash": 2008.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLN DIL XXL LARGE", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8245215", "type": "CDM"}], "standard_charges": [{"gross_charge": 1879.0, "discounted_cash": 1409.25, "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": 4810.0, "discounted_cash": 3607.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLN PTA POWERFLX P3", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8245240", "type": "CDM"}], "standard_charges": [{"gross_charge": 955.0, "discounted_cash": 716.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLN RANGER GLOBAL DCB", "code_information": [{"code": "C2623", "type": "HCPCS"}, {"code": "8050015", "type": "CDM"}], "standard_charges": [{"gross_charge": 1830.0, "discounted_cash": 1372.5, "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": 4747.0, "discounted_cash": 3560.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLN TIS DISSCT NVAS", "code_information": [{"code": "C1727", "type": "HCPCS"}, {"code": "8240076", "type": "CDM"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLN VENOGRAM", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056101", "type": "CDM"}], "standard_charges": [{"gross_charge": 681.0, "discounted_cash": 510.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BRACHYTHER SEED ADM", "code_information": [{"code": "C1728", "type": "HCPCS"}, {"code": "8240078", "type": "CDM"}], "standard_charges": [{"gross_charge": 23883.0, "discounted_cash": 17912.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH CARD ULT ICE 9F9MHZ", "code_information": [{"code": "C1759", "type": "HCPCS"}, {"code": "8240772", "type": "CDM"}], "standard_charges": [{"gross_charge": 7783.0, "discounted_cash": 5837.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH CERVICAL RIPENING", "code_information": [{"code": "C1726", "type": "HCPCS"}, {"code": "8031589", "type": "CDM"}], "standard_charges": [{"gross_charge": 372.0, "discounted_cash": 279.0, "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": 23109.0, "discounted_cash": 17331.75, "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": 23109.0, "discounted_cash": 17331.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH COR DIAG OPTITORQUE", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8058045", "type": "CDM"}], "standard_charges": [{"gross_charge": 291.0, "discounted_cash": 218.25, "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": 18868.0, "discounted_cash": 14151.0, "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": 18868.0, "discounted_cash": 14151.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH CORONARY IMAGING", "code_information": [{"code": "C1753", "type": "HCPCS"}, {"code": "8058046", "type": "CDM"}], "standard_charges": [{"gross_charge": 892.0, "discounted_cash": 669.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH CROSSING CTO", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8058048", "type": "CDM"}], "standard_charges": [{"gross_charge": 26216.0, "discounted_cash": 19662.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH CROSSING CTO OCELOT", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8058047", "type": "CDM"}], "standard_charges": [{"gross_charge": 26216.0, "discounted_cash": 19662.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH CROSSING CTO VIANCE", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056372", "type": "CDM"}], "standard_charges": [{"gross_charge": 12882.0, "discounted_cash": 9661.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH CRYO ABL ELECTRD", "code_information": [{"code": "C1732", "type": "HCPCS"}, {"code": "4031300", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 46424.0, "discounted_cash": 34818.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH CRYOABL ARCTC FRONT", "code_information": [{"code": "C1733", "type": "HCPCS"}, {"code": "8056374", "type": "CDM"}], "standard_charges": [{"gross_charge": 37534.0, "discounted_cash": 28150.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH DELIVERY LONG SHTH", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056911", "type": "CDM"}], "standard_charges": [{"gross_charge": 6405.0, "discounted_cash": 4803.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH DIAG ENSITE ARRAY", "code_information": [{"code": "C1732", "type": "HCPCS"}, {"code": "4033040", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 22927.0, "discounted_cash": 17195.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH DIAG EP MAPPING", "code_information": [{"code": "C1730", "type": "HCPCS"}, {"code": "8058050", "type": "CDM"}], "standard_charges": [{"gross_charge": 5458.0, "discounted_cash": 4093.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH DIAG MAPP ADVISOR HD GRID", "code_information": [{"code": "C1730", "type": "HCPCS"}, {"code": "8058040", "type": "CDM"}], "standard_charges": [{"gross_charge": 20489.0, "discounted_cash": 15366.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH DIAG MULTI ELCT MAP", "code_information": [{"code": "C1732", "type": "HCPCS"}, {"code": "8056384", "type": "CDM"}], "standard_charges": [{"gross_charge": 14041.0, "discounted_cash": 10530.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH DIAG NAVI-STAR", "code_information": [{"code": "C1732", "type": "HCPCS"}, {"code": "8240080", "type": "CDM"}], "standard_charges": [{"gross_charge": 14170.0, "discounted_cash": 10627.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH DIAG STEERBL DECPLR", "code_information": [{"code": "C1730", "type": "HCPCS"}, {"code": "8055078", "type": "CDM"}], "standard_charges": [{"gross_charge": 4456.0, "discounted_cash": 3342.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH DIAG/ABL DEFL TP SF", "code_information": [{"code": "C1732", "type": "HCPCS"}, {"code": "8056382", "type": "CDM"}], "standard_charges": [{"gross_charge": 22152.0, "discounted_cash": 16614.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH DIAL PALINDROME", "code_information": [{"code": "C1752", "type": "HCPCS"}, {"code": "4031309", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 22066.0, "discounted_cash": 16549.5, "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": 19120.0, "discounted_cash": 14340.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH DIL BLN PTA RIVAL", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8055079", "type": "CDM"}], "standard_charges": [{"gross_charge": 879.0, "discounted_cash": 659.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH DIL PTA ATLAS", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8240793", "type": "CDM"}], "standard_charges": [{"gross_charge": 2655.0, "discounted_cash": 1991.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH DISTAL ACCESS AXS CAT 5", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8051732", "type": "CDM"}], "standard_charges": [{"gross_charge": 23009.0, "discounted_cash": 17256.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH DISTAL ACCESS PHENOM PLUS", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8051731", "type": "CDM"}], "standard_charges": [{"gross_charge": 20469.0, "discounted_cash": 15351.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH DRAINAGE", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8240082", "type": "CDM"}], "standard_charges": [{"gross_charge": 225.0, "discounted_cash": 168.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH DRAINAGE MALECOT", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8245531", "type": "CDM"}], "standard_charges": [{"gross_charge": 195.0, "discounted_cash": 146.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH DUAL ACCES TWIN-PAS", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8051729", "type": "CDM"}], "standard_charges": [{"gross_charge": 2552.0, "discounted_cash": 1914.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ELECTROHEMOSTASIS", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8056489", "type": "CDM"}], "standard_charges": [{"gross_charge": 2078.0, "discounted_cash": 1558.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH EMBOLECTOMY", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8056318", "type": "CDM"}], "standard_charges": [{"gross_charge": 444.0, "discounted_cash": 333.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH EP DECAPOLAR", "code_information": [{"code": "C1730", "type": "HCPCS"}, {"code": "4031345", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5064.0, "discounted_cash": 3798.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH EP DECAPOLR DEFL TI", "code_information": [{"code": "C1730", "type": "HCPCS"}, {"code": "8240810", "type": "CDM"}], "standard_charges": [{"gross_charge": 4823.0, "discounted_cash": 3617.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH EP DFLECT TP BS WEB", "code_information": [{"code": "C1730", "type": "HCPCS"}, {"code": "8245550", "type": "CDM"}], "standard_charges": [{"gross_charge": 6024.0, "discounted_cash": 4518.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH EP DIAG NOT3D 19OR<", "code_information": [{"code": "C1730", "type": "HCPCS"}, {"code": "8240084", "type": "CDM"}], "standard_charges": [{"gross_charge": 1230.0, "discounted_cash": 922.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH EP DIAG NOT3D 20OR>", "code_information": [{"code": "C1731", "type": "HCPCS"}, {"code": "8240086", "type": "CDM"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH EP DX/ABL 3D/VECTR", "code_information": [{"code": "C1732", "type": "HCPCS"}, {"code": "8240088", "type": "CDM"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH EP FC RESPONSE", "code_information": [{"code": "C1730", "type": "HCPCS"}, {"code": "8245572", "type": "CDM"}], "standard_charges": [{"gross_charge": 1159.0, "discounted_cash": 869.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH EP FC SUPREME", "code_information": [{"code": "C1730", "type": "HCPCS"}, {"code": "8245574", "type": "CDM"}], "standard_charges": [{"gross_charge": 1333.0, "discounted_cash": 999.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH EP INQUIRY OPTIMA", "code_information": [{"code": "C1731", "type": "HCPCS"}, {"code": "4031348", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 15173.0, "discounted_cash": 11379.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH EP INQUIRY STEER", "code_information": [{"code": "C1730", "type": "HCPCS"}, {"code": "4031347", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3156.0, "discounted_cash": 2367.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH EP LASSO DEFL CIRC", "code_information": [{"code": "C1731", "type": "HCPCS"}, {"code": "8240817", "type": "CDM"}], "standard_charges": [{"gross_charge": 8269.0, "discounted_cash": 6201.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH EP LVWR STEERABLE", "code_information": [{"code": "C1730", "type": "HCPCS"}, {"code": "8240818", "type": "CDM"}], "standard_charges": [{"gross_charge": 3162.0, "discounted_cash": 2371.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH EP MAP ISMUS AUTOID", "code_information": [{"code": "C1731", "type": "HCPCS"}, {"code": "8056348", "type": "CDM"}], "standard_charges": [{"gross_charge": 8089.0, "discounted_cash": 6066.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH EP MARINR", "code_information": [{"code": "C1733", "type": "HCPCS"}, {"code": "8245600", "type": "CDM"}], "standard_charges": [{"gross_charge": 4369.0, "discounted_cash": 3276.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH EP OCTAPOLR DEFL TI", "code_information": [{"code": "C1730", "type": "HCPCS"}, {"code": "8240832", "type": "CDM"}], "standard_charges": [{"gross_charge": 2155.0, "discounted_cash": 1616.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH EP OTH THN COOL TIP", "code_information": [{"code": "C1733", "type": "HCPCS"}, {"code": "8240092", "type": "CDM"}], "standard_charges": [{"gross_charge": 3611.0, "discounted_cash": 2708.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH EP OTH THN COOL TP2", "code_information": [{"code": "C1733", "type": "HCPCS"}, {"code": "4031352", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 7894.0, "discounted_cash": 5920.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH EP RESPONSE DECAPLR", "code_information": [{"code": "C1730", "type": "HCPCS"}, {"code": "4031351", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2939.0, "discounted_cash": 2204.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH EP SUPREME QUAD", "code_information": [{"code": "C1730", "type": "HCPCS"}, {"code": "4031355", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1080.0, "discounted_cash": 810.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH EP THERMCOOL IRR TP", "code_information": [{"code": "C2630", "type": "HCPCS"}, {"code": "8056349", "type": "CDM"}], "standard_charges": [{"gross_charge": 10047.0, "discounted_cash": 7535.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH EP WEBSTR CS BI-DIR", "code_information": [{"code": "C1730", "type": "HCPCS"}, {"code": "8056351", "type": "CDM"}], "standard_charges": [{"gross_charge": 3503.0, "discounted_cash": 2627.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ESOPHAGEAL MAPPING", "code_information": [{"code": "C1732", "type": "HCPCS"}, {"code": "8056344", "type": "CDM"}], "standard_charges": [{"gross_charge": 3189.0, "discounted_cash": 2391.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH FLOW-DIRECTED BLLN", "code_information": [{"code": "C2628", "type": "HCPCS"}, {"code": "8056396", "type": "CDM"}], "standard_charges": [{"gross_charge": 6867.0, "discounted_cash": 5150.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH FREEZOR XTRA", "code_information": [{"code": "C1733", "type": "HCPCS"}, {"code": "4031398", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10594.0, "discounted_cash": 7945.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH FULLY ARTICULATING", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8050016", "type": "CDM"}], "standard_charges": [{"gross_charge": 85339.17, "discounted_cash": 64004.38, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH GD OUTER PEELABLE", "code_information": [{"code": "C1892", "type": "HCPCS"}, {"code": "8056437", "type": "CDM"}], "standard_charges": [{"gross_charge": 2511.0, "discounted_cash": 1883.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH GDE ACUITY CUT-AWAY", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056433", "type": "CDM"}], "standard_charges": [{"gross_charge": 3372.0, "discounted_cash": 2529.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH GDE CUT-AWAY INNER", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056432", "type": "CDM"}], "standard_charges": [{"gross_charge": 1483.0, "discounted_cash": 1112.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH GLIDE", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056439", "type": "CDM"}], "standard_charges": [{"gross_charge": 428.0, "discounted_cash": 321.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH GUIDE EXTEN TELESCOPE", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8058240", "type": "CDM"}], "standard_charges": [{"gross_charge": 1958.0, "discounted_cash": 1468.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH GUIDE RTSITE COR 7F 43CM", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056444", "type": "CDM"}], "standard_charges": [{"gross_charge": 1832.0, "discounted_cash": 1374.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH GUIDE SLIT OUTR CPS", "code_information": [{"code": "C1893", "type": "HCPCS"}, {"code": "8056436", "type": "CDM"}], "standard_charges": [{"gross_charge": 1728.0, "discounted_cash": 1296.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH GUIDELNR NAVIAGT RX", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056456", "type": "CDM"}], "standard_charges": [{"gross_charge": 1107.0, "discounted_cash": 830.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH GUIDING", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056037", "type": "CDM"}], "standard_charges": [{"gross_charge": 760.0, "discounted_cash": 570.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH GUIDING", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8240096", "type": "CDM"}], "standard_charges": [{"gross_charge": 547.0, "discounted_cash": 410.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH GUIDING 2", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8240097", "type": "CDM"}], "standard_charges": [{"gross_charge": 279.0, "discounted_cash": 209.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH GUIDING 3", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8240099", "type": "CDM"}], "standard_charges": [{"gross_charge": 788.0, "discounted_cash": 591.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH GUIDING CONVEY", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056458", "type": "CDM"}], "standard_charges": [{"gross_charge": 360.0, "discounted_cash": 270.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH GUIDING LAUNCHER", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8241084", "type": "CDM"}], "standard_charges": [{"gross_charge": 356.0, "discounted_cash": 267.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH GUIDING TURNPIKE", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056073", "type": "CDM"}], "standard_charges": [{"gross_charge": 3881.0, "discounted_cash": 2910.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH HEMODIAL LONG TERM", "code_information": [{"code": "C1750", "type": "HCPCS"}, {"code": "8240098", "type": "CDM"}], "standard_charges": [{"gross_charge": 3554.0, "discounted_cash": 2665.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH HEMODIAL SHORT TERM", "code_information": [{"code": "C1752", "type": "HCPCS"}, {"code": "8240102", "type": "CDM"}], "standard_charges": [{"gross_charge": 978.0, "discounted_cash": 733.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH HICKMAN", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8056470", "type": "CDM"}], "standard_charges": [{"gross_charge": 1014.0, "discounted_cash": 760.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH HICKMAN", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8056475", "type": "CDM"}], "standard_charges": [{"gross_charge": 1163.0, "discounted_cash": 872.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH INF PICC DL PWR", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8245753", "type": "CDM"}], "standard_charges": [{"gross_charge": 1013.0, "discounted_cash": 759.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH INF UNIFUS ANGIODYN", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8245780", "type": "CDM"}], "standard_charges": [{"gross_charge": 1341.0, "discounted_cash": 1005.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH INJ R VENTRIC/ATRIA", "code_information": [{"code": "93566", "type": "CPT"}, {"code": "4613568", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 7982.0, "discounted_cash": 5986.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH INJ R VENTRIC/ATRIA", "code_information": [{"code": "93566", "type": "CPT"}, {"code": "4613568", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 7982.0, "discounted_cash": 5986.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH INJ SUPRVLV AORTOGR", "code_information": [{"code": "93567", "type": "CPT"}, {"code": "4613569", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 7931.0, "discounted_cash": 5948.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH INJ SUPRVLV AORTOGR", "code_information": [{"code": "93567", "type": "CPT"}, {"code": "4613569", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 7931.0, "discounted_cash": 5948.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH INNR SLIT INTEG VLV", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056516", "type": "CDM"}], "standard_charges": [{"gross_charge": 785.0, "discounted_cash": 588.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH INTRACRAN SUPPRT NAVIEN", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056528", "type": "CDM"}], "standard_charges": [{"gross_charge": 16757.0, "discounted_cash": 12567.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH INTRADISCAL", "code_information": [{"code": "C1754", "type": "HCPCS"}, {"code": "8240108", "type": "CDM"}], "standard_charges": [{"gross_charge": 6201.0, "discounted_cash": 4650.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH INTRASPINAL", "code_information": [{"code": "C1755", "type": "HCPCS"}, {"code": "8058052", "type": "CDM"}], "standard_charges": [{"gross_charge": 576.0, "discounted_cash": 432.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH INTRASPINAL", "code_information": [{"code": "C1755", "type": "HCPCS"}, {"code": "8240111", "type": "CDM"}], "standard_charges": [{"gross_charge": 2514.0, "discounted_cash": 1885.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH INTRATHECAL 1 PIECE", "code_information": [{"code": "C1755", "type": "HCPCS"}, {"code": "8173328", "type": "CDM"}], "standard_charges": [{"gross_charge": 5330.0, "discounted_cash": 3997.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH INTRATHECAL ASCENDA", "code_information": [{"code": "C1755", "type": "HCPCS"}, {"code": "8056424", "type": "CDM"}], "standard_charges": [{"gross_charge": 7220.0, "discounted_cash": 5415.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH INTRCRAN NEURON DEL", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056526", "type": "CDM"}], "standard_charges": [{"gross_charge": 8650.0, "discounted_cash": 6487.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH IVUS DIGITL PV.035", "code_information": [{"code": "C1753", "type": "HCPCS"}, {"code": "8056543", "type": "CDM"}], "standard_charges": [{"gross_charge": 6550.0, "discounted_cash": 4912.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH IVUS GD PIONEER PLS", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056538", "type": "CDM"}], "standard_charges": [{"gross_charge": 18846.0, "discounted_cash": 14134.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH IVUS IMAG PLATINUM", "code_information": [{"code": "C1753", "type": "HCPCS"}, {"code": "8056546", "type": "CDM"}], "standard_charges": [{"gross_charge": 4702.0, "discounted_cash": 3526.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH KT JETI", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8245781", "type": "CDM"}], "standard_charges": [{"gross_charge": 39309.0, "discounted_cash": 29481.75, "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": 42818.0, "discounted_cash": 32113.5, "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": 42818.0, "discounted_cash": 32113.5, "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": 41441.0, "discounted_cash": 31080.75, "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": 41441.0, "discounted_cash": 31080.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH L VENTRICAL/ATRIAL", "code_information": [{"code": "93565", "type": "CPT"}, {"code": "4613566", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 7604.0, "discounted_cash": 5703.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH L VENTRICAL/ATRIAL", "code_information": [{"code": "93565", "type": "CPT"}, {"code": "4613566", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 7604.0, "discounted_cash": 5703.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH LRG DIST PLATFORM ZOOM 88", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8058272", "type": "CDM"}], "standard_charges": [{"gross_charge": 28143.0, "discounted_cash": 21107.25, "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": 5071.0, "discounted_cash": 3803.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH LT HRT/TRSEPTPUNCT", "code_information": [{"code": "93462", "type": "CPT"}, {"code": "4613463", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 23851.0, "discounted_cash": 17888.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH LT HRT/TRSEPTPUNCT", "code_information": [{"code": "93462", "type": "CPT"}, {"code": "4613463", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 23851.0, "discounted_cash": 17888.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH MAPPING ACHIEVE ADVANCE", "code_information": [{"code": "C1730", "type": "HCPCS"}, {"code": "8056586", "type": "CDM"}], "standard_charges": [{"gross_charge": 7783.0, "discounted_cash": 5837.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH MAPPING OCTARAY NAV", "code_information": [{"code": "C1732", "type": "HCPCS"}, {"code": "8056398", "type": "CDM"}], "standard_charges": [{"gross_charge": 26630.0, "discounted_cash": 19972.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH MAPPING OPTRELL", "code_information": [{"code": "C1732", "type": "HCPCS"}, {"code": "8056401", "type": "CDM"}], "standard_charges": [{"gross_charge": 26630.0, "discounted_cash": 19972.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH MICRO TELEPORT", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056589", "type": "CDM"}], "standard_charges": [{"gross_charge": 4465.0, "discounted_cash": 3348.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH MULT LUM CV", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8056590", "type": "CDM"}], "standard_charges": [{"gross_charge": 371.0, "discounted_cash": 278.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH MUSHROOM MALECOT", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8056596", "type": "CDM"}], "standard_charges": [{"gross_charge": 488.0, "discounted_cash": 366.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH NEPHROSTOMY", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8056615", "type": "CDM"}], "standard_charges": [{"gross_charge": 2948.0, "discounted_cash": 2211.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH NEURON SELECT", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056617", "type": "CDM"}], "standard_charges": [{"gross_charge": 1393.0, "discounted_cash": 1044.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH OCC BLN TRNSFRM COMPLIANT", "code_information": [{"code": "C2628", "type": "HCPCS"}, {"code": "8056623", "type": "CDM"}], "standard_charges": [{"gross_charge": 17678.0, "discounted_cash": 13258.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH OCCLUSION", "code_information": [{"code": "C2628", "type": "HCPCS"}, {"code": "8240115", "type": "CDM"}], "standard_charges": [{"gross_charge": 705.0, "discounted_cash": 528.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH OCCLUSION COMPLIANT BLN", "code_information": [{"code": "C2628", "type": "HCPCS"}, {"code": "8056621", "type": "CDM"}], "standard_charges": [{"gross_charge": 15471.0, "discounted_cash": 11603.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PERI IMGNG OPTICROSS", "code_information": [{"code": "C1753", "type": "HCPCS"}, {"code": "8058056", "type": "CDM"}], "standard_charges": [{"gross_charge": 819.0, "discounted_cash": 614.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PERIPH IVL SHOCKWAVE S4", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056883", "type": "CDM"}], "standard_charges": [{"gross_charge": 14341.0, "discounted_cash": 10755.75, "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": 9551.0, "discounted_cash": 7163.25, "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": 3866.0, "discounted_cash": 2899.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PERIT DIAL LNG TRM", "code_information": [{"code": "C1750", "type": "HCPCS"}, {"code": "4031484", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3491.0, "discounted_cash": 2618.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH POST ERGOTR STDY", "code_information": [{"code": "93024", "type": "CPT"}, {"code": "4613552", "type": "CDM"}, {"code": "730", "type": "RC"}], "standard_charges": [{"gross_charge": 4835.0, "discounted_cash": 3626.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PRPH DIL OTW VIATRC", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8240786", "type": "CDM"}], "standard_charges": [{"gross_charge": 1861.0, "discounted_cash": 1395.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PRPH DIL POLARCATH", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8240045", "type": "CDM"}], "standard_charges": [{"gross_charge": 3237.0, "discounted_cash": 2427.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PRPH DIL RX VTRC 14", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8240090", "type": "CDM"}], "standard_charges": [{"gross_charge": 2460.0, "discounted_cash": 1845.0, "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": 1288.0, "discounted_cash": 966.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTA AMPHIRION DEEP", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8245964", "type": "CDM"}], "standard_charges": [{"gross_charge": 2358.0, "discounted_cash": 1768.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTA ANGIOSCULPT", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "4031495", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 7780.0, "discounted_cash": 5835.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTA ARMADA 18 BLLN", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056888", "type": "CDM"}], "standard_charges": [{"gross_charge": 1647.0, "discounted_cash": 1235.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTA ARMADA 35 BLLN", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056668", "type": "CDM"}], "standard_charges": [{"gross_charge": 1443.0, "discounted_cash": 1082.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTA ARMADA14 BLN", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8058258", "type": "CDM"}], "standard_charges": [{"gross_charge": 2613.0, "discounted_cash": 1959.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTA BLN DIL OTW JADE", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8058230", "type": "CDM"}], "standard_charges": [{"gross_charge": 1681.0, "discounted_cash": 1260.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTA BLN FF ULTRASCORE", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056882", "type": "CDM"}], "standard_charges": [{"gross_charge": 7675.0, "discounted_cash": 5756.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTA CHOCOLATE BLN", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056671", "type": "CDM"}], "standard_charges": [{"gross_charge": 8697.0, "discounted_cash": 6522.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTA CORDIS MAXI LD", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8240046", "type": "CDM"}], "standard_charges": [{"gross_charge": 2110.0, "discounted_cash": 1582.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTA CROSSTELLA RX BLN", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056899", "type": "CDM"}], "standard_charges": [{"gross_charge": 3071.0, "discounted_cash": 2303.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTA DIL AVIATOR PLS", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056893", "type": "CDM"}], "standard_charges": [{"gross_charge": 1655.0, "discounted_cash": 1241.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTA DIL ULTRAVERSE", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8245961", "type": "CDM"}], "standard_charges": [{"gross_charge": 1826.0, "discounted_cash": 1369.5, "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": 1996.0, "discounted_cash": 1497.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTA DRUG COATED BLN", "code_information": [{"code": "C2623", "type": "HCPCS"}, {"code": "8056891", "type": "CDM"}], "standard_charges": [{"gross_charge": 32508.0, "discounted_cash": 24381.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTA EVERCROSS BLN", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056663", "type": "CDM"}], "standard_charges": [{"gross_charge": 1594.0, "discounted_cash": 1195.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTA IN.PACT ADMIRAL", "code_information": [{"code": "C2623", "type": "HCPCS"}, {"code": "8058260", "type": "CDM"}], "standard_charges": [{"gross_charge": 25077.0, "discounted_cash": 18807.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTA MUSTANG BLLN", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056664", "type": "CDM"}], "standard_charges": [{"gross_charge": 1367.0, "discounted_cash": 1025.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTA NANOCROSS 014", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056672", "type": "CDM"}], "standard_charges": [{"gross_charge": 2506.0, "discounted_cash": 1879.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTA OTW METACROSS", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056075", "type": "CDM"}], "standard_charges": [{"gross_charge": 1455.0, "discounted_cash": 1091.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTA PACIFC PLUS BLN", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8058261", "type": "CDM"}], "standard_charges": [{"gross_charge": 1927.0, "discounted_cash": 1445.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTA PACIFIC XTREME", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056662", "type": "CDM"}], "standard_charges": [{"gross_charge": 2020.0, "discounted_cash": 1515.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTA POWERCROSS 018", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056676", "type": "CDM"}], "standard_charges": [{"gross_charge": 2279.0, "discounted_cash": 1709.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTA SV FOX", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8245969", "type": "CDM"}], "standard_charges": [{"gross_charge": 3150.0, "discounted_cash": 2362.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTA VASCUTRAK BLN", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056673", "type": "CDM"}], "standard_charges": [{"gross_charge": 4614.0, "discounted_cash": 3460.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTCA BLN MR EMERGE", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056649", "type": "CDM"}], "standard_charges": [{"gross_charge": 1365.0, "discounted_cash": 1023.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTCA EMERGE MR US BLN", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056708", "type": "CDM"}], "standard_charges": [{"gross_charge": 1082.0, "discounted_cash": 811.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTCA MAVERICK OTW", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8240846", "type": "CDM"}], "standard_charges": [{"gross_charge": 2467.0, "discounted_cash": 1850.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTCA SCORING EVO BLN", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056907", "type": "CDM"}], "standard_charges": [{"gross_charge": 7355.0, "discounted_cash": 5516.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTCA SCORING RX BLN", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056892", "type": "CDM"}], "standard_charges": [{"gross_charge": 4961.0, "discounted_cash": 3720.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTV DILATATION VIDA", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056679", "type": "CDM"}], "standard_charges": [{"gross_charge": 3560.0, "discounted_cash": 2670.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH R HRT ART/GRFT ANGI", "code_information": [{"code": "93457", "type": "CPT"}, {"code": "4613457", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 45955.0, "discounted_cash": 34466.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH R HRT ART/GRFT ANGI", "code_information": [{"code": "93457", "type": "CPT"}, {"code": "4613457", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 45955.0, "discounted_cash": 34466.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH R HRT COR ART ANG", "code_information": [{"code": "93456", "type": "CPT"}, {"code": "4613456", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 32522.0, "discounted_cash": 24391.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH R HRT COR ART ANG", "code_information": [{"code": "93456", "type": "CPT"}, {"code": "4613456", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 32522.0, "discounted_cash": 24391.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH R&L HRT AR/VNT BPGF", "code_information": [{"code": "93461", "type": "CPT"}, {"code": "4613461", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 44493.0, "discounted_cash": 33369.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH R&L HRT AR/VNT BPGF", "code_information": [{"code": "93461", "type": "CPT"}, {"code": "4613461", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 44493.0, "discounted_cash": 33369.75, "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": 40250.0, "discounted_cash": 30187.5, "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": 40250.0, "discounted_cash": 30187.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH R&L HRT W/VENTRICLG", "code_information": [{"code": "93453", "type": "CPT"}, {"code": "4613453", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 31549.0, "discounted_cash": 23661.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH R&L HRT W/VENTRICLG", "code_information": [{"code": "93453", "type": "CPT"}, {"code": "4613453", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 31549.0, "discounted_cash": 23661.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH REPERFUS ASPIRAT RED KIT", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8050014", "type": "CDM"}], "standard_charges": [{"gross_charge": 30621.0, "discounted_cash": 22965.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH REPERFUS ASPIRATION", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056689", "type": "CDM"}], "standard_charges": [{"gross_charge": 22299.0, "discounted_cash": 16724.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH REPERFUSION ZOOM", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8058270", "type": "CDM"}], "standard_charges": [{"gross_charge": 15833.0, "discounted_cash": 11874.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH REPREFUSION ZOOM 71", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8058271", "type": "CDM"}], "standard_charges": [{"gross_charge": 23350.0, "discounted_cash": 17512.5, "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": 15289.0, "discounted_cash": 11466.75, "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": 15289.0, "discounted_cash": 11466.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH SHOCKWAVE C2", "code_information": [{"code": "C1761", "type": "HCPCS"}, {"code": "8056916", "type": "CDM"}], "standard_charges": [{"gross_charge": 49384.0, "discounted_cash": 37038.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH SHOCKWAVE M5 +IVL", "code_information": [{"code": "C1761", "type": "HCPCS"}, {"code": "8056917", "type": "CDM"}], "standard_charges": [{"gross_charge": 33564.0, "discounted_cash": 25173.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH SINUS GUIDE", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056701", "type": "CDM"}], "standard_charges": [{"gross_charge": 3545.0, "discounted_cash": 2658.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH SPYGLASS DISCOVER DIGI", "code_information": [{"code": "C1726", "type": "HCPCS"}, {"code": "8056718", "type": "CDM"}], "standard_charges": [{"gross_charge": 26754.0, "discounted_cash": 20065.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH SUPPORT CXI", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8058279", "type": "CDM"}], "standard_charges": [{"gross_charge": 2056.0, "discounted_cash": 1542.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH SUPPORT KITTYCAT2", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056733", "type": "CDM"}], "standard_charges": [{"gross_charge": 10030.0, "discounted_cash": 7522.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH SUPPORT NAVICROSS", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056734", "type": "CDM"}], "standard_charges": [{"gross_charge": 1403.0, "discounted_cash": 1052.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH SUPPORT RUBICON", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056737", "type": "CDM"}], "standard_charges": [{"gross_charge": 1394.0, "discounted_cash": 1045.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH SUPPORT TRAILBLAZER", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056738", "type": "CDM"}], "standard_charges": [{"gross_charge": 1122.0, "discounted_cash": 841.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH SUPPRT SOFIA PLS LL", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056731", "type": "CDM"}], "standard_charges": [{"gross_charge": 22224.0, "discounted_cash": 16668.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH SUPRAPUBC/CYSTOSCOP", "code_information": [{"code": "C2627", "type": "HCPCS"}, {"code": "8240119", "type": "CDM"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH SYS ACCESS/DELIV SPYSCOPE", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8051721", "type": "CDM"}], "standard_charges": [{"gross_charge": 25743.0, "discounted_cash": 19307.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH THORACIC", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8056780", "type": "CDM"}], "standard_charges": [{"gross_charge": 335.0, "discounted_cash": 251.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH THROMB/EMBOLECT 4", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8240109", "type": "CDM"}], "standard_charges": [{"gross_charge": 9025.0, "discounted_cash": 6768.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH THROMB/EMBOLECTOMY", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8240121", "type": "CDM"}], "standard_charges": [{"gross_charge": 7912.0, "discounted_cash": 5934.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH THROMBECTOMY", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8056687", "type": "CDM"}], "standard_charges": [{"gross_charge": 18556.0, "discounted_cash": 13917.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH THROMBECTOMY HIPPO", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8056713", "type": "CDM"}], "standard_charges": [{"gross_charge": 40903.0, "discounted_cash": 30677.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH TRAY DIALYSIS", "code_information": [{"code": "C1752", "type": "HCPCS"}, {"code": "8081016", "type": "CDM"}], "standard_charges": [{"gross_charge": 997.0, "discounted_cash": 747.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH TRI-LOBE BALLOON", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056804", "type": "CDM"}], "standard_charges": [{"gross_charge": 3720.0, "discounted_cash": 2790.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH TRIP-LUMEN", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8056805", "type": "CDM"}], "standard_charges": [{"gross_charge": 1110.0, "discounted_cash": 832.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH URET FLEXT", "code_information": [{"code": "C1758", "type": "HCPCS"}, {"code": "8041245", "type": "CDM"}], "standard_charges": [{"gross_charge": 130.0, "discounted_cash": 97.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH URETERAL", "code_information": [{"code": "C1758", "type": "HCPCS"}, {"code": "8041251", "type": "CDM"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 83.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH URETERAL", "code_information": [{"code": "C1758", "type": "HCPCS"}, {"code": "8161100", "type": "CDM"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH URETERAL", "code_information": [{"code": "C1758", "type": "HCPCS"}, {"code": "8240131", "type": "CDM"}], "standard_charges": [{"gross_charge": 541.0, "discounted_cash": 405.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH URETHRAL BALLOON", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8056828", "type": "CDM"}], "standard_charges": [{"gross_charge": 26444.0, "discounted_cash": 19833.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH URTRL FLEXIMA", "code_information": [{"code": "C1758", "type": "HCPCS"}, {"code": "8246050", "type": "CDM"}], "standard_charges": [{"gross_charge": 94.0, "discounted_cash": 70.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH US INTRAVASCULAR", "code_information": [{"code": "C1753", "type": "HCPCS"}, {"code": "8240113", "type": "CDM"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH US IVAS ELITE BALLOON", "code_information": [{"code": "C1753", "type": "HCPCS"}, {"code": "8240881", "type": "CDM"}], "standard_charges": [{"gross_charge": 19670.0, "discounted_cash": 14752.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH US SOUNDSTAR 3D", "code_information": [{"code": "C1759", "type": "HCPCS"}, {"code": "8056813", "type": "CDM"}], "standard_charges": [{"gross_charge": 25606.0, "discounted_cash": 19204.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH US SOUNDSTAR ECO", "code_information": [{"code": "C1759", "type": "HCPCS"}, {"code": "8058288", "type": "CDM"}], "standard_charges": [{"gross_charge": 37340.0, "discounted_cash": 28005.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH VALVULOPLSTY BLLN", "code_information": [{"code": "C1726", "type": "HCPCS"}, {"code": "8056819", "type": "CDM"}], "standard_charges": [{"gross_charge": 9139.0, "discounted_cash": 6854.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH VENTR", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8141275", "type": "CDM"}], "standard_charges": [{"gross_charge": 1304.0, "discounted_cash": 978.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH VENTRICULAR STNDRD", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8141274", "type": "CDM"}], "standard_charges": [{"gross_charge": 2042.0, "discounted_cash": 1531.5, "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": 284.0, "discounted_cash": 213.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CBC AUTO W/O DIFF", "code_information": [{"code": "85027", "type": "CPT"}, {"code": "4120056", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CBC AUTO W/O DIFF", "code_information": [{"code": "85027", "type": "CPT"}, {"code": "4150056", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 284.0, "discounted_cash": 213.0, "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": 339.0, "discounted_cash": 254.25, "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": 23.0, "discounted_cash": 17.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CBC WITH AUTO DIFF", "code_information": [{"code": "85025", "type": "CPT"}, {"code": "4155028", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 323.0, "discounted_cash": 242.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CBL ORTHO W CRIMP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131515", "type": "CDM"}], "standard_charges": [{"gross_charge": 4180.0, "discounted_cash": 3135.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CBLE FIX BN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131513", "type": "CDM"}], "standard_charges": [{"gross_charge": 3641.0, "discounted_cash": 2730.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CBLE FIX BN SLEVE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131514", "type": "CDM"}], "standard_charges": [{"gross_charge": 3860.0, "discounted_cash": 2895.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CCHD", "code_information": [{"code": "94760", "type": "CPT"}, {"code": "3110670", "type": "CDM"}, {"code": "460", "type": "RC"}], "standard_charges": [{"gross_charge": 191.0, "discounted_cash": 143.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFACLOR 250MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302085", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 69.0, "discounted_cash": 51.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFACLOR 250MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302085", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 69.0, "discounted_cash": 51.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFACLOR 500MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302089", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 83.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFACLOR 500MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302089", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 83.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFADROXIL 500MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302112", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFADROXIL 500MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302112", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "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": 36.0, "discounted_cash": 27.0, "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": 36.0, "discounted_cash": 27.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "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": 17.0, "discounted_cash": 12.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 320.0, "discounted_cash": 240.0, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 320.0, "discounted_cash": 240.0, "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": 0.75, "discounted_cash": 0.56, "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": 59.0, "discounted_cash": 44.25, "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": 59.0, "discounted_cash": 44.25, "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": 172.0, "discounted_cash": 129.0, "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": 172.0, "discounted_cash": 129.0, "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": 36.0, "discounted_cash": 27.0, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFEPIME PER500MG PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0692", "type": "HCPCS"}, {"code": "5318989", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 164.0, "discounted_cash": 123.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFEPIME PER500MG PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0692", "type": "HCPCS"}, {"code": "5318989", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 164.0, "discounted_cash": 123.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFIDEROCOL PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0699", "type": "HCPCS"}, {"code": "5318998", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 15.0, "discounted_cash": 11.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFIDEROCOL PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0699", "type": "HCPCS"}, {"code": "5318998", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 15.0, "discounted_cash": 11.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFOTAXIME NEO IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5319026", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFOTAXIME NEO IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5319026", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "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": 158.0, "discounted_cash": 118.5, "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": 158.0, "discounted_cash": 118.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFOTETAN PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0525", "type": "HCPCS"}, {"code": "5319029", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.48, "discounted_cash": 1.11, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFOTETAN PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0525", "type": "HCPCS"}, {"code": "5319029", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1.48, "discounted_cash": 1.11, "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": 157.0, "discounted_cash": 117.75, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 157.0, "discounted_cash": 117.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFOXITIN PER 1GM PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0694", "type": "HCPCS"}, {"code": "5319050", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 134.0, "discounted_cash": 100.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFOXITIN PER 1GM PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0694", "type": "HCPCS"}, {"code": "5319050", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 134.0, "discounted_cash": 100.5, "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": 11.0, "discounted_cash": 8.25, "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": 11.0, "discounted_cash": 8.25, "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": 544.0, "discounted_cash": 408.0, "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": 544.0, "discounted_cash": 408.0, "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": 36.0, "discounted_cash": 27.0, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "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": 156.0, "discounted_cash": 117.0, "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": 156.0, "discounted_cash": 117.0, "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": 47.0, "discounted_cash": 35.25, "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": 47.0, "discounted_cash": 35.25, "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": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFTRIAX PER250MG PMXIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0696", "type": "HCPCS"}, {"code": "5319092", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFTRIAX PER250MG PMXIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0696", "type": "HCPCS"}, {"code": "5319092", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 407.0, "discounted_cash": 305.25, "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": 407.0, "discounted_cash": 305.25, "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": 93.0, "discounted_cash": 69.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "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": 84.0, "discounted_cash": 63.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "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": 156.0, "discounted_cash": 117.0, "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": 156.0, "discounted_cash": 117.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFUROXIME PER750MGPMXIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0697", "type": "HCPCS"}, {"code": "5319104", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 387.0, "discounted_cash": 290.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFUROXIME PER750MGPMXIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0697", "type": "HCPCS"}, {"code": "5319104", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 387.0, "discounted_cash": 290.25, "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": 23.0, "discounted_cash": 17.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 23.0, "discounted_cash": 17.25, "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": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "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": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CELL COUNT MISC BODY FLD", "code_information": [{"code": "89050", "type": "CPT"}, {"code": "4129050", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "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": 446.0, "discounted_cash": 334.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CELL COUNT MISC W/DIFF", "code_information": [{"code": "89051", "type": "CPT"}, {"code": "4129051", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CELL COUNT MISC W/DIFF", "code_information": [{"code": "89051", "type": "CPT"}, {"code": "4159051", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 308.0, "discounted_cash": 231.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CELLULOSE OXIDIZ 1X2 EA", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5337359", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 211.0, "discounted_cash": 158.25, "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": 415.0, "discounted_cash": 311.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CELLULOSE OXIDIZ 3X4 EA", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5337365", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1124.0, "discounted_cash": 843.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CELLULOSE OXIDIZ 4X8 EA", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5337366", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 400.0, "discounted_cash": 300.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CELLULOSE OXIDIZ 6X9 EA", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5337367", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1386.0, "discounted_cash": 1039.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CEMT BN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131520", "type": "CDM"}], "standard_charges": [{"gross_charge": 1305.0, "discounted_cash": 978.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CEMT BN ANTIFUL ZIMM CAP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011935", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3984.0, "discounted_cash": 2988.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CEMT BN HIGH VISCUS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8139910", "type": "CDM"}], "standard_charges": [{"gross_charge": 12910.28, "discounted_cash": 9682.71, "setting": "both", "billing_class": "facility"}]}, {"description": "CEMT BN INJECT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8173508", "type": "CDM"}], "standard_charges": [{"gross_charge": 23457.0, "discounted_cash": 17592.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CEMT BN PL FUL ZIMMR CAP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011934", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1259.0, "discounted_cash": 944.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CEMT BN W/ANTIBIOTIC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131522", "type": "CDM"}], "standard_charges": [{"gross_charge": 3764.0, "discounted_cash": 2823.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CEMT BON", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8173505", "type": "CDM"}], "standard_charges": [{"gross_charge": 15067.0, "discounted_cash": 11300.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CEPBA GENE ANALYSIS", "code_information": [{"code": "81218", "type": "CPT"}, {"code": "7050061", "type": "CDM"}], "standard_charges": [{"gross_charge": 1119.0, "discounted_cash": 839.25, "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": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "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": 50.0, "discounted_cash": 37.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "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": 216.0, "discounted_cash": 162.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 216.0, "discounted_cash": 162.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CEPHALEXIN250/5 200 PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314567", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 368.0, "discounted_cash": 276.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CEPHALEXIN250/5 200 PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314567", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 368.0, "discounted_cash": 276.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CERULOPLASMIN", "code_information": [{"code": "82390", "type": "CPT"}, {"code": "7002390", "type": "CDM"}], "standard_charges": [{"gross_charge": 695.0, "discounted_cash": 521.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CERULOPLASMIN", "code_information": [{"code": "82390", "type": "CPT"}, {"code": "7252390", "type": "CDM"}], "standard_charges": [{"gross_charge": 695.0, "discounted_cash": 521.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CERVICAL MYELO LUMB INJ", "code_information": [{"code": "4902301", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7112.0, "discounted_cash": 5334.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CETUXIMAB PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9055", "type": "HCPCS"}, {"code": "5319201", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 629.0, "discounted_cash": 471.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CETUXIMAB PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9055", "type": "HCPCS"}, {"code": "5319201", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 629.0, "discounted_cash": 471.75, "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": 7319.0, "discounted_cash": 5489.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHANGE BILIARY DRAIN CTH", "code_information": [{"code": "4917515", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3368.0, "discounted_cash": 2526.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHANGE NEPHROSTOMY TUBE", "code_information": [{"code": "4917520", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 674.0, "discounted_cash": 505.5, "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": 1118.0, "discounted_cash": 838.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHANGE PERC DRAIN CATH", "code_information": [{"code": "75984", "type": "CPT"}, {"code": "5055984", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1158.0, "discounted_cash": 868.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHANGE PERC DRAIN CATH", "code_information": [{"code": "75984", "type": "CPT"}, {"code": "5065984", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1158.0, "discounted_cash": 868.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHANGE URETER STENT PERC", "code_information": [{"code": "4917526", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5905.0, "discounted_cash": 4428.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHANGE URETER STENT TRAN", "code_information": [{"code": "4910387", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 13291.0, "discounted_cash": 9968.25, "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": 180.0, "discounted_cash": 135.0, "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": 180.0, "discounted_cash": 135.0, "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": 107.0, "discounted_cash": 80.25, "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": 107.0, "discounted_cash": 80.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHARCOAL 25GM/120ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314036", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 232.0, "discounted_cash": 174.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHARCOAL 25GM/120ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314036", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 232.0, "discounted_cash": 174.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHARCOAL 30GM/120ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314038", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 178.0, "discounted_cash": 133.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHARCOAL 30GM/120ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314038", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 178.0, "discounted_cash": 133.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHEM CAUTERY OF TISSUE", "code_information": [{"code": "6904010", "type": "CDM"}], "standard_charges": [{"gross_charge": 1463.0, "discounted_cash": 1097.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHEM PLEURODESIS INSTIL AGNT", "code_information": [{"code": "5052560", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4049.0, "discounted_cash": 3036.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHEMILUMINESCENT ASY", "code_information": [{"code": "82397", "type": "CPT"}, {"code": "7002397", "type": "CDM"}], "standard_charges": [{"gross_charge": 871.0, "discounted_cash": 653.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHEMILUMINESCENT ASY/2", "code_information": [{"code": "82397", "type": "CPT"}, {"code": "7252397", "type": "CDM"}], "standard_charges": [{"gross_charge": 1312.0, "discounted_cash": 984.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHEMILUMINESCENT ASY/5", "code_information": [{"code": "82397", "type": "CPT"}, {"code": "7252642", "type": "CDM"}], "standard_charges": [{"gross_charge": 340.0, "discounted_cash": 255.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHEMILUMINESCENT ASY/6", "code_information": [{"code": "82397", "type": "CPT"}, {"code": "7253558", "type": "CDM"}], "standard_charges": [{"gross_charge": 592.0, "discounted_cash": 444.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHEMO ADM CNS", "code_information": [{"code": "96450", "type": "CPT"}, {"code": "4906450", "type": "CDM"}, {"code": "331", "type": "RC"}], "standard_charges": [{"gross_charge": 2191.0, "discounted_cash": 1643.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHEMO ADM CNS", "code_information": [{"code": "96450", "type": "CPT"}, {"code": "4916450", "type": "CDM"}, {"code": "331", "type": "RC"}], "standard_charges": [{"gross_charge": 2191.0, "discounted_cash": 1643.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHEMO INF EA ADD HR", "code_information": [{"code": "96415", "type": "CPT"}, {"code": "6926415", "type": "CDM"}], "standard_charges": [{"gross_charge": 556.0, "discounted_cash": 417.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHEMO INF SEQ ADD DRUG", "code_information": [{"code": "96417", "type": "CPT"}, {"code": "6926417", "type": "CDM"}], "standard_charges": [{"gross_charge": 556.0, "discounted_cash": 417.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHEMO IV <=1H INIT", "code_information": [{"code": "96413", "type": "CPT"}, {"code": "6926413", "type": "CDM"}], "standard_charges": [{"gross_charge": 784.0, "discounted_cash": 588.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHEMO SQ/IM HORMONAL", "code_information": [{"code": "96402", "type": "CPT"}, {"code": "6926402", "type": "CDM"}], "standard_charges": [{"gross_charge": 496.0, "discounted_cash": 372.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHEMO SQ/IM NONHORMONAL", "code_information": [{"code": "96401", "type": "CPT"}, {"code": "6926401", "type": "CDM"}], "standard_charges": [{"gross_charge": 2001.0, "discounted_cash": 1500.75, "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": 1112.0, "discounted_cash": 834.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHEST 1 VIEW", "code_information": [{"code": "71045", "type": "CPT"}, {"code": "5011045", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1112.0, "discounted_cash": 834.0, "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": 1112.0, "discounted_cash": 834.0, "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": 1431.0, "discounted_cash": 1073.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHEST 2 VIEWS", "code_information": [{"code": "71046", "type": "CPT"}, {"code": "5011046", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1323.0, "discounted_cash": 992.25, "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": 1160.0, "discounted_cash": 870.0, "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": 1436.0, "discounted_cash": 1077.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHEST 3 VIEWS", "code_information": [{"code": "71047", "type": "CPT"}, {"code": "5011047", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1436.0, "discounted_cash": 1077.0, "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": 1436.0, "discounted_cash": 1077.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHEST 4+ VIEWS", "code_information": [{"code": "71048", "type": "CPT"}, {"code": "4901030", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1188.0, "discounted_cash": 891.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHEST 4+ VIEWS", "code_information": [{"code": "71048", "type": "CPT"}, {"code": "5011030", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1436.0, "discounted_cash": 1077.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLAMYDIA AB", "code_information": [{"code": "86631", "type": "CPT"}, {"code": "7256631", "type": "CDM"}], "standard_charges": [{"gross_charge": 147.0, "discounted_cash": 110.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLAMYDIA AB/2", "code_information": [{"code": "86631", "type": "CPT"}, {"code": "7256633", "type": "CDM"}], "standard_charges": [{"gross_charge": 210.0, "discounted_cash": 157.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLAMYDIA AB/5", "code_information": [{"code": "86631", "type": "CPT"}, {"code": "7256903", "type": "CDM"}], "standard_charges": [{"gross_charge": 673.0, "discounted_cash": 504.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLAMYDIA AB/6", "code_information": [{"code": "86631", "type": "CPT"}, {"code": "7006903", "type": "CDM"}], "standard_charges": [{"gross_charge": 673.0, "discounted_cash": 504.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLAMYDIA AMP PROBE", "code_information": [{"code": "87491", "type": "CPT"}, {"code": "7007492", "type": "CDM"}], "standard_charges": [{"gross_charge": 149.0, "discounted_cash": 111.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLAMYDIA AMP PROBE/2", "code_information": [{"code": "87491", "type": "CPT"}, {"code": "7257492", "type": "CDM"}], "standard_charges": [{"gross_charge": 149.0, "discounted_cash": 111.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLAMYDIA DFA", "code_information": [{"code": "87270", "type": "CPT"}, {"code": "7256630", "type": "CDM"}], "standard_charges": [{"gross_charge": 157.0, "discounted_cash": 117.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLAMYDIA DIRECT PRB", "code_information": [{"code": "87490", "type": "CPT"}, {"code": "7007179", "type": "CDM"}], "standard_charges": [{"gross_charge": 208.0, "discounted_cash": 156.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLAMYDIA DIRECT PRB", "code_information": [{"code": "87490", "type": "CPT"}, {"code": "7027179", "type": "CDM"}], "standard_charges": [{"gross_charge": 223.0, "discounted_cash": 167.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLAMYDIA DIRECT PRB/2", "code_information": [{"code": "87490", "type": "CPT"}, {"code": "7257179", "type": "CDM"}], "standard_charges": [{"gross_charge": 223.0, "discounted_cash": 167.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLAMYDIA IGM", "code_information": [{"code": "86632", "type": "CPT"}, {"code": "7256629", "type": "CDM"}], "standard_charges": [{"gross_charge": 147.0, "discounted_cash": 110.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLAMYDIA IGM/2", "code_information": [{"code": "86632", "type": "CPT"}, {"code": "7006629", "type": "CDM"}], "standard_charges": [{"gross_charge": 147.0, "discounted_cash": 110.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLAMYDIA IGM/2", "code_information": [{"code": "86632", "type": "CPT"}, {"code": "7256632", "type": "CDM"}], "standard_charges": [{"gross_charge": 147.0, "discounted_cash": 110.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLAMYDIA IGM/3", "code_information": [{"code": "86632", "type": "CPT"}, {"code": "7256945", "type": "CDM"}], "standard_charges": [{"gross_charge": 147.0, "discounted_cash": 110.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLAMYDIA PNEUM AMP PRB", "code_information": [{"code": "87486", "type": "CPT"}, {"code": "7257488", "type": "CDM"}], "standard_charges": [{"gross_charge": 619.0, "discounted_cash": 464.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLAMYDIA TRACH DIR OPT", "code_information": [{"code": "87810", "type": "CPT"}, {"code": "4107810", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 332.0, "discounted_cash": 249.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLAMYDIA TRACH DIR OPT", "code_information": [{"code": "87810", "type": "CPT"}, {"code": "4127811", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "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": 39.0, "discounted_cash": 29.25, "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": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORAMBUCIL 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302331", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2924.0, "discounted_cash": 2193.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORAMBUCIL 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302331", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2924.0, "discounted_cash": 2193.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORDIAZEPOXIDE 10MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302389", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORDIAZEPOXIDE 10MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302389", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "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": 36.0, "discounted_cash": 27.0, "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": 36.0, "discounted_cash": 27.0, "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": 34.0, "discounted_cash": 25.5, "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": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORDIZ/CLID 5/2.5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302380", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORDIZ/CLID 5/2.5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302380", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORHEXID AF.12%473MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314637", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORHEXID AF.12%473MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314637", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORHEXID.12%480ML MMTS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5334770", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 120.0, "discounted_cash": 90.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORHEXID.12%480ML MMTS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5334770", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 120.0, "discounted_cash": 90.0, "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": 11.0, "discounted_cash": 8.25, "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": 11.0, "discounted_cash": 8.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORHEXIDINE4%120ML TS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334769", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 126.0, "discounted_cash": 94.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORHEXIDINE4%120ML TS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334769", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 126.0, "discounted_cash": 94.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORHEXIDINE4%480ML TS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334773", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 282.0, "discounted_cash": 211.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORHEXIDINE4%480ML TS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334773", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 282.0, "discounted_cash": 211.5, "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": 557.0, "discounted_cash": 417.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORIDE", "code_information": [{"code": "82435", "type": "CPT"}, {"code": "4122439", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORIDE", "code_information": [{"code": "82435", "type": "CPT"}, {"code": "4152439", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 223.0, "discounted_cash": 167.25, "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": 504.0, "discounted_cash": 378.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORIDE OTHER SOURCE/2", "code_information": [{"code": "82438", "type": "CPT"}, {"code": "4122438", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORIDE OTHER SOURCE/3", "code_information": [{"code": "82438", "type": "CPT"}, {"code": "7252442", "type": "CDM"}], "standard_charges": [{"gross_charge": 252.0, "discounted_cash": 189.0, "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": 864.0, "discounted_cash": 648.0, "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": 584.0, "discounted_cash": 438.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORIDE URINE/2", "code_information": [{"code": "82436", "type": "CPT"}, {"code": "4122436", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLOROPROCAINE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2401", "type": "HCPCS"}, {"code": "5329245", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.32, "discounted_cash": 0.24, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLOROPROCAINE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2401", "type": "HCPCS"}, {"code": "5329245", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 0.32, "discounted_cash": 0.24, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORPHENIRAMINE 4MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5302565", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORPHENIRAMINE 4MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5302565", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "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": 157.0, "discounted_cash": 117.75, "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": 157.0, "discounted_cash": 117.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORPROMAZINE", "code_information": [{"code": "80342", "type": "CPT"}, {"code": "7258402", "type": "CDM"}], "standard_charges": [{"gross_charge": 719.0, "discounted_cash": 539.25, "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": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "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": 39.0, "discounted_cash": 29.25, "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": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORPROMAZINE 12.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302593", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORPROMAZINE 12.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302593", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORPROMAZINE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302598", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORPROMAZINE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302598", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORPROPAMIDE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302637", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORPROPAMIDE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302637", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORZOXAZONE 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302694", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORZOXAZONE 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302694", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "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": 2096.0, "discounted_cash": 1572.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHOLANGIO+INJ EXIST CTH", "code_information": [{"code": "4907531", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1900.0, "discounted_cash": 1425.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHOLANGIO+INJ EXIST CTH", "code_information": [{"code": "4917531", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1900.0, "discounted_cash": 1425.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHOLANGIO+INJ NEW", "code_information": [{"code": "4917532", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 22608.0, "discounted_cash": 16956.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHOLECYSTROGRAPHY ORAL", "code_information": [{"code": "74290", "type": "CPT"}, {"code": "4904290", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2476.0, "discounted_cash": 1857.0, "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": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHOLESTEROL", "code_information": [{"code": "84311", "type": "CPT"}, {"code": "7258432", "type": "CDM"}], "standard_charges": [{"gross_charge": 161.0, "discounted_cash": 120.75, "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": 106.0, "discounted_cash": 79.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHOLESTEROL HDL", "code_information": [{"code": "83718", "type": "CPT"}, {"code": "4122477", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "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": 223.0, "discounted_cash": 167.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHOLESTEROL TOTAL", "code_information": [{"code": "82465", "type": "CPT"}, {"code": "4122465", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHOLESTEROL TOTAL", "code_information": [{"code": "82465", "type": "CPT"}, {"code": "4152465", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 94.0, "discounted_cash": 70.5, "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": 32.0, "discounted_cash": 24.0, "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": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHOLESTYRAMINE 5GM PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314681", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 62.0, "discounted_cash": 46.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHOLESTYRAMINE 5GM PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314681", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 62.0, "discounted_cash": 46.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHOLINESTERASE PSEUDO", "code_information": [{"code": "82480", "type": "CPT"}, {"code": "4102480", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 158.0, "discounted_cash": 118.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHOLINESTERASE PSEUDO", "code_information": [{"code": "82480", "type": "CPT"}, {"code": "4122480", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHRM ANAL 15-20 CELL W/BND", "code_information": [{"code": "88262", "type": "CPT"}, {"code": "7258256", "type": "CDM"}], "standard_charges": [{"gross_charge": 386.0, "discounted_cash": 289.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHRM ANAL 15-20 CELL W/BND/2", "code_information": [{"code": "88262", "type": "CPT"}, {"code": "7058255", "type": "CDM"}], "standard_charges": [{"gross_charge": 1488.0, "discounted_cash": 1116.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHRM ANAL 20-25 CELLS", "code_information": [{"code": "88264", "type": "CPT"}, {"code": "7038264", "type": "CDM"}], "standard_charges": [{"gross_charge": 736.0, "discounted_cash": 552.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHRM ANAL 20-25 CELLS", "code_information": [{"code": "88264", "type": "CPT"}, {"code": "7058264", "type": "CDM"}], "standard_charges": [{"gross_charge": 737.0, "discounted_cash": 552.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHRM ANAL 5 CELL W/BND", "code_information": [{"code": "88261", "type": "CPT"}, {"code": "7038275", "type": "CDM"}], "standard_charges": [{"gross_charge": 5578.0, "discounted_cash": 4183.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHRM ANAL 5 CELL W/BND", "code_information": [{"code": "88261", "type": "CPT"}, {"code": "7059809", "type": "CDM"}], "standard_charges": [{"gross_charge": 2076.0, "discounted_cash": 1557.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHROM/MASS SPEC NES QL/13", "code_information": [{"code": "82542", "type": "CPT"}, {"code": "7252566", "type": "CDM"}], "standard_charges": [{"gross_charge": 107.0, "discounted_cash": 80.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHROM/MASS SPEC NES QL/2", "code_information": [{"code": "82542", "type": "CPT"}, {"code": "7002481", "type": "CDM"}], "standard_charges": [{"gross_charge": 549.0, "discounted_cash": 411.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHROM/MASS SPEC NES QL/22", "code_information": [{"code": "82542", "type": "CPT"}, {"code": "7255428", "type": "CDM"}], "standard_charges": [{"gross_charge": 870.0, "discounted_cash": 652.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHROM/MASS SPEC NES QL/25", "code_information": [{"code": "82542", "type": "CPT"}, {"code": "7258250", "type": "CDM"}], "standard_charges": [{"gross_charge": 289.0, "discounted_cash": 216.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHROM/MASS SPEC NES QL/28", "code_information": [{"code": "82542", "type": "CPT"}, {"code": "7258333", "type": "CDM"}], "standard_charges": [{"gross_charge": 1700.0, "discounted_cash": 1275.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHROM/MASS SPEC NES QL/4", "code_information": [{"code": "82542", "type": "CPT"}, {"code": "7002516", "type": "CDM"}], "standard_charges": [{"gross_charge": 415.0, "discounted_cash": 311.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHROM/MASS SPEC NES QL/4", "code_information": [{"code": "82542", "type": "CPT"}, {"code": "7252491", "type": "CDM"}], "standard_charges": [{"gross_charge": 443.0, "discounted_cash": 332.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHROMIUM/2", "code_information": [{"code": "82495", "type": "CPT"}, {"code": "7252495", "type": "CDM"}], "standard_charges": [{"gross_charge": 149.0, "discounted_cash": 111.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHROMO ADD KARYOTYPES EA", "code_information": [{"code": "88280", "type": "CPT"}, {"code": "7058280", "type": "CDM"}], "standard_charges": [{"gross_charge": 419.0, "discounted_cash": 314.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHROMO ADD KARYOTYPES EA/2", "code_information": [{"code": "88280", "type": "CPT"}, {"code": "7038280", "type": "CDM"}], "standard_charges": [{"gross_charge": 293.0, "discounted_cash": 219.75, "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": 481.0, "discounted_cash": 360.75, "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": 388.0, "discounted_cash": 291.0, "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": 32.0, "discounted_cash": 24.0, "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": 32.0, "discounted_cash": 24.0, "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": 33.0, "discounted_cash": 24.75, "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": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CIMETIDINE 400MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302747", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CIMETIDINE 400MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302747", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 164.0, "discounted_cash": 123.0, "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": 164.0, "discounted_cash": 123.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CINE/VIDEO TO COMPLIMENT", "code_information": [{"code": "76125", "type": "CPT"}, {"code": "6216127", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 667.0, "discounted_cash": 500.25, "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": 19.0, "discounted_cash": 14.25, "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": 19.0, "discounted_cash": 14.25, "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": 279.0, "discounted_cash": 209.25, "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": 279.0, "discounted_cash": 209.25, "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": 98.0, "discounted_cash": 73.5, "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": 98.0, "discounted_cash": 73.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "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": 63.0, "discounted_cash": 47.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "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": 63.0, "discounted_cash": 47.25, "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": 252.0, "discounted_cash": 189.0, "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": 252.0, "discounted_cash": 189.0, "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": 407.0, "discounted_cash": 305.25, "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": 407.0, "discounted_cash": 305.25, "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": 99.0, "discounted_cash": 74.25, "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": 99.0, "discounted_cash": 74.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CIRCUMCISION", "code_information": [{"code": "3110150", "type": "CDM"}, {"code": "723", "type": "RC"}], "standard_charges": [{"gross_charge": 584.0, "discounted_cash": 438.0, "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": 62.0, "discounted_cash": 46.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CISPLATIN PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9060", "type": "HCPCS"}, {"code": "5319398", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 732.0, "discounted_cash": 549.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CISPLATIN PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9060", "type": "HCPCS"}, {"code": "5319398", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 732.0, "discounted_cash": 549.0, "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": 2341.0, "discounted_cash": 1755.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CITALOPRAM 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302771", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CITALOPRAM 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302771", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "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": 48.0, "discounted_cash": 36.0, "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": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CITALOPRAM 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302772", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CITALOPRAM 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302772", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CITALOPRAM 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302769", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CITALOPRAM 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302769", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CITRATE", "code_information": [{"code": "82507", "type": "CPT"}, {"code": "7002507", "type": "CDM"}], "standard_charges": [{"gross_charge": 972.0, "discounted_cash": 729.0, "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": 50.0, "discounted_cash": 37.5, "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": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CITRATE/2", "code_information": [{"code": "82507", "type": "CPT"}, {"code": "7252509", "type": "CDM"}], "standard_charges": [{"gross_charge": 972.0, "discounted_cash": 729.0, "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": 520.0, "discounted_cash": 390.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CK MB FRACTION", "code_information": [{"code": "82553", "type": "CPT"}, {"code": "4122553", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLADRIBINE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9065", "type": "HCPCS"}, {"code": "5319421", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 171.0, "discounted_cash": 128.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLADRIBINE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9065", "type": "HCPCS"}, {"code": "5319421", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 171.0, "discounted_cash": 128.25, "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": 1039.0, "discounted_cash": 779.25, "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": 1039.0, "discounted_cash": 779.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 94.0, "discounted_cash": 70.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 94.0, "discounted_cash": 70.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CLARITHROMYCIN 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302781", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLARITHROMYCIN 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302781", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "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": 1357.0, "discounted_cash": 1017.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLAVICLE COMPLETE", "code_information": [{"code": "73000", "type": "CPT"}, {"code": "5013000", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1357.0, "discounted_cash": 1017.75, "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": 1525.0, "discounted_cash": 1143.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLEVIDIPINE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0759", "type": "HCPCS"}, {"code": "5319409", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLEVIDIPINE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0759", "type": "HCPCS"}, {"code": "5319409", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 244.0, "discounted_cash": 183.0, "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": 244.0, "discounted_cash": 183.0, "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": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CLINDAMYCIN 2% 40GM VCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334863", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 725.0, "discounted_cash": 543.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLINDAMYCIN 2% 40GM VCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334863", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 725.0, "discounted_cash": 543.75, "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": 108.0, "discounted_cash": 81.0, "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": 108.0, "discounted_cash": 81.0, "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": 561.0, "discounted_cash": 420.75, "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": 561.0, "discounted_cash": 420.75, "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": 353.0, "discounted_cash": 264.75, "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": 353.0, "discounted_cash": 264.75, "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": 95.0, "discounted_cash": 71.25, "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": 95.0, "discounted_cash": 71.25, "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": 50.0, "discounted_cash": 37.5, "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": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CLIP ANUERSYM", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8151210", "type": "CDM"}], "standard_charges": [{"gross_charge": 3501.0, "discounted_cash": 2625.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLMP CRANIAL TITANIUM", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8192009", "type": "CDM"}], "standard_charges": [{"gross_charge": 792.0, "discounted_cash": 594.0, "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": 261.0, "discounted_cash": 195.75, "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": 261.0, "discounted_cash": 195.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOMIPRAMINE 25MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302890", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOMIPRAMINE 25MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302890", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOMIPRAMINE 50MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302891", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 58.0, "discounted_cash": 43.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOMIPRAMINE 50MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302891", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 58.0, "discounted_cash": 43.5, "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": 55.0, "discounted_cash": 41.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLONAZEPAM 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302914", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLONAZEPAM 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302914", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "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": 48.0, "discounted_cash": 36.0, "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": 48.0, "discounted_cash": 36.0, "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": 226.0, "discounted_cash": 169.5, "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": 226.0, "discounted_cash": 169.5, "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": 230.0, "discounted_cash": 172.5, "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": 230.0, "discounted_cash": 172.5, "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": 308.0, "discounted_cash": 231.0, "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": 308.0, "discounted_cash": 231.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLONIDINE 0.05MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302939", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLONIDINE 0.05MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302939", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CLONIDINE CMPD LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314781", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLONIDINE CMPD LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314781", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLONIDINE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0735", "type": "HCPCS"}, {"code": "5319440", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 271.0, "discounted_cash": 203.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLONIDINE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0735", "type": "HCPCS"}, {"code": "5319440", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 271.0, "discounted_cash": 203.25, "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": 227.0, "discounted_cash": 170.25, "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": 227.0, "discounted_cash": 170.25, "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": 94.0, "discounted_cash": 70.5, "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": 94.0, "discounted_cash": 70.5, "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": 16.0, "discounted_cash": 12.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLORAZEPATE 7.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302980", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLORAZEPATE 7.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302980", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "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": 203.0, "discounted_cash": 152.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FACTOR II PRTHRMBN", "code_information": [{"code": "85210", "type": "CPT"}, {"code": "4105210", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 947.0, "discounted_cash": 710.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FACTOR II PRTHRMBN", "code_information": [{"code": "85210", "type": "CPT"}, {"code": "4125210", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "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": 978.0, "discounted_cash": 733.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FACTOR V(LABILE)", "code_information": [{"code": "85220", "type": "CPT"}, {"code": "4125220", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "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": 845.0, "discounted_cash": 633.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FACTOR VII(STABLE)", "code_information": [{"code": "85230", "type": "CPT"}, {"code": "4125230", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "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": 857.0, "discounted_cash": 642.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FCTR IX(PTC/XMAS)", "code_information": [{"code": "85250", "type": "CPT"}, {"code": "4125250", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "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": 822.0, "discounted_cash": 616.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FCTR VIII(AHG)1 STG", "code_information": [{"code": "85240", "type": "CPT"}, {"code": "4125240", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "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": 845.0, "discounted_cash": 633.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FCTR X(STUART-PRWR)", "code_information": [{"code": "85260", "type": "CPT"}, {"code": "4125260", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FCTR X(STUART-PRWR)/2", "code_information": [{"code": "85260", "type": "CPT"}, {"code": "7255261", "type": "CDM"}], "standard_charges": [{"gross_charge": 1889.0, "discounted_cash": 1416.75, "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": 1176.0, "discounted_cash": 882.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FCTR XI(PTA)", "code_information": [{"code": "85270", "type": "CPT"}, {"code": "4125270", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FCTR XI(PTA)", "code_information": [{"code": "85270", "type": "CPT"}, {"code": "7075270", "type": "CDM"}], "standard_charges": [{"gross_charge": 544.0, "discounted_cash": 408.0, "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": 1119.0, "discounted_cash": 839.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FCTR XII(HAGEMANN)", "code_information": [{"code": "85280", "type": "CPT"}, {"code": "4125280", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FCTR XIII SCREEN", "code_information": [{"code": "85291", "type": "CPT"}, {"code": "7072460", "type": "CDM"}], "standard_charges": [{"gross_charge": 365.0, "discounted_cash": 273.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FCTR XIII(FBRN STB)", "code_information": [{"code": "85290", "type": "CPT"}, {"code": "4105290", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1357.0, "discounted_cash": 1017.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 303.0, "discounted_cash": 227.25, "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": 303.0, "discounted_cash": 227.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOTRIMAZ/BETAMET 45GMCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334895", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 712.0, "discounted_cash": 534.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOTRIMAZ/BETAMET 45GMCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334895", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 712.0, "discounted_cash": 534.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOTRIMAZOLE 1% 15GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334871", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 143.0, "discounted_cash": 107.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOTRIMAZOLE 1% 15GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334871", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 143.0, "discounted_cash": 107.25, "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": 292.0, "discounted_cash": 219.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 292.0, "discounted_cash": 219.0, "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": 47.0, "discounted_cash": 35.25, "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": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOZAPINE", "code_information": [{"code": "80159", "type": "CPT"}, {"code": "7250062", "type": "CDM"}], "standard_charges": [{"gross_charge": 1017.0, "discounted_cash": 762.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "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": 90.0, "discounted_cash": 67.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "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": 52.0, "discounted_cash": 39.0, "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": 43190.0, "discounted_cash": 32392.5, "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": 43190.0, "discounted_cash": 32392.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CMP FEM OXI GN REN OXLEG SN CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012891", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 22777.0, "discounted_cash": 17082.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CMRI MORPH FUNCT WO CONT", "code_information": [{"code": "75557", "type": "CPT"}, {"code": "5255557", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 3746.0, "discounted_cash": 2809.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CMRI MORPH FUNCT WO/W", "code_information": [{"code": "75561", "type": "CPT"}, {"code": "5255561", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 4033.0, "discounted_cash": 3024.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CMV QUANT", "code_information": [{"code": "87497", "type": "CPT"}, {"code": "7007498", "type": "CDM"}], "standard_charges": [{"gross_charge": 1620.0, "discounted_cash": 1215.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CMV QUANT/2", "code_information": [{"code": "87497", "type": "CPT"}, {"code": "7257497", "type": "CDM"}], "standard_charges": [{"gross_charge": 1088.0, "discounted_cash": 816.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CNS PATHOGENS 12-25/2", "code_information": [{"code": "87483", "type": "CPT"}, {"code": "7257484", "type": "CDM"}], "standard_charges": [{"gross_charge": 2031.0, "discounted_cash": 1523.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CNSLT/RPT REFRD MATERIAL", "code_information": [{"code": "88323", "type": "CPT"}, {"code": "7058323", "type": "CDM"}], "standard_charges": [{"gross_charge": 455.0, "discounted_cash": 341.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CNT MTR EP T/CRAN L/L", "code_information": [{"code": "95929", "type": "CPT"}, {"code": "3215929", "type": "CDM"}, {"code": "922", "type": "RC"}], "standard_charges": [{"gross_charge": 1062.0, "discounted_cash": 796.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CNT MTR EP T/CRAN U/L", "code_information": [{"code": "95928", "type": "CPT"}, {"code": "3215928", "type": "CDM"}, {"code": "922", "type": "RC"}], "standard_charges": [{"gross_charge": 1062.0, "discounted_cash": 796.5, "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": 862.0, "discounted_cash": 646.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COAGULATION TIME ACTIVTD", "code_information": [{"code": "85347", "type": "CPT"}, {"code": "4125347", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COAGULATION TIME ACTIVTD", "code_information": [{"code": "85347", "type": "CPT"}, {"code": "4613585", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 897.0, "discounted_cash": 672.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COBICISTAT 150MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303023", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 74.0, "discounted_cash": 55.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COBICISTAT 150MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303023", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 74.0, "discounted_cash": 55.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COCAINE", "code_information": [{"code": "80353", "type": "CPT"}, {"code": "7252520", "type": "CDM"}], "standard_charges": [{"gross_charge": 189.0, "discounted_cash": 141.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COCAINE 4% 10ML TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5327316", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1237.0, "discounted_cash": 927.75, "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": 284.0, "discounted_cash": 213.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COCAINE/2", "code_information": [{"code": "80353", "type": "CPT"}, {"code": "7002520", "type": "CDM"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "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": 335.0, "discounted_cash": 251.25, "setting": "both", "billing_class": "facility"}]}, {"description": "COCCIDIOIDES ANTIBODY/8", "code_information": [{"code": "86635", "type": "CPT"}, {"code": "7258681", "type": "CDM"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CODEINE 30MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327368", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CODEINE 30MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327368", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "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": 142.0, "discounted_cash": 106.5, "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": 142.0, "discounted_cash": 106.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COIL EMB COMPLEX HYPERSOFT", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8187027", "type": "CDM"}], "standard_charges": [{"gross_charge": 20489.0, "discounted_cash": 15366.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COIL EMB DETACH HELICAL ULTRA", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8173724", "type": "CDM"}], "standard_charges": [{"gross_charge": 3105.0, "discounted_cash": 2328.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COIL EMB DETACH TARGET 360", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8173720", "type": "CDM"}], "standard_charges": [{"gross_charge": 24286.0, "discounted_cash": 18214.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COIL EMB DETACH TARGT 360 NANO", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8173723", "type": "CDM"}], "standard_charges": [{"gross_charge": 26122.0, "discounted_cash": 19591.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COIL EMB HYDROSOFT 3D ADVANCED", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "4020992", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 18971.0, "discounted_cash": 14228.25, "setting": "both", "billing_class": "facility"}]}, {"description": "COIL EMB PERIPH COMPLEX", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8187026", "type": "CDM"}], "standard_charges": [{"gross_charge": 12816.0, "discounted_cash": 9612.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COIL EMB POD PACKNG J-SFT RUBY", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8173718", "type": "CDM"}], "standard_charges": [{"gross_charge": 14907.0, "discounted_cash": 11180.25, "setting": "both", "billing_class": "facility"}]}, {"description": "COIL EMBOLIC", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8031745", "type": "CDM"}], "standard_charges": [{"gross_charge": 873.0, "discounted_cash": 654.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COIL EMBOLIC DETACH", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8060300", "type": "CDM"}], "standard_charges": [{"gross_charge": 9377.0, "discounted_cash": 7032.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COIL EMBOLIZATION MICRO NESTER", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8173719", "type": "CDM"}], "standard_charges": [{"gross_charge": 937.0, "discounted_cash": 702.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COIL NV 3D", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "4021002", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 33773.0, "discounted_cash": 25329.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COIL NV ULTRSFT", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "4021015", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16814.0, "discounted_cash": 12610.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COIL SWIFTPAC", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8173712", "type": "CDM"}], "standard_charges": [{"gross_charge": 16457.0, "discounted_cash": 12342.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COLCHICINE .3MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303041", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 29.0, "discounted_cash": 21.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COLCHICINE .3MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303041", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 29.0, "discounted_cash": 21.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COLCHICINE .6MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303040", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COLCHICINE .6MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303040", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "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": 173.0, "discounted_cash": 129.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COLD AGGLUTINATN TITER", "code_information": [{"code": "86157", "type": "CPT"}, {"code": "7256015", "type": "CDM"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COLD AGGLUTININ SCREEN", "code_information": [{"code": "86156", "type": "CPT"}, {"code": "4106050", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 94.0, "discounted_cash": 70.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COLD AGGLUTININ SCREEN", "code_information": [{"code": "86156", "type": "CPT"}, {"code": "7016050", "type": "CDM"}], "standard_charges": [{"gross_charge": 411.0, "discounted_cash": 308.25, "setting": "both", "billing_class": "facility"}]}, {"description": "COLESEVELAM 625MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303043", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COLESEVELAM 625MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303043", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "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": 1220.0, "discounted_cash": 915.0, "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": 1220.0, "discounted_cash": 915.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COLLAGEN BINDING ASSAY", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7253591", "type": "CDM"}], "standard_charges": [{"gross_charge": 625.0, "discounted_cash": 468.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COLLAGEN CROSS LINKS/3", "code_information": [{"code": "82523", "type": "CPT"}, {"code": "7252527", "type": "CDM"}], "standard_charges": [{"gross_charge": 320.0, "discounted_cash": 240.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COLLAGEN CROSS LINKS/5", "code_information": [{"code": "82523", "type": "CPT"}, {"code": "7253950", "type": "CDM"}], "standard_charges": [{"gross_charge": 546.0, "discounted_cash": 409.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COLLAGEN CROSS LINKS/6", "code_information": [{"code": "82523", "type": "CPT"}, {"code": "7258252", "type": "CDM"}], "standard_charges": [{"gross_charge": 856.0, "discounted_cash": 642.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COLLAGEN MIC SPNG3X4 EA", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5336607", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1190.0, "discounted_cash": 892.5, "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": 2227.0, "discounted_cash": 1670.25, "setting": "both", "billing_class": "facility"}]}, {"description": "COLLAGENASE PER DOSE OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334950", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 75.0, "discounted_cash": 56.25, "setting": "both", "billing_class": "facility"}]}, {"description": "COLLAGENASE PER DOSE OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334950", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 75.0, "discounted_cash": 56.25, "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": 505.0, "discounted_cash": 378.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 505.0, "discounted_cash": 378.75, "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": 870.0, "discounted_cash": 652.5, "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": 870.0, "discounted_cash": 652.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COLLAR MIAMI J", "code_information": [{"code": "L0174", "type": "HCPCS"}, {"code": "8114198", "type": "CDM"}], "standard_charges": [{"gross_charge": 1398.0, "discounted_cash": 1048.5, "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": 4053.0, "discounted_cash": 3039.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COLON DBL CM STUDY INCLD GLUC", "code_information": [{"code": "74280", "type": "CPT"}, {"code": "5014280", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 4513.0, "discounted_cash": 3384.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COLON DBL CM STUDY INCLD GLUC", "code_information": [{"code": "74280", "type": "CPT"}, {"code": "5114280", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 5148.0, "discounted_cash": 3861.0, "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": 2991.0, "discounted_cash": 2243.25, "setting": "both", "billing_class": "facility"}]}, {"description": "COLON SNGL CM STUDY", "code_information": [{"code": "74270", "type": "CPT"}, {"code": "5014270", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2991.0, "discounted_cash": 2243.25, "setting": "both", "billing_class": "facility"}]}, {"description": "COLON SNGL CM STUDY", "code_information": [{"code": "74270", "type": "CPT"}, {"code": "5114270", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 3802.0, "discounted_cash": 2851.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COLONIC LAVAGE 2L PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314379", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 293.0, "discounted_cash": 219.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COLONIC LAVAGE 2L PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314379", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 293.0, "discounted_cash": 219.75, "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": 367.0, "discounted_cash": 275.25, "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": 367.0, "discounted_cash": 275.25, "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": 47593.0, "discounted_cash": 35694.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COMP EP EVAL/LA FRM CS R", "code_information": [{"code": "93621", "type": "CPT"}, {"code": "4610610", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 49805.0, "discounted_cash": 37353.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COMP EP EVAL/LV RECORD", "code_information": [{"code": "93622", "type": "CPT"}, {"code": "4610612", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 30165.0, "discounted_cash": 22623.75, "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": 51408.0, "discounted_cash": 38556.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COMP EP W/O INDUC/ARRYTH", "code_information": [{"code": "93619", "type": "CPT"}, {"code": "4610615", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 36216.0, "discounted_cash": 27162.0, "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": 45327.0, "discounted_cash": 33995.25, "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": 21529.0, "discounted_cash": 16146.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COMP FEM PATELLO FEM STRYK CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013048", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 22547.0, "discounted_cash": 16910.25, "setting": "both", "billing_class": "facility"}]}, {"description": "COMP FEM UNCOAT PTLL CORIN CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013216", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 17258.0, "discounted_cash": 12943.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COMP FEM UNCOATED CONFORMIS CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013319", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 22066.0, "discounted_cash": 16549.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COMP FEM UNCT GND PR VG ZM CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012963", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 21239.0, "discounted_cash": 15929.25, "setting": "both", "billing_class": "facility"}]}, {"description": "COMP FEM UNCTD PATL FEM SN CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012893", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 18222.0, "discounted_cash": 13666.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COMP FEM UNCTD TRIATH STRY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013050", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 17822.0, "discounted_cash": 13366.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COMP KNEE FEM REVISION SN CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012882", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 51931.0, "discounted_cash": 38948.25, "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": 2022.0, "discounted_cash": 1516.5, "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": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COMP METABOLIC PANEL", "code_information": [{"code": "80053", "type": "CPT"}, {"code": "4150111", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 300.0, "discounted_cash": 225.0, "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": 1174.0, "discounted_cash": 880.5, "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": 1219.0, "discounted_cash": 914.25, "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": 370.0, "discounted_cash": 277.5, "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": 531.0, "discounted_cash": 398.25, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPLEMENT AG EA", "code_information": [{"code": "86160", "type": "CPT"}, {"code": "4126332", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPLEMENT AG EA", "code_information": [{"code": "86160", "type": "CPT"}, {"code": "7006136", "type": "CDM"}], "standard_charges": [{"gross_charge": 1086.0, "discounted_cash": 814.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPLEMENT AG EA", "code_information": [{"code": "86160", "type": "CPT"}, {"code": "7256136", "type": "CDM"}], "standard_charges": [{"gross_charge": 1086.0, "discounted_cash": 814.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPLEMENT AG EA/12", "code_information": [{"code": "86160", "type": "CPT"}, {"code": "7256334", "type": "CDM"}], "standard_charges": [{"gross_charge": 1209.0, "discounted_cash": 906.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPLEMENT AG EA/13", "code_information": [{"code": "86160", "type": "CPT"}, {"code": "7006334", "type": "CDM"}], "standard_charges": [{"gross_charge": 1209.0, "discounted_cash": 906.75, "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": 1257.0, "discounted_cash": 942.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPLEMENT AG EA/2", "code_information": [{"code": "86160", "type": "CPT"}, {"code": "4126333", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "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": 806.0, "discounted_cash": 604.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPLEMENT AG EA/3", "code_information": [{"code": "86160", "type": "CPT"}, {"code": "7256157", "type": "CDM"}], "standard_charges": [{"gross_charge": 1254.0, "discounted_cash": 940.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPLEMENT TOTAL CH50", "code_information": [{"code": "86162", "type": "CPT"}, {"code": "7006162", "type": "CDM"}], "standard_charges": [{"gross_charge": 424.0, "discounted_cash": 318.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPLEMENT TOTAL CH50", "code_information": [{"code": "86162", "type": "CPT"}, {"code": "7256162", "type": "CDM"}], "standard_charges": [{"gross_charge": 424.0, "discounted_cash": 318.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPLEMNT FUNCT ACTIV EA", "code_information": [{"code": "86161", "type": "CPT"}, {"code": "7258308", "type": "CDM"}], "standard_charges": [{"gross_charge": 1499.0, "discounted_cash": 1124.25, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPLEMNT FUNCT ACTIV EA/2", "code_information": [{"code": "86161", "type": "CPT"}, {"code": "7006153", "type": "CDM"}], "standard_charges": [{"gross_charge": 1499.0, "discounted_cash": 1124.25, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPONENT ART GRFT HERO", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8174122", "type": "CDM"}], "standard_charges": [{"gross_charge": 11557.0, "discounted_cash": 8667.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPONENT FEM PFJ ZIMMER CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012961", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 45164.0, "discounted_cash": 33873.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPONENT FEM UNCTD STRYKR CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013049", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 65101.0, "discounted_cash": 48825.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPONENT HUM STM FRE EXCT CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012838", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 44427.0, "discounted_cash": 33320.25, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPONENT VEN OUTFLOW", "code_information": [{"code": "C1750", "type": "HCPCS"}, {"code": "8173799", "type": "CDM"}], "standard_charges": [{"gross_charge": 25217.0, "discounted_cash": 18912.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CONCENTRATION INF AGENT", "code_information": [{"code": "87015", "type": "CPT"}, {"code": "7007015", "type": "CDM"}], "standard_charges": [{"gross_charge": 157.0, "discounted_cash": 117.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CONCENTRATION INF AGENT", "code_information": [{"code": "87015", "type": "CPT"}, {"code": "7077014", "type": "CDM"}], "standard_charges": [{"gross_charge": 232.0, "discounted_cash": 174.0, "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": 414.0, "discounted_cash": 310.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CONCENTRATION INF AGENT/2", "code_information": [{"code": "87015", "type": "CPT"}, {"code": "7257015", "type": "CDM"}], "standard_charges": [{"gross_charge": 304.0, "discounted_cash": 228.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CONCENTRATION INF AGENT/7", "code_information": [{"code": "87015", "type": "CPT"}, {"code": "7257212", "type": "CDM"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CONIVAPTAN PER 1MG PMXIJ", "code_information": [{"code": "C9488", "type": "HCPCS"}, {"code": "5319504", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 266.0, "discounted_cash": 199.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CONIVAPTAN PER 1MG PMXIJ", "code_information": [{"code": "C9488", "type": "HCPCS"}, {"code": "5319504", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 266.0, "discounted_cash": 199.5, "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": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "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": 43.0, "discounted_cash": 32.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CONJ ESTROGEN .9MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303070", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CONJ ESTROGEN .9MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303070", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "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": 1784.0, "discounted_cash": 1338.0, "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": 1784.0, "discounted_cash": 1338.0, "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": 705.0, "discounted_cash": 528.75, "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": 705.0, "discounted_cash": 528.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CONJUGATED ESTR 1.25MG", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303073", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CONJUGATED ESTR 1.25MG", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303073", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CONNECT TRANSSEPTAL DILATOR", "code_information": [{"code": "C1893", "type": "HCPCS"}, {"code": "8187030", "type": "CDM"}], "standard_charges": [{"gross_charge": 11866.0, "discounted_cash": 8899.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CONNECTOR IMP ALL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131551", "type": "CDM"}], "standard_charges": [{"gross_charge": 6017.51, "discounted_cash": 4513.13, "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": 82.0, "discounted_cash": 61.5, "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": 283.0, "discounted_cash": 212.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CONT AER MED OBSTR 1STHR", "code_information": [{"code": "94644", "type": "CPT"}, {"code": "5504644", "type": "CDM"}, {"code": "410", "type": "RC"}], "standard_charges": [{"gross_charge": 510.0, "discounted_cash": 382.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CONT AER MED OBSTR ADDHR", "code_information": [{"code": "94645", "type": "CPT"}, {"code": "5504645", "type": "CDM"}, {"code": "410", "type": "RC"}], "standard_charges": [{"gross_charge": 303.0, "discounted_cash": 227.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CONT RENAL REPLACE THRPY", "code_information": [{"code": "90945", "type": "CPT"}, {"code": "5601100", "type": "CDM"}, {"code": "801", "type": "RC"}], "standard_charges": [{"gross_charge": 1701.0, "discounted_cash": 1275.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CONT RENAL REPLACE THRPY", "code_information": [{"code": "90945", "type": "CPT"}, {"code": "5601100", "type": "CDM"}, {"code": "821", "type": "RC"}], "standard_charges": [{"gross_charge": 1701.0, "discounted_cash": 1275.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CONTRST EVAL EXISTNG CVD", "code_information": [{"code": "4906598", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 495.0, "discounted_cash": 371.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CONTRST EVAL EXISTNG CVD", "code_information": [{"code": "4916598", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 495.0, "discounted_cash": 371.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CONVERSION ARRHYTHMIA", "code_information": [{"code": "92960", "type": "CPT"}, {"code": "4603286", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 3156.0, "discounted_cash": 2367.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CONVERT EXT BILI DRAIN", "code_information": [{"code": "4917986", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 21489.0, "discounted_cash": 16116.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CONVRT NEPHOST TO URETER", "code_information": [{"code": "4910434", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4000.0, "discounted_cash": 3000.0, "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": 363.0, "discounted_cash": 272.25, "setting": "both", "billing_class": "facility"}]}, {"description": "COOMBS DIRECT EA", "code_information": [{"code": "86880", "type": "CPT"}, {"code": "4126031", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COOMBS DIRECT EA", "code_information": [{"code": "86880", "type": "CPT"}, {"code": "4156031", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 201.0, "discounted_cash": 150.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COOMBS DIRECT EA/2", "code_information": [{"code": "86880", "type": "CPT"}, {"code": "7016033", "type": "CDM"}], "standard_charges": [{"gross_charge": 222.0, "discounted_cash": 166.5, "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": 385.0, "discounted_cash": 288.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COOMBS INDIRECT EA", "code_information": [{"code": "86885", "type": "CPT"}, {"code": "4159621", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 253.0, "discounted_cash": 189.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COOMBS INDIRECT EA", "code_information": [{"code": "86885", "type": "CPT"}, {"code": "7016885", "type": "CDM"}], "standard_charges": [{"gross_charge": 946.0, "discounted_cash": 709.5, "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": 501.0, "discounted_cash": 375.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COOMBS INDIRECT EA AB TITR/2", "code_information": [{"code": "86886", "type": "CPT"}, {"code": "4156032", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 266.0, "discounted_cash": 199.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COPPER", "code_information": [{"code": "82525", "type": "CPT"}, {"code": "7002525", "type": "CDM"}], "standard_charges": [{"gross_charge": 512.0, "discounted_cash": 384.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COPPER CL .4MG/ML10MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5319518", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 168.0, "discounted_cash": 126.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COPPER/3", "code_information": [{"code": "82525", "type": "CPT"}, {"code": "7252525", "type": "CDM"}], "standard_charges": [{"gross_charge": 512.0, "discounted_cash": 384.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COPPER/4", "code_information": [{"code": "82525", "type": "CPT"}, {"code": "7252526", "type": "CDM"}], "standard_charges": [{"gross_charge": 512.0, "discounted_cash": 384.0, "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": 6906.0, "discounted_cash": 5179.5, "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": 20713.0, "discounted_cash": 15534.75, "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": 71701.0, "discounted_cash": 53775.75, "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": 46194.0, "discounted_cash": 34645.5, "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": 23883.0, "discounted_cash": 17912.25, "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": 66620.0, "discounted_cash": 49965.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CORONARY CARE UNIT", "code_information": [{"code": "1990026", "type": "CDM"}, {"code": "210", "type": "RC"}], "standard_charges": [{"gross_charge": 8983.0, "discounted_cash": 6737.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CORONARY CARE UNIT", "code_information": [{"code": "2020026", "type": "CDM"}, {"code": "210", "type": "RC"}], "standard_charges": [{"gross_charge": 8983.0, "discounted_cash": 6737.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CORONARY THROMBLYSIS IV", "code_information": [{"code": "92977", "type": "CPT"}, {"code": "6102977", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 8533.0, "discounted_cash": 6399.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CORONARY THROMBLYSIS IV", "code_information": [{"code": "92977", "type": "CPT"}, {"code": "6112977", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 8533.0, "discounted_cash": 6399.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CORTICOSTERONE", "code_information": [{"code": "82528", "type": "CPT"}, {"code": "7258225", "type": "CDM"}], "standard_charges": [{"gross_charge": 276.0, "discounted_cash": 207.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CORTISOL FREE/2", "code_information": [{"code": "82530", "type": "CPT"}, {"code": "7002535", "type": "CDM"}], "standard_charges": [{"gross_charge": 995.0, "discounted_cash": 746.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CORTISOL FREE/2", "code_information": [{"code": "82530", "type": "CPT"}, {"code": "7252534", "type": "CDM"}], "standard_charges": [{"gross_charge": 995.0, "discounted_cash": 746.25, "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": 736.0, "discounted_cash": 552.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CORTISOL TOTAL", "code_information": [{"code": "82533", "type": "CPT"}, {"code": "4122533", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CORTISOL TOTAL", "code_information": [{"code": "82533", "type": "CPT"}, {"code": "4152533", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 355.0, "discounted_cash": 266.25, "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": 229.0, "discounted_cash": 171.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CORTISOL TOTAL/2", "code_information": [{"code": "82533", "type": "CPT"}, {"code": "4122537", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "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": 208.0, "discounted_cash": 156.0, "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": 48.0, "discounted_cash": 36.0, "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": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CORTISONE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303086", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CORTISONE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303086", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "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": 1212.0, "discounted_cash": 909.0, "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": 1212.0, "discounted_cash": 909.0, "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": 407.0, "discounted_cash": 305.25, "setting": "both", "billing_class": "facility"}]}, {"description": "COVID 19", "code_information": [{"code": "U0002", "type": "HCPCS"}, {"code": "7020024", "type": "CDM"}], "standard_charges": [{"gross_charge": 402.0, "discounted_cash": 301.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COVID 19", "code_information": [{"code": "U0002", "type": "HCPCS"}, {"code": "7070017", "type": "CDM"}], "standard_charges": [{"gross_charge": 554.0, "discounted_cash": 415.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COVID 19", "code_information": [{"code": "U0002", "type": "HCPCS"}, {"code": "7250043", "type": "CDM"}], "standard_charges": [{"gross_charge": 407.0, "discounted_cash": 305.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CPAP MANAGEMENT DLY", "code_information": [{"code": "94660", "type": "CPT"}, {"code": "5504661", "type": "CDM"}, {"code": "410", "type": "RC"}], "standard_charges": [{"gross_charge": 2717.0, "discounted_cash": 2037.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CPR", "code_information": [{"code": "92950", "type": "CPT"}, {"code": "4619130", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 1634.0, "discounted_cash": 1225.5, "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": 2691.0, "discounted_cash": 2018.25, "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": 2691.0, "discounted_cash": 2018.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATINE", "code_information": [{"code": "82540", "type": "CPT"}, {"code": "7002540", "type": "CDM"}], "standard_charges": [{"gross_charge": 327.0, "discounted_cash": 245.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATINE KINASE ISONZ", "code_information": [{"code": "82552", "type": "CPT"}, {"code": "7002552", "type": "CDM"}], "standard_charges": [{"gross_charge": 794.0, "discounted_cash": 595.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATINE KINASE ISONZ", "code_information": [{"code": "82552", "type": "CPT"}, {"code": "7252552", "type": "CDM"}], "standard_charges": [{"gross_charge": 157.0, "discounted_cash": 117.75, "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": 475.0, "discounted_cash": 356.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATINE KINASE TOTAL", "code_information": [{"code": "82550", "type": "CPT"}, {"code": "4122550", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATINE KINASE TOTAL", "code_information": [{"code": "82550", "type": "CPT"}, {"code": "4152550", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATINE KINASE TOTAL", "code_information": [{"code": "82550", "type": "CPT"}, {"code": "7252550", "type": "CDM"}], "standard_charges": [{"gross_charge": 69.0, "discounted_cash": 51.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATININE BLOOD", "code_information": [{"code": "82565", "type": "CPT"}, {"code": "4122565", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATININE BLOOD", "code_information": [{"code": "82565", "type": "CPT"}, {"code": "4152565", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 106.0, "discounted_cash": 79.5, "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": 323.0, "discounted_cash": 242.25, "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": 788.0, "discounted_cash": 591.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATININE CLEARANCE", "code_information": [{"code": "82575", "type": "CPT"}, {"code": "4122575", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATININE CLEARANCE", "code_information": [{"code": "82575", "type": "CPT"}, {"code": "4152575", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 266.0, "discounted_cash": 199.5, "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": 82.0, "discounted_cash": 61.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATININE OTHR SRCE", "code_information": [{"code": "82570", "type": "CPT"}, {"code": "4122570", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "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": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATININE OTHR SRCE/2", "code_information": [{"code": "82570", "type": "CPT"}, {"code": "4122571", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATININE OTHR SRCE/2", "code_information": [{"code": "82570", "type": "CPT"}, {"code": "4152571", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 240.0, "discounted_cash": 180.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATININE OTHR SRCE/2", "code_information": [{"code": "82570", "type": "CPT"}, {"code": "7252570", "type": "CDM"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "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": 368.0, "discounted_cash": 276.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATININE OTHR SRCE/3", "code_information": [{"code": "82570", "type": "CPT"}, {"code": "4122573", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATININE OTHR SRCE/3", "code_information": [{"code": "82570", "type": "CPT"}, {"code": "7252571", "type": "CDM"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATININE OTHR SRCE/4", "code_information": [{"code": "82570", "type": "CPT"}, {"code": "7252573", "type": "CDM"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATININE OTHR SRCE/5", "code_information": [{"code": "82570", "type": "CPT"}, {"code": "7252574", "type": "CDM"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "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": 7376.0, "discounted_cash": 5532.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CRIT CARE E&M 30-74 MIN", "code_information": [{"code": "99291", "type": "CPT"}, {"code": "6119291", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 8512.0, "discounted_cash": 6384.0, "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": 4798.0, "discounted_cash": 3598.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CRIT CARE E&M ADDL 30MIN", "code_information": [{"code": "99292", "type": "CPT"}, {"code": "6119292", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 544.0, "discounted_cash": 408.0, "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": 2648.0, "discounted_cash": 1986.0, "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": 815.0, "discounted_cash": 611.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CROMOLYN 10MG/ML 2ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330569", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CROMOLYN 10MG/ML 2ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330569", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CROMOLYN 4% 10ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330551", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 368.0, "discounted_cash": 276.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CROMOLYN 4% 10ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330551", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 368.0, "discounted_cash": 276.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CRP HI SENSITIVITY", "code_information": [{"code": "86141", "type": "CPT"}, {"code": "7256363", "type": "CDM"}], "standard_charges": [{"gross_charge": 171.0, "discounted_cash": 128.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CRYO POOR PLASMA", "code_information": [{"code": "P9044", "type": "HCPCS"}, {"code": "4501005", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 370.0, "discounted_cash": 277.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CRYOABLATE SGL PULM TUMOR UNI", "code_information": [{"code": "5052994", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 36414.0, "discounted_cash": 27310.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CRYOCRIT QUAL/SEMI QNT", "code_information": [{"code": "82595", "type": "CPT"}, {"code": "7002595", "type": "CDM"}], "standard_charges": [{"gross_charge": 440.0, "discounted_cash": 330.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CRYOCRIT QUAL/SEMI QNT/2", "code_information": [{"code": "82595", "type": "CPT"}, {"code": "7252596", "type": "CDM"}], "standard_charges": [{"gross_charge": 29.0, "discounted_cash": 21.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CRYOCRIT QUAL/SEMI QNT/3", "code_information": [{"code": "82595", "type": "CPT"}, {"code": "7252652", "type": "CDM"}], "standard_charges": [{"gross_charge": 440.0, "discounted_cash": 330.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CRYPTOSPORIDIUM DFA", "code_information": [{"code": "87272", "type": "CPT"}, {"code": "7077272", "type": "CDM"}], "standard_charges": [{"gross_charge": 221.0, "discounted_cash": 165.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CRYPTOSPORIDIUM IA", "code_information": [{"code": "87328", "type": "CPT"}, {"code": "7257330", "type": "CDM"}], "standard_charges": [{"gross_charge": 473.0, "discounted_cash": 354.75, "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": 352.0, "discounted_cash": 264.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CRYST ID BODY FLD EX URN", "code_information": [{"code": "89060", "type": "CPT"}, {"code": "4129363", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CRYST ID BODY FLD EX URN", "code_information": [{"code": "89060", "type": "CPT"}, {"code": "4159363", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 249.0, "discounted_cash": 186.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CSF RESER", "code_information": [{"code": "C1813", "type": "HCPCS"}, {"code": "8141320", "type": "CDM"}], "standard_charges": [{"gross_charge": 3550.0, "discounted_cash": 2662.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT ABD & PELVIS W/CM", "code_information": [{"code": "74177", "type": "CPT"}, {"code": "5014177", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 20746.0, "discounted_cash": 15559.5, "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": 20746.0, "discounted_cash": 15559.5, "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": 20746.0, "discounted_cash": 15559.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT ABD & PELVIS W/O CM", "code_information": [{"code": "74176", "type": "CPT"}, {"code": "5014176", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 14992.0, "discounted_cash": 11244.0, "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": 16527.0, "discounted_cash": 12395.25, "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": 15740.0, "discounted_cash": 11805.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CT ABD & PELVIS WO/W CM", "code_information": [{"code": "74178", "type": "CPT"}, {"code": "5014178", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 23256.0, "discounted_cash": 17442.0, "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": 30440.0, "discounted_cash": 22830.0, "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": 26791.0, "discounted_cash": 20093.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CT ABDOMEN W/ CM", "code_information": [{"code": "74160", "type": "CPT"}, {"code": "5017225", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 9333.0, "discounted_cash": 6999.75, "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": 9333.0, "discounted_cash": 6999.75, "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": 10831.0, "discounted_cash": 8123.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CT ABDOMEN W/O CM", "code_information": [{"code": "74150", "type": "CPT"}, {"code": "5017220", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 7246.0, "discounted_cash": 5434.5, "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": 7246.0, "discounted_cash": 5434.5, "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": 7246.0, "discounted_cash": 5434.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT ABDOMEN WO/W CM", "code_information": [{"code": "74170", "type": "CPT"}, {"code": "5014170", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 10503.0, "discounted_cash": 7877.25, "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": 10503.0, "discounted_cash": 7877.25, "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": 10503.0, "discounted_cash": 7877.25, "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": 519.0, "discounted_cash": 389.25, "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": 519.0, "discounted_cash": 389.25, "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": 8703.0, "discounted_cash": 6527.25, "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": 3258.0, "discounted_cash": 2443.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT GUIDANCE NDL PLACEMNT", "code_information": [{"code": "77012", "type": "CPT"}, {"code": "4917012", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 7944.0, "discounted_cash": 5958.0, "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": 8222.0, "discounted_cash": 6166.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT GUIDE CORE BRST BX", "code_information": [{"code": "5059499", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6501.0, "discounted_cash": 4875.75, "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": 2601.0, "discounted_cash": 1950.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT GUIDE RAD THERAPY FL", "code_information": [{"code": "77014", "type": "CPT"}, {"code": "5106370", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 2911.0, "discounted_cash": 2183.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CT HEAD/BRAIN W CONTRAST", "code_information": [{"code": "70460", "type": "CPT"}, {"code": "5017015", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 10548.0, "discounted_cash": 7911.0, "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": 8303.0, "discounted_cash": 6227.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CT HEAD/BRAIN W CONTRAST", "code_information": [{"code": "70460", "type": "CPT"}, {"code": "5110460", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 10548.0, "discounted_cash": 7911.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CT HEAD/BRAIN WO CONTRST", "code_information": [{"code": "70450", "type": "CPT"}, {"code": "5017010", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 7480.0, "discounted_cash": 5610.0, "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": 8740.0, "discounted_cash": 6555.0, "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": 7929.0, "discounted_cash": 5946.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT HEAD/BRAIN WO/W CONTR", "code_information": [{"code": "70470", "type": "CPT"}, {"code": "5017020", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 9885.0, "discounted_cash": 7413.75, "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": 11001.0, "discounted_cash": 8250.75, "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": 11385.0, "discounted_cash": 8538.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT LOWER EXTRMTY W/ CM", "code_information": [{"code": "73701", "type": "CPT"}, {"code": "5013701", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 9071.0, "discounted_cash": 6803.25, "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": 9071.0, "discounted_cash": 6803.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CT LOWER EXTRMTY W/O CM", "code_information": [{"code": "73700", "type": "CPT"}, {"code": "5017205", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 7449.0, "discounted_cash": 5586.75, "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": 7094.0, "discounted_cash": 5320.5, "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": 7094.0, "discounted_cash": 5320.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT LOWER EXTRMTY WO/W CM", "code_information": [{"code": "73702", "type": "CPT"}, {"code": "5013702", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 9237.0, "discounted_cash": 6927.75, "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": 8712.0, "discounted_cash": 6534.0, "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": 11066.0, "discounted_cash": 8299.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT LTD OR LOC F/U STUDY", "code_information": [{"code": "76380", "type": "CPT"}, {"code": "5016380", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 2824.0, "discounted_cash": 2118.0, "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": 2417.0, "discounted_cash": 1812.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT LUNG SCREENING", "code_information": [{"code": "71271", "type": "CPT"}, {"code": "5011250", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 1961.0, "discounted_cash": 1470.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT MAXILLOFACIAL W/CM", "code_information": [{"code": "70487", "type": "CPT"}, {"code": "5010487", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 8312.0, "discounted_cash": 6234.0, "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": 8312.0, "discounted_cash": 6234.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CT MAXILLOFACIAL W/O CM", "code_information": [{"code": "70486", "type": "CPT"}, {"code": "5017040", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 6035.0, "discounted_cash": 4526.25, "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": 6998.0, "discounted_cash": 5248.5, "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": 6685.0, "discounted_cash": 5013.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT MAXILLOFACIAL WO/W CM", "code_information": [{"code": "70488", "type": "CPT"}, {"code": "5010488", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 10869.0, "discounted_cash": 8151.75, "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": 10002.0, "discounted_cash": 7501.5, "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": 11981.0, "discounted_cash": 8985.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT ORB/EAR/FOSSA W/CM", "code_information": [{"code": "70481", "type": "CPT"}, {"code": "5017105", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 9338.0, "discounted_cash": 7003.5, "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": 8388.0, "discounted_cash": 6291.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CT ORB/EAR/FOSSA W/CM", "code_information": [{"code": "70481", "type": "CPT"}, {"code": "5110481", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 9338.0, "discounted_cash": 7003.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT ORB/EAR/FOSSA W/O CM", "code_information": [{"code": "70480", "type": "CPT"}, {"code": "5010780", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 6099.0, "discounted_cash": 4574.25, "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": 6899.0, "discounted_cash": 5174.25, "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": 6693.0, "discounted_cash": 5019.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT ORB/EAR/FOSSA WO/W CM", "code_information": [{"code": "70482", "type": "CPT"}, {"code": "5010782", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 8770.0, "discounted_cash": 6577.5, "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": 8770.0, "discounted_cash": 6577.5, "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": 8770.0, "discounted_cash": 6577.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT PELVIS W/O CONTRAST", "code_information": [{"code": "72192", "type": "CPT"}, {"code": "5017175", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 6564.0, "discounted_cash": 4923.0, "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": 6564.0, "discounted_cash": 4923.0, "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": 6564.0, "discounted_cash": 4923.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CT PELVIS WITH CONTRAST", "code_information": [{"code": "72193", "type": "CPT"}, {"code": "5017180", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 8491.0, "discounted_cash": 6368.25, "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": 8491.0, "discounted_cash": 6368.25, "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": 8903.0, "discounted_cash": 6677.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CT PELVIS WO/W CM", "code_information": [{"code": "72194", "type": "CPT"}, {"code": "5012194", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 13198.0, "discounted_cash": 9898.5, "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": 15522.0, "discounted_cash": 11641.5, "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": 15963.0, "discounted_cash": 11972.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SFT TISS NECK WO/W CM", "code_information": [{"code": "70492", "type": "CPT"}, {"code": "5010492", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 10475.0, "discounted_cash": 7856.25, "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": 11067.0, "discounted_cash": 8300.25, "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": 12551.0, "discounted_cash": 9413.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SINUS W/O CONTRAST", "code_information": [{"code": "70486", "type": "CPT"}, {"code": "5010202", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 6998.0, "discounted_cash": 5248.5, "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": 6035.0, "discounted_cash": 4526.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SINUS W/O CONTRAST", "code_information": [{"code": "70486", "type": "CPT"}, {"code": "5110486", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 6685.0, "discounted_cash": 5013.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SINUS WITH CONTRAST", "code_information": [{"code": "70487", "type": "CPT"}, {"code": "5010201", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 7808.0, "discounted_cash": 5856.0, "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": 7364.0, "discounted_cash": 5523.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SINUS WITH CONTRAST", "code_information": [{"code": "70487", "type": "CPT"}, {"code": "5110487", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 8906.0, "discounted_cash": 6679.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SINUS WO/W CONTRAST", "code_information": [{"code": "70488", "type": "CPT"}, {"code": "5010204", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 11981.0, "discounted_cash": 8985.75, "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": 10869.0, "discounted_cash": 8151.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SINUS WO/W CONTRAST", "code_information": [{"code": "70488", "type": "CPT"}, {"code": "5110488", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 11981.0, "discounted_cash": 8985.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SOFT TISS NECK W CM", "code_information": [{"code": "70491", "type": "CPT"}, {"code": "5010491", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 7555.0, "discounted_cash": 5666.25, "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": 7555.0, "discounted_cash": 5666.25, "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": 8054.0, "discounted_cash": 6040.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SOFT TISS NECK WO CM", "code_information": [{"code": "70490", "type": "CPT"}, {"code": "5010490", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 5823.0, "discounted_cash": 4367.25, "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": 7257.0, "discounted_cash": 5442.75, "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": 7393.0, "discounted_cash": 5544.75, "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": 7816.0, "discounted_cash": 5862.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SPINE CERVICAL W/O CM", "code_information": [{"code": "72125", "type": "CPT"}, {"code": "5017130", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 6993.0, "discounted_cash": 5244.75, "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": 8166.0, "discounted_cash": 6124.5, "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": 8175.0, "discounted_cash": 6131.25, "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": 7873.0, "discounted_cash": 5904.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SPINE LUMBAR W/CM", "code_information": [{"code": "72132", "type": "CPT"}, {"code": "5012132", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 8986.0, "discounted_cash": 6739.5, "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": 7816.0, "discounted_cash": 5862.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SPINE LUMBAR W/CM", "code_information": [{"code": "72132", "type": "CPT"}, {"code": "5112132", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 9522.0, "discounted_cash": 7141.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SPINE LUMBAR W/O CM", "code_information": [{"code": "72131", "type": "CPT"}, {"code": "5017160", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 6993.0, "discounted_cash": 5244.75, "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": 8195.0, "discounted_cash": 6146.25, "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": 8175.0, "discounted_cash": 6131.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SPINE LUMBAR WO/W CM", "code_information": [{"code": "72133", "type": "CPT"}, {"code": "5012133", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 5673.0, "discounted_cash": 4254.75, "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": 5403.0, "discounted_cash": 4052.25, "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": 6862.0, "discounted_cash": 5146.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SPINE THORACIC W/CM", "code_information": [{"code": "72129", "type": "CPT"}, {"code": "5012129", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 8555.0, "discounted_cash": 6416.25, "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": 7816.0, "discounted_cash": 5862.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SPINE THORACIC W/O CM", "code_information": [{"code": "72128", "type": "CPT"}, {"code": "5012128", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 8166.0, "discounted_cash": 6124.5, "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": 6993.0, "discounted_cash": 5244.75, "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": 8584.0, "discounted_cash": 6438.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SPINE THORACIC WO/W", "code_information": [{"code": "72130", "type": "CPT"}, {"code": "5012130", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 8639.0, "discounted_cash": 6479.25, "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": 8268.0, "discounted_cash": 6201.0, "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": 9522.0, "discounted_cash": 7141.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT THORAX W/O CONTRAST", "code_information": [{"code": "71250", "type": "CPT"}, {"code": "5017115", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 6682.0, "discounted_cash": 5011.5, "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": 8082.0, "discounted_cash": 6061.5, "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": 7699.0, "discounted_cash": 5774.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CT THORAX WITH CONTRAST", "code_information": [{"code": "71260", "type": "CPT"}, {"code": "5017120", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 10221.0, "discounted_cash": 7665.75, "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": 10221.0, "discounted_cash": 7665.75, "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": 9693.0, "discounted_cash": 7269.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT THORAX WO/W CONTRAST", "code_information": [{"code": "71270", "type": "CPT"}, {"code": "5012154", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 11010.0, "discounted_cash": 8257.5, "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": 11010.0, "discounted_cash": 8257.5, "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": 12149.0, "discounted_cash": 9111.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT UPPER EXTRMTY W/ CM", "code_information": [{"code": "73201", "type": "CPT"}, {"code": "5013201", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 9945.0, "discounted_cash": 7458.75, "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": 9153.0, "discounted_cash": 6864.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT UPPER EXTRMTY W/ CM", "code_information": [{"code": "73201", "type": "CPT"}, {"code": "5113201", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 11624.0, "discounted_cash": 8718.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CT UPPER EXTRMTY W/O CM", "code_information": [{"code": "73200", "type": "CPT"}, {"code": "5017190", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 7028.0, "discounted_cash": 5271.0, "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": 7028.0, "discounted_cash": 5271.0, "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": 7028.0, "discounted_cash": 5271.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CT UPPER EXTRMTY WO/W CM", "code_information": [{"code": "73202", "type": "CPT"}, {"code": "5013202", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 8712.0, "discounted_cash": 6534.0, "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": 9470.0, "discounted_cash": 7102.5, "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": 11066.0, "discounted_cash": 8299.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA ABD LE RO W CONT ONL", "code_information": [{"code": "75635", "type": "CPT"}, {"code": "5015635", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 8816.0, "discounted_cash": 6612.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA ABD LE RO W CONT ONL", "code_information": [{"code": "75635", "type": "CPT"}, {"code": "5055635", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 8316.0, "discounted_cash": 6237.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA ABD LE RO WO/W CONT", "code_information": [{"code": "75635", "type": "CPT"}, {"code": "5010496", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 8316.0, "discounted_cash": 6237.0, "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": 8316.0, "discounted_cash": 6237.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA ABD LE RO WO/W CONT", "code_information": [{"code": "75635", "type": "CPT"}, {"code": "5110496", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 9721.0, "discounted_cash": 7290.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA ABD W CONTRAST ONLY", "code_information": [{"code": "74175", "type": "CPT"}, {"code": "5014175", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 5085.0, "discounted_cash": 3813.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA ABD W CONTRAST ONLY", "code_information": [{"code": "74175", "type": "CPT"}, {"code": "5054175", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 5150.0, "discounted_cash": 3862.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA ABD/PEL W CONTRAST", "code_information": [{"code": "74174", "type": "CPT"}, {"code": "5054180", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 17246.0, "discounted_cash": 12934.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA ABD/PEL WO/W CM", "code_information": [{"code": "74174", "type": "CPT"}, {"code": "5014174", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 15869.0, "discounted_cash": 11901.75, "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": 15869.0, "discounted_cash": 11901.75, "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": 19437.0, "discounted_cash": 14577.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA ABDOMEN WO/W CM", "code_information": [{"code": "74175", "type": "CPT"}, {"code": "5010498", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 8316.0, "discounted_cash": 6237.0, "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": 8316.0, "discounted_cash": 6237.0, "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": 9721.0, "discounted_cash": 7290.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA CHEST (NONCOR) W CM", "code_information": [{"code": "71275", "type": "CPT"}, {"code": "5051274", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 8094.0, "discounted_cash": 6070.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA CHEST (NONCOR) WO/W", "code_information": [{"code": "71275", "type": "CPT"}, {"code": "5010460", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 8703.0, "discounted_cash": 6527.25, "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": 9313.0, "discounted_cash": 6984.75, "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": 9714.0, "discounted_cash": 7285.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA CHEST W CONTRST ONLY", "code_information": [{"code": "71275", "type": "CPT"}, {"code": "5011274", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 6045.0, "discounted_cash": 4533.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA HEAD W CONTRAST ONLY", "code_information": [{"code": "70496", "type": "CPT"}, {"code": "5010497", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 8703.0, "discounted_cash": 6527.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA HEAD W CONTRAST ONLY", "code_information": [{"code": "70496", "type": "CPT"}, {"code": "5050497", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 8703.0, "discounted_cash": 6527.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA HEAD W CONTRAST ONLY", "code_information": [{"code": "70496", "type": "CPT"}, {"code": "5110497", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 9714.0, "discounted_cash": 7285.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA HEAD WO/W CONTRAST", "code_information": [{"code": "70496", "type": "CPT"}, {"code": "5010500", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 8703.0, "discounted_cash": 6527.25, "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": 8703.0, "discounted_cash": 6527.25, "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": 9714.0, "discounted_cash": 7285.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA HEART W CONTRAST", "code_information": [{"code": "75574", "type": "CPT"}, {"code": "5050215", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 3102.0, "discounted_cash": 2326.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA LOW EXT W CNTRST ONL", "code_information": [{"code": "73706", "type": "CPT"}, {"code": "5053706", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 8730.0, "discounted_cash": 6547.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA LOWR EXTRMTY WO/W CM", "code_information": [{"code": "73706", "type": "CPT"}, {"code": "5010510", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 7653.0, "discounted_cash": 5739.75, "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": 8996.0, "discounted_cash": 6747.0, "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": 9715.0, "discounted_cash": 7286.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA NECK W CONTRAST ONLY", "code_information": [{"code": "70498", "type": "CPT"}, {"code": "5010499", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 8703.0, "discounted_cash": 6527.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA NECK W CONTRAST ONLY", "code_information": [{"code": "70498", "type": "CPT"}, {"code": "5050499", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 9251.0, "discounted_cash": 6938.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA NECK W CONTRAST ONLY", "code_information": [{"code": "70498", "type": "CPT"}, {"code": "5110499", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 9714.0, "discounted_cash": 7285.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA NECK WO/W CONTRAST", "code_information": [{"code": "70498", "type": "CPT"}, {"code": "5010502", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 8703.0, "discounted_cash": 6527.25, "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": 9313.0, "discounted_cash": 6984.75, "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": 9714.0, "discounted_cash": 7285.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA PELVIS WO/W CONTRAST", "code_information": [{"code": "72191", "type": "CPT"}, {"code": "5010504", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 9714.0, "discounted_cash": 7285.5, "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": 8695.0, "discounted_cash": 6521.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA PELVIS WO/W CONTRAST", "code_information": [{"code": "72191", "type": "CPT"}, {"code": "5110504", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 9714.0, "discounted_cash": 7285.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA PELVS W CONTRST ONLY", "code_information": [{"code": "72191", "type": "CPT"}, {"code": "5011296", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 4663.0, "discounted_cash": 3497.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA PELVS W CONTRST ONLY", "code_information": [{"code": "72191", "type": "CPT"}, {"code": "5052196", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 4663.0, "discounted_cash": 3497.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA UP EXT W CONTRST ONL", "code_information": [{"code": "73206", "type": "CPT"}, {"code": "5013206", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 9253.0, "discounted_cash": 6939.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA UP EXT W CONTRST ONL", "code_information": [{"code": "73206", "type": "CPT"}, {"code": "5053206", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 9253.0, "discounted_cash": 6939.75, "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": 7653.0, "discounted_cash": 5739.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CULT ANAEROBIC ANY EX BLD", "code_information": [{"code": "87075", "type": "CPT"}, {"code": "7077058", "type": "CDM"}], "standard_charges": [{"gross_charge": 408.0, "discounted_cash": 306.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CULT ANAEROBIC ANY EX BLD", "code_information": [{"code": "87075", "type": "CPT"}, {"code": "7257058", "type": "CDM"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "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": 164.0, "discounted_cash": 123.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CULT ANAEROBIC ANY EX BLD/2", "code_information": [{"code": "87075", "type": "CPT"}, {"code": "4127075", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "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": 192.0, "discounted_cash": 144.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CULT DIR PRB EA ORGANISM", "code_information": [{"code": "87149", "type": "CPT"}, {"code": "4127149", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 192.0, "discounted_cash": 144.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CULT DIR PRB EA ORGANISM", "code_information": [{"code": "87149", "type": "CPT"}, {"code": "4157149", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 192.0, "discounted_cash": 144.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CULT DIR PRB EA ORGANISM", "code_information": [{"code": "87149", "type": "CPT"}, {"code": "7057149", "type": "CDM"}], "standard_charges": [{"gross_charge": 750.0, "discounted_cash": 562.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CULT DIR PRB EA ORGANISM", "code_information": [{"code": "87149", "type": "CPT"}, {"code": "7077500", "type": "CDM"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CULT FUNGI ID MOLD EA", "code_information": [{"code": "87107", "type": "CPT"}, {"code": "7257111", "type": "CDM"}], "standard_charges": [{"gross_charge": 80.0, "discounted_cash": 60.0, "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": 174.0, "discounted_cash": 130.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CULT FUNGI ID YEAST EA", "code_information": [{"code": "87106", "type": "CPT"}, {"code": "7257106", "type": "CDM"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CULT MYCOBACTERIAL EA ISOL", "code_information": [{"code": "87118", "type": "CPT"}, {"code": "7077118", "type": "CDM"}], "standard_charges": [{"gross_charge": 584.0, "discounted_cash": 438.0, "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": 330.0, "discounted_cash": 247.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CULT STOOL ADD PATH EA", "code_information": [{"code": "87046", "type": "CPT"}, {"code": "7027048", "type": "CDM"}], "standard_charges": [{"gross_charge": 112.0, "discounted_cash": 84.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CULT STOOL ADD PATH EA/4", "code_information": [{"code": "87046", "type": "CPT"}, {"code": "4107057", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "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": 143.0, "discounted_cash": 107.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE AEROBIC DEF ID", "code_information": [{"code": "87077", "type": "CPT"}, {"code": "4128707", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE AEROBIC DEF ID", "code_information": [{"code": "87077", "type": "CPT"}, {"code": "7058707", "type": "CDM"}], "standard_charges": [{"gross_charge": 303.0, "discounted_cash": 227.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE AEROBIC DEF ID", "code_information": [{"code": "87077", "type": "CPT"}, {"code": "7077083", "type": "CDM"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "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": 668.0, "discounted_cash": 501.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE AEROBIC QUANT OTH", "code_information": [{"code": "87071", "type": "CPT"}, {"code": "4127021", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "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": 1451.0, "discounted_cash": 1088.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE AFB", "code_information": [{"code": "87116", "type": "CPT"}, {"code": "4127116", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 128.0, "discounted_cash": 96.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE AFB", "code_information": [{"code": "87116", "type": "CPT"}, {"code": "4157116", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 525.0, "discounted_cash": 393.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE AFB/2", "code_information": [{"code": "87116", "type": "CPT"}, {"code": "7077134", "type": "CDM"}], "standard_charges": [{"gross_charge": 689.0, "discounted_cash": 516.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE ANAEROBIC DEF ID/2", "code_information": [{"code": "87076", "type": "CPT"}, {"code": "4157097", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 388.0, "discounted_cash": 291.0, "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": 752.0, "discounted_cash": 564.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4127022", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "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": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/10", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4127065", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "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": 101.0, "discounted_cash": 75.75, "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": 156.0, "discounted_cash": 117.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/14", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4157070", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 178.0, "discounted_cash": 133.5, "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": 89.0, "discounted_cash": 66.75, "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": 845.0, "discounted_cash": 633.75, "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": 122.0, "discounted_cash": 91.5, "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": 134.0, "discounted_cash": 100.5, "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": 128.0, "discounted_cash": 96.0, "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": 128.0, "discounted_cash": 96.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/22", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4107082", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 89.0, "discounted_cash": 66.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/22", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4127085", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "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": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/25", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4127133", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "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": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/4", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4127033", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "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": 122.0, "discounted_cash": 91.5, "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": 120.0, "discounted_cash": 90.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/8", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "7257162", "type": "CDM"}], "standard_charges": [{"gross_charge": 1360.0, "discounted_cash": 1020.0, "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": 439.0, "discounted_cash": 329.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACTERIAL SCREEN", "code_information": [{"code": "87081", "type": "CPT"}, {"code": "4127039", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 80.0, "discounted_cash": 60.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACTERIAL SCREEN", "code_information": [{"code": "87081", "type": "CPT"}, {"code": "4157039", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 168.0, "discounted_cash": 126.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACTERIAL SCREEN", "code_information": [{"code": "87081", "type": "CPT"}, {"code": "7007039", "type": "CDM"}], "standard_charges": [{"gross_charge": 1360.0, "discounted_cash": 1020.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACTERIAL SCREEN/10", "code_information": [{"code": "87081", "type": "CPT"}, {"code": "4108781", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACTERIAL SCREEN/2", "code_information": [{"code": "87081", "type": "CPT"}, {"code": "4120500", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 94.0, "discounted_cash": 70.5, "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": 83.0, "discounted_cash": 62.25, "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": 133.0, "discounted_cash": 99.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACTERIAL SCREEN/5", "code_information": [{"code": "87081", "type": "CPT"}, {"code": "4127053", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 80.0, "discounted_cash": 60.0, "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": 161.0, "discounted_cash": 120.75, "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": 99.0, "discounted_cash": 74.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACTERIAL SCREEN/7", "code_information": [{"code": "87081", "type": "CPT"}, {"code": "4127081", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 80.0, "discounted_cash": 60.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACTERIAL SCREEN/9", "code_information": [{"code": "87081", "type": "CPT"}, {"code": "4127160", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 80.0, "discounted_cash": 60.0, "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": 1210.0, "discounted_cash": 907.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BLOOD", "code_information": [{"code": "87040", "type": "CPT"}, {"code": "4127040", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 122.0, "discounted_cash": 91.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE CHLAMYDIA", "code_information": [{"code": "87110", "type": "CPT"}, {"code": "7007110", "type": "CDM"}], "standard_charges": [{"gross_charge": 932.0, "discounted_cash": 699.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE CHLAMYDIA", "code_information": [{"code": "87110", "type": "CPT"}, {"code": "7257110", "type": "CDM"}], "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": "4107103", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1684.0, "discounted_cash": 1263.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE FUNGI BLOOD", "code_information": [{"code": "87103", "type": "CPT"}, {"code": "7077135", "type": "CDM"}], "standard_charges": [{"gross_charge": 380.0, "discounted_cash": 285.0, "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": 1603.0, "discounted_cash": 1202.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE FUNGI OTHER", "code_information": [{"code": "87102", "type": "CPT"}, {"code": "4127102", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE FUNGI OTHER", "code_information": [{"code": "87102", "type": "CPT"}, {"code": "4157102", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 464.0, "discounted_cash": 348.0, "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": 996.0, "discounted_cash": 747.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE STOOL", "code_information": [{"code": "87045", "type": "CPT"}, {"code": "4127055", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 112.0, "discounted_cash": 84.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE TYPNG FLUORO EA", "code_information": [{"code": "87140", "type": "CPT"}, {"code": "7007140", "type": "CDM"}], "standard_charges": [{"gross_charge": 347.0, "discounted_cash": 260.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE TYPNG FLUORO EA", "code_information": [{"code": "87140", "type": "CPT"}, {"code": "7257140", "type": "CDM"}], "standard_charges": [{"gross_charge": 467.0, "discounted_cash": 350.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE TYPNG GC/HPLC", "code_information": [{"code": "87143", "type": "CPT"}, {"code": "7007143", "type": "CDM"}], "standard_charges": [{"gross_charge": 225.0, "discounted_cash": 168.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE TYPNG SEROLOGIC", "code_information": [{"code": "87147", "type": "CPT"}, {"code": "4157147", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "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": 99.0, "discounted_cash": 74.25, "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": 350.0, "discounted_cash": 262.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE URINE IDENT", "code_information": [{"code": "87088", "type": "CPT"}, {"code": "4127088", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE URINE IDENT", "code_information": [{"code": "87088", "type": "CPT"}, {"code": "4157088", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 276.0, "discounted_cash": 207.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CUP ACE UN CTD PLR DL MB SN CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012877", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9109.0, "discounted_cash": 6831.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CUP ACET CTD PLR/DL MOB SN CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012874", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 13666.0, "discounted_cash": 10249.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CUP ACETAB ADM CUP STRYKR CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013113", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 13756.0, "discounted_cash": 10317.0, "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": 8756.0, "discounted_cash": 6567.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CUP ACETABULAR CUP R3 SN CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012875", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10248.0, "discounted_cash": 7686.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CUP ACETABULR COATD ZIMMER CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012944", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10644.0, "discounted_cash": 7983.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CUP ACETABULR COATED STRYK CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013114", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10168.0, "discounted_cash": 7626.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CUP ACETABULR REGENERX ZIM CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012947", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12268.0, "discounted_cash": 9201.0, "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": 11961.0, "discounted_cash": 8970.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CUP ACTB OSSEOT LMT HLE ZIM CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012945", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16958.42, "discounted_cash": 12718.82, "setting": "both", "billing_class": "facility"}]}, {"description": "CUP HIP RESURF ACET BHR SN CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012902", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 26192.0, "discounted_cash": 19644.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CUP HIP REV TRIRANM STRYK CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013108", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 21156.0, "discounted_cash": 15867.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CUP HIP REVISION SN CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012873", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 22207.0, "discounted_cash": 16655.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CUP HUMERAL STRYKER CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013034", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10763.0, "discounted_cash": 8072.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CUP MOD ACETB OSTEOREMEDIES CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013355", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 14454.0, "discounted_cash": 10840.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CV CATH OH IABP", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056937", "type": "CDM"}], "standard_charges": [{"gross_charge": 8021.0, "discounted_cash": 6015.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CVP MULTILUMEN", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8031975", "type": "CDM"}], "standard_charges": [{"gross_charge": 1055.0, "discounted_cash": 791.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CYANIDE", "code_information": [{"code": "82600", "type": "CPT"}, {"code": "7002600", "type": "CDM"}], "standard_charges": [{"gross_charge": 360.0, "discounted_cash": 270.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYANIDE", "code_information": [{"code": "82600", "type": "CPT"}, {"code": "7252600", "type": "CDM"}], "standard_charges": [{"gross_charge": 360.0, "discounted_cash": 270.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYANIDE ANTIDOTE KT IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5319669", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3984.0, "discounted_cash": 2988.0, "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": 157.0, "discounted_cash": 117.75, "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": 157.0, "discounted_cash": 117.75, "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": 528.0, "discounted_cash": 396.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYANOCOBLMN(VIT B12)", "code_information": [{"code": "82607", "type": "CPT"}, {"code": "4122611", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CYANOCOBLMN(VIT B12)", "code_information": [{"code": "82607", "type": "CPT"}, {"code": "4152611", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 261.0, "discounted_cash": 195.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYC CITRULLINATED PEP AB", "code_information": [{"code": "86200", "type": "CPT"}, {"code": "7003596", "type": "CDM"}], "standard_charges": [{"gross_charge": 251.0, "discounted_cash": 188.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CYC CITRULLINATED PEP AB", "code_information": [{"code": "86200", "type": "CPT"}, {"code": "7253596", "type": "CDM"}], "standard_charges": [{"gross_charge": 251.0, "discounted_cash": 188.25, "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": 53.0, "discounted_cash": 39.75, "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": 53.0, "discounted_cash": 39.75, "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": 116.0, "discounted_cash": 87.0, "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": 266.0, "discounted_cash": 199.5, "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": 282.0, "discounted_cash": 211.5, "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": 347.0, "discounted_cash": 260.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CYCLOPENTOLATE.5%15ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330586", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 232.0, "discounted_cash": 174.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYCLOPHOSPH NOS PER 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9075", "type": "HCPCS"}, {"code": "5319600", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 23.0, "discounted_cash": 17.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CYCLOPHOSPH NOS PER 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9075", "type": "HCPCS"}, {"code": "5319600", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 23.0, "discounted_cash": 17.25, "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": 89.0, "discounted_cash": 66.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 89.0, "discounted_cash": 66.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYCLOPHOSPHAMIDE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8530", "type": "HCPCS"}, {"code": "5303277", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CYCLOPHOSPHAMIDE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8530", "type": "HCPCS"}, {"code": "5303277", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CYCLOPHOSPHAMIDE 50MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8530", "type": "HCPCS"}, {"code": "5303282", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 156.0, "discounted_cash": 117.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYCLOPHOSPHAMIDE 50MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8530", "type": "HCPCS"}, {"code": "5303282", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 156.0, "discounted_cash": 117.0, "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": 27.0, "discounted_cash": 20.25, "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": 27.0, "discounted_cash": 20.25, "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": 147.0, "discounted_cash": 110.25, "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": 147.0, "discounted_cash": 110.25, "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": 31.0, "discounted_cash": 23.25, "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": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CYCLOSPORINE", "code_information": [{"code": "80158", "type": "CPT"}, {"code": "7002613", "type": "CDM"}], "standard_charges": [{"gross_charge": 1858.0, "discounted_cash": 1393.5, "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": 39.0, "discounted_cash": 29.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "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": 53.0, "discounted_cash": 39.75, "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": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYCLOSPORINE PER250MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7516", "type": "HCPCS"}, {"code": "5319715", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 703.0, "discounted_cash": 527.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CYCLOSPORINE PER250MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7516", "type": "HCPCS"}, {"code": "5319715", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 703.0, "discounted_cash": 527.25, "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": 48.0, "discounted_cash": 36.0, "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": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYCLOSPORINE/2", "code_information": [{"code": "80158", "type": "CPT"}, {"code": "7252613", "type": "CDM"}], "standard_charges": [{"gross_charge": 1858.0, "discounted_cash": 1393.5, "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": 32.0, "discounted_cash": 24.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CYSTATIN C", "code_information": [{"code": "82610", "type": "CPT"}, {"code": "7255607", "type": "CDM"}], "standard_charges": [{"gross_charge": 80.0, "discounted_cash": 60.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYSTO DILAT STRIX/STENOSIS", "code_information": [{"code": "4912279", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 11616.0, "discounted_cash": 8712.0, "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": 1474.0, "discounted_cash": 1105.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CYSTOGRAPHY 3VW MIN", "code_information": [{"code": "74430", "type": "CPT"}, {"code": "5014434", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1515.0, "discounted_cash": 1136.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTAL WND 6-LYR 7CMX10CM SQ CM", "code_information": [{"code": "Q4166", "type": "HCPCS"}, {"code": "4027996", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTAL WND 6-LYR 7CMX10CM SQ CM", "code_information": [{"code": "Q4166", "type": "HCPCS"}, {"code": "4027996", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTARABINE 100MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9100", "type": "HCPCS"}, {"code": "5319680", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 251.0, "discounted_cash": 188.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTARABINE 100MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9100", "type": "HCPCS"}, {"code": "5319680", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 251.0, "discounted_cash": 188.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTARABINE LIP PER10MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9098", "type": "HCPCS"}, {"code": "5319727", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 8600.0, "discounted_cash": 6450.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTARABINE LIP PER10MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9098", "type": "HCPCS"}, {"code": "5319727", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 8600.0, "discounted_cash": 6450.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTO CONSLT INITIAL SITE", "code_information": [{"code": "88333", "type": "CPT"}, {"code": "4308166", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 4300.0, "discounted_cash": 3225.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTO CONSULT EA ADD SITE", "code_information": [{"code": "88334", "type": "CPT"}, {"code": "4308168", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 193.0, "discounted_cash": 144.75, "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": 1027.0, "discounted_cash": 770.25, "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": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTO FNA INTRP/REPORT", "code_information": [{"code": "88173", "type": "CPT"}, {"code": "4308173", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 516.0, "discounted_cash": 387.0, "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": 261.0, "discounted_cash": 195.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTOMEGALOVIRUS AB IGM", "code_information": [{"code": "86645", "type": "CPT"}, {"code": "7256645", "type": "CDM"}], "standard_charges": [{"gross_charge": 673.0, "discounted_cash": 504.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTOMEGALOVIRUS AB IGM/2", "code_information": [{"code": "86645", "type": "CPT"}, {"code": "7006645", "type": "CDM"}], "standard_charges": [{"gross_charge": 673.0, "discounted_cash": 504.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTOMEGALOVIRUS AB IGM/2", "code_information": [{"code": "86645", "type": "CPT"}, {"code": "7256646", "type": "CDM"}], "standard_charges": [{"gross_charge": 238.0, "discounted_cash": 178.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTOMEGALOVIRUS AB/2", "code_information": [{"code": "86644", "type": "CPT"}, {"code": "7256915", "type": "CDM"}], "standard_charges": [{"gross_charge": 504.0, "discounted_cash": 378.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTOMEGALOVIRUS AB/3", "code_information": [{"code": "86644", "type": "CPT"}, {"code": "4109060", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 673.0, "discounted_cash": 504.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTOMEGALOVIRUS AB/4", "code_information": [{"code": "86644", "type": "CPT"}, {"code": "7259425", "type": "CDM"}], "standard_charges": [{"gross_charge": 504.0, "discounted_cash": 378.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTOMEGALOVIRUS AMP PRB", "code_information": [{"code": "87496", "type": "CPT"}, {"code": "7017497", "type": "CDM"}], "standard_charges": [{"gross_charge": 1224.0, "discounted_cash": 918.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTOMEGALOVIRUS AMP PRB", "code_information": [{"code": "87496", "type": "CPT"}, {"code": "7257500", "type": "CDM"}], "standard_charges": [{"gross_charge": 1620.0, "discounted_cash": 1215.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTOMEGALOVIRUS AMP PRB/2", "code_information": [{"code": "87496", "type": "CPT"}, {"code": "7007497", "type": "CDM"}], "standard_charges": [{"gross_charge": 1224.0, "discounted_cash": 918.0, "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": 349.0, "discounted_cash": 261.75, "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": 445.0, "discounted_cash": 333.75, "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": 279.0, "discounted_cash": 209.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTOPATH WASH/BRUSH/SM/6", "code_information": [{"code": "88104", "type": "CPT"}, {"code": "4303438", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 335.0, "discounted_cash": 251.25, "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": 327.0, "discounted_cash": 245.25, "setting": "both", "billing_class": "facility"}]}, {"description": "D-XYLOSE 25G", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5355910", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1151.0, "discounted_cash": 863.25, "setting": "both", "billing_class": "facility"}]}, {"description": "D-XYLOSE 25G", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5355910", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1151.0, "discounted_cash": 863.25, "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": 436.0, "discounted_cash": 327.0, "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": 444.0, "discounted_cash": 333.0, "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": 353.0, "discounted_cash": 264.75, "setting": "both", "billing_class": "facility"}]}, {"description": "D20W 500ML TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5413345", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "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": 201.0, "discounted_cash": 150.75, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 201.0, "discounted_cash": 150.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 392.0, "discounted_cash": 294.0, "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": 392.0, "discounted_cash": 294.0, "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": 415.0, "discounted_cash": 311.25, "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": 415.0, "discounted_cash": 311.25, "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": 403.0, "discounted_cash": 302.25, "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": 438.0, "discounted_cash": 328.5, "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": 438.0, "discounted_cash": 328.5, "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": 154.0, "discounted_cash": 115.5, "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": 154.0, "discounted_cash": 115.5, "setting": "both", "billing_class": "facility"}]}, {"description": "D5 ELECT48 250ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412130", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 432.0, "discounted_cash": 324.0, "setting": "both", "billing_class": "facility"}]}, {"description": "D5 ELECT48 500ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412135", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 29.0, "discounted_cash": 21.75, "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": 133.0, "discounted_cash": 99.75, "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": 436.0, "discounted_cash": 327.0, "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": 436.0, "discounted_cash": 327.0, "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": 433.0, "discounted_cash": 324.75, "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": 433.0, "discounted_cash": 324.75, "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": 396.0, "discounted_cash": 297.0, "setting": "both", "billing_class": "facility"}]}, {"description": "D5 NACL 0.2 250ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412205", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 411.0, "discounted_cash": 308.25, "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": 379.0, "discounted_cash": 284.25, "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": 460.0, "discounted_cash": 345.0, "setting": "both", "billing_class": "facility"}]}, {"description": "D5 NACL 0.45 250ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412280", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 360.0, "discounted_cash": 270.0, "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": 338.0, "discounted_cash": 253.5, "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": 475.0, "discounted_cash": 356.25, "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": 475.0, "discounted_cash": 356.25, "setting": "both", "billing_class": "facility"}]}, {"description": "D5 NACL 0.9 250ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7042", "type": "HCPCS"}, {"code": "5412325", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 402.0, "discounted_cash": 301.5, "setting": "both", "billing_class": "facility"}]}, {"description": "D5 NACL 0.9 250ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7042", "type": "HCPCS"}, {"code": "5412325", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 402.0, "discounted_cash": 301.5, "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": 386.0, "discounted_cash": 289.5, "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": 386.0, "discounted_cash": 289.5, "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": 516.0, "discounted_cash": 387.0, "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": 566.0, "discounted_cash": 424.5, "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": 484.0, "discounted_cash": 363.0, "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": 460.0, "discounted_cash": 345.0, "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": 488.0, "discounted_cash": 366.0, "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": 706.0, "discounted_cash": 529.5, "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": 549.0, "discounted_cash": 411.75, "setting": "both", "billing_class": "facility"}]}, {"description": "D50W 500ML TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5413385", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 791.0, "discounted_cash": 593.25, "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": 432.0, "discounted_cash": 324.0, "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": 432.0, "discounted_cash": 324.0, "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": 513.0, "discounted_cash": 384.75, "setting": "both", "billing_class": "facility"}]}, {"description": "D70W 1000ML TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5413420", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "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": 101.0, "discounted_cash": 75.75, "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": 0.7, "discounted_cash": 0.53, "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": 47.0, "discounted_cash": 35.25, "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": 47.0, "discounted_cash": 35.25, "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": 47.0, "discounted_cash": 35.25, "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": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DACARBAZINE 100MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9130", "type": "HCPCS"}, {"code": "5319735", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 428.0, "discounted_cash": 321.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DACARBAZINE 100MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9130", "type": "HCPCS"}, {"code": "5319735", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 428.0, "discounted_cash": 321.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DACTINOMYCIN PER.5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9120", "type": "HCPCS"}, {"code": "5319745", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 314.0, "discounted_cash": 235.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DACTINOMYCIN PER.5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9120", "type": "HCPCS"}, {"code": "5319745", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 314.0, "discounted_cash": 235.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DALBAVANCIN PER 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0875", "type": "HCPCS"}, {"code": "5319741", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 87.0, "discounted_cash": 65.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DALBAVANCIN PER 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0875", "type": "HCPCS"}, {"code": "5319741", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 87.0, "discounted_cash": 65.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DALTEPARIN PER 2500U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1645", "type": "HCPCS"}, {"code": "5319750", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 498.0, "discounted_cash": 373.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DALTEPARIN PER 2500U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1645", "type": "HCPCS"}, {"code": "5319750", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 498.0, "discounted_cash": 373.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DANAZOL 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303373", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DANAZOL 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303373", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DANAZOL 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303327", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DANAZOL 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303327", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "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": 1345.0, "discounted_cash": 1008.75, "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": 50.0, "discounted_cash": 37.5, "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": 50.0, "discounted_cash": 37.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 114.0, "discounted_cash": 85.5, "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": 114.0, "discounted_cash": 85.5, "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": 114.0, "discounted_cash": 85.5, "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": 114.0, "discounted_cash": 85.5, "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": 14.0, "discounted_cash": 10.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "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": 39.0, "discounted_cash": 29.25, "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": 39.0, "discounted_cash": 29.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "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": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DARATUMUMAB PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9145", "type": "HCPCS"}, {"code": "5319768", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 380.0, "discounted_cash": 285.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DARATUMUMAB PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9145", "type": "HCPCS"}, {"code": "5319768", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 380.0, "discounted_cash": 285.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DARBEPO ALFA PER 1MCG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0881", "type": "HCPCS"}, {"code": "5319765", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 123.0, "discounted_cash": 92.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DARBEPO ALFA PER 1MCG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0881", "type": "HCPCS"}, {"code": "5319765", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 123.0, "discounted_cash": 92.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DARUN/COBICIS 800/150 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303467", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 427.0, "discounted_cash": 320.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DARUN/COBICIS 800/150 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303467", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 427.0, "discounted_cash": 320.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DARUNAVIR 300MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303448", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DARUNAVIR 300MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303448", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DARUNAVIR 400MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303444", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 252.0, "discounted_cash": 189.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DARUNAVIR 400MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303444", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 252.0, "discounted_cash": 189.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DARUNAVIR 600MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303447", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 201.0, "discounted_cash": 150.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DARUNAVIR 600MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303447", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 201.0, "discounted_cash": 150.75, "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": 327.0, "discounted_cash": 245.25, "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": 327.0, "discounted_cash": 245.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DAUNORUBICIN PER10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9150", "type": "HCPCS"}, {"code": "5319775", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3149.0, "discounted_cash": 2361.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DAUNORUBICIN PER10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9150", "type": "HCPCS"}, {"code": "5319775", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 3149.0, "discounted_cash": 2361.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DBM INFLUX PLUS CRUNCH 10CC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8134888", "type": "CDM"}], "standard_charges": [{"gross_charge": 17948.0, "discounted_cash": 13461.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DBM INFLUX PLUS CRUNCH 2.5CC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8134891", "type": "CDM"}], "standard_charges": [{"gross_charge": 8348.0, "discounted_cash": 6261.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DBM INFLUX PLUS CRUNCH 5CC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8134890", "type": "CDM"}], "standard_charges": [{"gross_charge": 9889.0, "discounted_cash": 7416.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DCLOT CVAD THROMBL AGNT", "code_information": [{"code": "4906593", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1903.0, "discounted_cash": 1427.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DCLOT CVAD THROMBL AGNT", "code_information": [{"code": "4916593", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2252.0, "discounted_cash": 1689.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRD INFCT SKN UP TO 10", "code_information": [{"code": "6900134", "type": "CDM"}], "standard_charges": [{"gross_charge": 4931.0, "discounted_cash": 3698.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRID SUBQ 1ST 20 SQ CM OR <", "code_information": [{"code": "6900040", "type": "CDM"}], "standard_charges": [{"gross_charge": 3285.0, "discounted_cash": 2463.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRIDE BONE 20SQ CM/<", "code_information": [{"code": "6900044", "type": "CDM"}], "standard_charges": [{"gross_charge": 14253.0, "discounted_cash": 10689.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRIDE BONE EA ADD 20SQ", "code_information": [{"code": "6900045", "type": "CDM"}], "standard_charges": [{"gross_charge": 5572.0, "discounted_cash": 4179.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRIDE MSCL/FSCA 20SQCM", "code_information": [{"code": "6900042", "type": "CDM"}], "standard_charges": [{"gross_charge": 5161.0, "discounted_cash": 3870.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRIDE MSCL/FSCA EA ADD", "code_information": [{"code": "6900043", "type": "CDM"}], "standard_charges": [{"gross_charge": 3505.0, "discounted_cash": 2628.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRIDE NAIL 1-5", "code_information": [{"code": "6900036", "type": "CDM"}], "standard_charges": [{"gross_charge": 591.0, "discounted_cash": 443.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRIDE NAIL 6 OR MORE", "code_information": [{"code": "6900037", "type": "CDM"}], "standard_charges": [{"gross_charge": 591.0, "discounted_cash": 443.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRIDE SUBQ EA ADD 20SQ", "code_information": [{"code": "6900041", "type": "CDM"}], "standard_charges": [{"gross_charge": 2680.0, "discounted_cash": 2010.0, "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": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DECITABINE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0894", "type": "HCPCS"}, {"code": "5319781", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 327.0, "discounted_cash": 245.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DECITABINE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0894", "type": "HCPCS"}, {"code": "5319781", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 327.0, "discounted_cash": 245.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEFECOGRAM", "code_information": [{"code": "74270", "type": "CPT"}, {"code": "4904798", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1943.0, "discounted_cash": 1457.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEFECOGRAM", "code_information": [{"code": "74270", "type": "CPT"}, {"code": "6214270", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 3554.0, "discounted_cash": 2665.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DEFERASIROX 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303480", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 354.0, "discounted_cash": 265.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DEFERASIROX 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303480", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 354.0, "discounted_cash": 265.5, "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": 472.0, "discounted_cash": 354.0, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 472.0, "discounted_cash": 354.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DEHYDROEPIANDRST SULFATE", "code_information": [{"code": "82627", "type": "CPT"}, {"code": "7002631", "type": "CDM"}], "standard_charges": [{"gross_charge": 788.0, "discounted_cash": 591.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DEHYDROEPIANDRST SULFATE", "code_information": [{"code": "82627", "type": "CPT"}, {"code": "7252631", "type": "CDM"}], "standard_charges": [{"gross_charge": 788.0, "discounted_cash": 591.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DEHYDROEPIANDRSTRONE", "code_information": [{"code": "82626", "type": "CPT"}, {"code": "7002632", "type": "CDM"}], "standard_charges": [{"gross_charge": 1360.0, "discounted_cash": 1020.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DEHYDROEPIANDRSTRONE", "code_information": [{"code": "82626", "type": "CPT"}, {"code": "7252632", "type": "CDM"}], "standard_charges": [{"gross_charge": 1360.0, "discounted_cash": 1020.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DELAY PLC PROX ANEU INIT+S&I", "code_information": [{"code": "4914710", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 36727.0, "discounted_cash": 27545.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DELIVERY COMPLEX", "code_information": [{"code": "3101212", "type": "CDM"}, {"code": "722", "type": "RC"}], "standard_charges": [{"gross_charge": 8687.0, "discounted_cash": 6515.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DELIVERY SIMPLE", "code_information": [{"code": "3101210", "type": "CDM"}, {"code": "722", "type": "RC"}], "standard_charges": [{"gross_charge": 6780.0, "discounted_cash": 5085.0, "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": 117.0, "discounted_cash": 87.75, "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": 117.0, "discounted_cash": 87.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DEMECLOCYCLINE 300MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303525", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 178.0, "discounted_cash": 133.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DEMECLOCYCLINE 300MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303525", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 178.0, "discounted_cash": 133.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DEMINERALZD CORT FBRS ISTO 5CC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8134889", "type": "CDM"}], "standard_charges": [{"gross_charge": 5792.0, "discounted_cash": 4344.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DEMINRLZD CORT FBRS ISTO 2.5CC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8134884", "type": "CDM"}], "standard_charges": [{"gross_charge": 2946.0, "discounted_cash": 2209.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DENGUE FEVER AB", "code_information": [{"code": "86790", "type": "CPT"}, {"code": "7256717", "type": "CDM"}], "standard_charges": [{"gross_charge": 403.0, "discounted_cash": 302.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DENGUE FEVER AB/2", "code_information": [{"code": "86790", "type": "CPT"}, {"code": "7256720", "type": "CDM"}], "standard_charges": [{"gross_charge": 403.0, "discounted_cash": 302.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DENOSUMAB PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0897", "type": "HCPCS"}, {"code": "5319802", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 145.0, "discounted_cash": 108.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DENOSUMAB PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0897", "type": "HCPCS"}, {"code": "5319802", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 145.0, "discounted_cash": 108.75, "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": 829.0, "discounted_cash": 621.75, "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": 829.0, "discounted_cash": 621.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DES L/S FACET JNT ADDL", "code_information": [{"code": "4914636", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4096.0, "discounted_cash": 3072.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DES LUMB/SAC FACET JNT", "code_information": [{"code": "4914635", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 12704.0, "discounted_cash": 9528.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DESIPRAMINE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303568", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DESIPRAMINE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303568", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "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": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DESIPRAMINE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303573", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DESIPRAMINE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303573", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DESIPRAMINE 75MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303575", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DESIPRAMINE 75MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303575", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "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": 1830.0, "discounted_cash": 1372.5, "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": 1830.0, "discounted_cash": 1372.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DEST C/THO FACT JNT ADDL", "code_information": [{"code": "4914634", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3905.0, "discounted_cash": 2928.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DEST CERV/THO FACET JNT", "code_information": [{"code": "4914633", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 12704.0, "discounted_cash": 9528.0, "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": 47.0, "discounted_cash": 35.25, "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": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DESVENLAFAXINE100MG XRTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303591", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DESVENLAFAXINE100MG XRTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303591", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DEV CAPIO SUTURE OPEN", "code_information": [{"code": "C2631", "type": "HCPCS"}, {"code": "8240916", "type": "CDM"}], "standard_charges": [{"gross_charge": 2841.0, "discounted_cash": 2130.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DEV CLOSR VASC IMP/INSRT", "code_information": [{"code": "C1760", "type": "HCPCS"}, {"code": "8240133", "type": "CDM"}], "standard_charges": [{"gross_charge": 2140.0, "discounted_cash": 1605.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DEV OCULAR INTRAOP RETNA", "code_information": [{"code": "C1784", "type": "HCPCS"}, {"code": "8240171", "type": "CDM"}], "standard_charges": [{"gross_charge": 2868.0, "discounted_cash": 2151.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DEV REP URINARY W/OSLING", "code_information": [{"code": "C2631", "type": "HCPCS"}, {"code": "8240137", "type": "CDM"}], "standard_charges": [{"gross_charge": 5134.0, "discounted_cash": 3850.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DEV REP URINARY W/SLING", "code_information": [{"code": "C1771", "type": "HCPCS"}, {"code": "8240135", "type": "CDM"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DEV RETNL TAMPND SIL OIL", "code_information": [{"code": "C1814", "type": "HCPCS"}, {"code": "8243525", "type": "CDM"}], "standard_charges": [{"gross_charge": 4575.0, "discounted_cash": 3431.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEV RETRIEVAL INSERTABLE", "code_information": [{"code": "C1773", "type": "HCPCS"}, {"code": "8240139", "type": "CDM"}], "standard_charges": [{"gross_charge": 3983.0, "discounted_cash": 2987.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXA APPENDICULAR SKELTN", "code_information": [{"code": "77081", "type": "CPT"}, {"code": "3076076", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1815.0, "discounted_cash": 1361.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXA APPENDICULAR SKELTN", "code_information": [{"code": "77081", "type": "CPT"}, {"code": "5016076", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 543.0, "discounted_cash": 407.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXA AXIAL SKELETON", "code_information": [{"code": "77080", "type": "CPT"}, {"code": "4906050", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1815.0, "discounted_cash": 1361.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXA AXIAL SKELETON", "code_information": [{"code": "77080", "type": "CPT"}, {"code": "5016080", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 900.0, "discounted_cash": 675.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXAMETH VITR IMPL 0.1MG", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7312", "type": "HCPCS"}, {"code": "5330735", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1347.0, "discounted_cash": 1010.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXAMETH VITR IMPL 0.1MG", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7312", "type": "HCPCS"}, {"code": "5330735", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1347.0, "discounted_cash": 1010.25, "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": 187.0, "discounted_cash": 140.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 187.0, "discounted_cash": 140.25, "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": 187.0, "discounted_cash": 140.25, "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": 187.0, "discounted_cash": 140.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXAMETHASONE", "code_information": [{"code": "80299", "type": "CPT"}, {"code": "7252547", "type": "CDM"}], "standard_charges": [{"gross_charge": 514.0, "discounted_cash": 385.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXAMETHASONE .1% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330695", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 143.0, "discounted_cash": 107.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXAMETHASONE .1% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330695", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 143.0, "discounted_cash": 107.25, "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": 84.0, "discounted_cash": 63.0, "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": 84.0, "discounted_cash": 63.0, "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": 39.0, "discounted_cash": 29.25, "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": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXAMETHASONE .75MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303600", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXAMETHASONE .75MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303600", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXAMETHASONE 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303610", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXAMETHASONE 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303610", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXAMETHASONE 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303603", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXAMETHASONE 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303603", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "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": 47.0, "discounted_cash": 35.25, "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": 47.0, "discounted_cash": 35.25, "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": 3.0, "discounted_cash": 2.25, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "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": 379.0, "discounted_cash": 284.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXMEDETOM200MCG/50PMXIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5319881", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 863.0, "discounted_cash": 647.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXMEDETOMID PER20MCG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5314890", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "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": 1384.0, "discounted_cash": 1038.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXMETHYLPHEN 10MG XRCP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327417", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXMETHYLPHEN 10MG XRCP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327417", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXMETHYLPHEN 15MG XRCP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327419", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXMETHYLPHEN 15MG XRCP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327419", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXMETHYLPHEN 5MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327408", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXMETHYLPHEN 5MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327408", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXMETHYLPHENI 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327402", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXMETHYLPHENI 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327402", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXMETHYLPHENI 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327403", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXMETHYLPHENI 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327403", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXPANTHENOL 250MG/1MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5319892", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 486.0, "discounted_cash": 364.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXRAZOXANE PER 250MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1190", "type": "HCPCS"}, {"code": "5319890", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2728.0, "discounted_cash": 2046.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXRAZOXANE PER 250MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1190", "type": "HCPCS"}, {"code": "5319890", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 2728.0, "discounted_cash": 2046.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXTRAN40 D5W 500ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7100", "type": "HCPCS"}, {"code": "5412070", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 179.0, "discounted_cash": 134.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXTRAN40 D5W 500ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7100", "type": "HCPCS"}, {"code": "5412070", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 179.0, "discounted_cash": 134.25, "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": 146.0, "discounted_cash": 109.5, "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": 146.0, "discounted_cash": 109.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXTRAN70NACL.9 500MLIVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7110", "type": "HCPCS"}, {"code": "5412080", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 172.0, "discounted_cash": 129.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXTRAN70NACL.9 500MLIVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7110", "type": "HCPCS"}, {"code": "5412080", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 172.0, "discounted_cash": 129.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXTROAMPHETAMIN 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327405", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXTROAMPHETAMIN 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327405", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXTROMETHORP60MG/10MLLQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314892", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXTROMETHORP60MG/10MLLQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314892", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXTROSE 25% 10ML PFS IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5319898", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 137.0, "discounted_cash": 102.75, "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": 296.0, "discounted_cash": 222.0, "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": 267.0, "discounted_cash": 200.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB ACTICOR 7 VR-T DX 429525", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4000084", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 178486.0, "discounted_cash": 133864.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB AMPLIA MRI DTMB1QQ", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4000088", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 263945.0, "discounted_cash": 197958.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB CBLT VR MRI IS1DF1 DVPB3D1", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4000239", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 118462.0, "discounted_cash": 88846.5, "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": 221861.0, "discounted_cash": 166395.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB CLARIA MRI DTMA1D4", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008494", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 254169.0, "discounted_cash": 190626.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB CLARIA MRI DTMA1QQ", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008493", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 248867.0, "discounted_cash": 186650.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB COBALT CRTD DTPA2QQ", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008284", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 159107.0, "discounted_cash": 119330.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB COBALT CRTD DTPB2D4", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008286", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 155274.0, "discounted_cash": 116455.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB COBALT CRTD DTPB2QQ", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008288", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 195031.0, "discounted_cash": 146273.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB COBALT DR MRI DDPB3D4", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4008290", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 118732.0, "discounted_cash": 89049.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB COBALT IS1 DF1 DDPA2D4", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4008283", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 104106.0, "discounted_cash": 78079.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB DYNAGEN EL DR D152", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4008297", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 300134.0, "discounted_cash": 225100.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB DYNAGEN EL DR D153", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4008291", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 96015.0, "discounted_cash": 72011.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB DYNAGEN EL VR D150", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008298", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 277977.0, "discounted_cash": 208482.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB DYNAGEN EL VR D151", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008292", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 161417.0, "discounted_cash": 121062.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB DYNAGEN MINI VR D020", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4000124", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 158756.0, "discounted_cash": 119067.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB DYNAGEN X4 CRTD G158", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008299", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 350056.0, "discounted_cash": 262542.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB ELLIPSE DR CD231136Q", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4008427", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 114290.0, "discounted_cash": 85717.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB ELLIPSE DR CD241136C", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4000186", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 102315.0, "discounted_cash": 76736.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB ELLIPSE DR CD241136Q", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4000187", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 102315.0, "discounted_cash": 76736.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB ELLIPSE VR CD131136Q", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008428", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 100268.0, "discounted_cash": 75201.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB ELLIPSE VR CD141136C", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008425", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 84036.0, "discounted_cash": 63027.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB ELLIPSE VR CD141136Q", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008424", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 95496.0, "discounted_cash": 71622.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB EMBLEM MRI A219", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008333", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 239422.0, "discounted_cash": 179566.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB ENERGEN VR DF4 E140", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008430", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 88701.0, "discounted_cash": 66525.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB ENERGN CRTD DF1 N141", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008431", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 134769.0, "discounted_cash": 101076.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB EVERA MRI S DDMC3D4", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4008332", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 132401.0, "discounted_cash": 99300.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB EVERA MRI XT DDMB1D1", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4008337", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 189588.0, "discounted_cash": 142191.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB EVERA MRI XT DDMB1D4", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4008330", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 189939.0, "discounted_cash": 142454.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB EVERA MRI XT DVMB1D4", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008331", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 162727.0, "discounted_cash": 122045.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB FORTFY AS VR 135740Q", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008318", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 95496.0, "discounted_cash": 71622.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB FORTFY ASR DR DF4IS1", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4008317", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 114290.0, "discounted_cash": 85717.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB FORTFY ASR DR235740C", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4008335", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 102315.0, "discounted_cash": 76736.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB FORTFY ASR DR235740Q", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4008319", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 102315.0, "discounted_cash": 76736.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB FORTFY ASR VR135740C", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008336", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 95496.0, "discounted_cash": 71622.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB FORTFY ASSURA VR DF4", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008314", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 106668.0, "discounted_cash": 80001.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB GALLANT CRT-D HF CDHFA500Q", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4000292", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 116313.0, "discounted_cash": 87234.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB GALLNT DC ICD DR CDDRA500Q", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4000291", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 143764.0, "discounted_cash": 107823.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB ILIVIA PROMRI DR-T 404622", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4008342", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 186934.0, "discounted_cash": 140200.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB INCEPTA CRTD DF1N161", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4000198", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 150342.0, "discounted_cash": 112756.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB INCEPTA CRTD DF4N160", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4000197", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 159242.0, "discounted_cash": 119431.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB INCEPTA CRTD LV1N164", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008312", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 148245.0, "discounted_cash": 111183.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB INCEPTA DR DF1 E163", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4008313", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 109480.0, "discounted_cash": 82110.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB INCEPTA VR DF4 E160", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008310", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 115702.0, "discounted_cash": 86776.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB INOGEN MINI DR D012", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4008355", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 94270.0, "discounted_cash": 70702.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB INOGEN MINI VR D010", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008354", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 93134.0, "discounted_cash": 69850.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB MOMENTUM IS-1 CRT-D G125", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008458", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 198989.0, "discounted_cash": 149241.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB PERCIVA DR MINI RA D413", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4008450", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 92342.0, "discounted_cash": 69256.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB PERCIVA VR DF4 D412", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008449", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 122488.0, "discounted_cash": 91866.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB PERCIVA VR MRI D400", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008452", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 140925.0, "discounted_cash": 105693.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB PROTECTA XTVR 314VRM", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008416", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 105908.0, "discounted_cash": 79431.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB QUAD ASSUR CD336940Q", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008520", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 77441.0, "discounted_cash": 58080.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB QUADR ASSURA DF4/IS4", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008417", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 140954.0, "discounted_cash": 105715.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB QUADRA ASSR 336940C", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008443", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 259048.0, "discounted_cash": 194286.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB QUADRA ASSUR 336540C", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008437", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 119367.0, "discounted_cash": 89525.25, "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": 119367.0, "discounted_cash": 89525.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB RESONATE EL DR D433", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4000234", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 113501.0, "discounted_cash": 85125.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB RESONATE EL VR D432", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4000235", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 112067.0, "discounted_cash": 84050.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB UNIFY ASSUR 3357-40Q", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008423", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 119367.0, "discounted_cash": 89525.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB UNIFY ASSURA 335740C", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008479", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 119367.0, "discounted_cash": 89525.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB UNIFY ASSURA DF1/IS1", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008418", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 133336.0, "discounted_cash": 100002.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB UNIFY QUADRA CRT-D", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4000359", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 155054.0, "discounted_cash": 116290.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB VIGILANT EL DR D233", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4008478", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 166863.0, "discounted_cash": 125147.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB VISIA AF MRI DVFB1D1", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008491", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 127882.0, "discounted_cash": 95911.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB VISIA AF MRI DVFB1D4", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008488", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 175827.0, "discounted_cash": 131870.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB VISIA AF VR DVAB1D1", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008489", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 121669.0, "discounted_cash": 91251.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB VIVA QUAD XT DTBA1Q1", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008487", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 137526.0, "discounted_cash": 103144.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB VIVA QUAD XT DTBA1QQ", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008486", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 137526.0, "discounted_cash": 103144.5, "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": 144401.0, "discounted_cash": 108300.75, "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": 228101.0, "discounted_cash": 171075.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB ATLAS+ HF V343", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4000090", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 176092.0, "discounted_cash": 132069.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB COBALT XT DR ICD DDPA2D1", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4008280", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 104106.0, "discounted_cash": 78079.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB COBALT XT HF CRTD DTPA2D4", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008282", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 136145.0, "discounted_cash": 102108.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB COBALT XT VR MRI DVPA2D4", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008469", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 93306.0, "discounted_cash": 69979.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB COGNIS HE N118", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4000095", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 228638.0, "discounted_cash": 171478.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB COGNIS HE N119", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4000097", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 228638.0, "discounted_cash": 171478.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB CONCERTO CRTD", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4000096", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 233207.0, "discounted_cash": 174905.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB CONSULTA D224TRK", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4000099", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 225453.0, "discounted_cash": 169089.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB CURRENT DR RF 2207", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4000101", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 173664.0, "discounted_cash": 130248.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB CURRENT PLUS DR SJ4", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4008303", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 134518.0, "discounted_cash": 100888.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB CURRENT PLUS VR", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008300", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 181573.0, "discounted_cash": 136179.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB CURRENT PLUS VR SJ4", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008302", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 125551.0, "discounted_cash": 94163.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB CURRENT VR RF120736", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4000102", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 165067.0, "discounted_cash": 123800.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB CURRENT+ DR CD2211", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4008301", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 191513.0, "discounted_cash": 143634.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB DC ATLAS II HFV365", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4000111", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 217806.0, "discounted_cash": 163354.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB DC ATLAS II HFV366", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4000112", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 217806.0, "discounted_cash": 163354.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB DC ATLAS II+ V268", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4000106", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 169581.0, "discounted_cash": 127185.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB DC ATLAS+ DR V243", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4000109", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 174596.0, "discounted_cash": 130947.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB DC CONFIENT E030", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4000104", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 174332.0, "discounted_cash": 130749.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB DC ENTRUST", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4000114", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 197125.0, "discounted_cash": 147843.75, "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": 174596.0, "discounted_cash": 130947.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB DC LUMOS DR-T", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4000133", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 184805.0, "discounted_cash": 138603.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB DC MARQ DR 7230B", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4000145", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 152245.0, "discounted_cash": 114183.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB DC PRELIFE", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "8246130", "type": "CDM"}], "standard_charges": [{"gross_charge": 0.01, "discounted_cash": 0.01, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB DC PROTECTA XT DR", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4000162", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 144784.0, "discounted_cash": 108588.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB DC VIRTUOSO", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4000178", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 198005.0, "discounted_cash": 148503.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB DC VITALITY 2 T165", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4000182", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 198005.0, "discounted_cash": 148503.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB DC VITALITY 2 T180", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4000185", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 198005.0, "discounted_cash": 148503.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB DC VITALTY 2 T167", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4000184", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 206805.0, "discounted_cash": 155103.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB DC VITALTY DS T125", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4000179", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 176004.0, "discounted_cash": 132003.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB ENERGEN DR DF4 E142", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4008308", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 114327.0, "discounted_cash": 85745.25, "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": 117511.0, "discounted_cash": 88133.25, "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": 111916.0, "discounted_cash": 83937.0, "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": 124586.0, "discounted_cash": 93439.5, "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": 115377.0, "discounted_cash": 86532.75, "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": 115377.0, "discounted_cash": 86532.75, "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": 84306.0, "discounted_cash": 63229.5, "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": 100866.0, "discounted_cash": 75649.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB FORTIFY DR SJ4 CONN", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4000193", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 134518.0, "discounted_cash": 100888.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB FORTIFY VR DF1/IS1", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4000196", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 117337.0, "discounted_cash": 88002.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB FORTIFY VR SJ4 CONN", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4000194", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 125551.0, "discounted_cash": 94163.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB GALLANT SC VR CDVRA500Q", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4000290", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 151546.0, "discounted_cash": 113659.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB INCEPTA DR DF4 E162", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4000199", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 122456.0, "discounted_cash": 91842.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB INSYNC MARQ 7277", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4000200", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 204607.0, "discounted_cash": 153455.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB INSYNC SENTRY 7299", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4000205", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 249046.0, "discounted_cash": 186784.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB KRONOS LVT 347406", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4000210", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 198005.0, "discounted_cash": 148503.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB LUMAX 340 DR-T", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4000215", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 167205.0, "discounted_cash": 125403.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB LUMAX 340 HF-T", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4000213", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 206805.0, "discounted_cash": 155103.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB LUMAX 340 VR-T", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4000217", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 106122.0, "discounted_cash": 79591.5, "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": 108052.0, "discounted_cash": 81039.0, "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": 138926.0, "discounted_cash": 104194.5, "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": 100330.0, "discounted_cash": 75247.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB PRELIFE OTHER", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "8246169", "type": "CDM"}], "standard_charges": [{"gross_charge": 0.01, "discounted_cash": 0.01, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB PROMOTE RF 3207-36", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4000222", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 198005.0, "discounted_cash": 148503.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB PROMOTE+ CRT-D 3211", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008404", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 248501.0, "discounted_cash": 186375.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB PROMOTE+ CRT-D SJ4", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008405", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 163435.0, "discounted_cash": 122576.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB PROTECTA XT CRT-D", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008410", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 179248.0, "discounted_cash": 134436.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB PROTECTA XT D314TRM", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008414", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 172351.0, "discounted_cash": 129263.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB PROTECTA XT DR DF4", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4008415", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 133260.0, "discounted_cash": 99945.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB RENEWAL 3 CONTK HE", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4000224", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 217806.0, "discounted_cash": 163354.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB RENEWAL 3 RF", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4000230", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 222208.0, "discounted_cash": 166656.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB RENEWAL 3 RF H215", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4000231", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 222208.0, "discounted_cash": 166656.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB RENEWAL 3 RF HE", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4000229", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 231008.0, "discounted_cash": 173256.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB RENEWL 3 RF HE H219", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4000232", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 231008.0, "discounted_cash": 173256.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB SC ATLAS II VR V168", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4000295", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 160779.0, "discounted_cash": 120584.25, "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": 178116.0, "discounted_cash": 133587.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB SC ENTRUST", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4000313", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 166325.0, "discounted_cash": 124743.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB SC LUMOS VR-T", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4000321", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 167205.0, "discounted_cash": 125403.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB SC PRELIFE", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "8240865", "type": "CDM"}], "standard_charges": [{"gross_charge": 0.01, "discounted_cash": 0.01, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB SC PRIZM", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4000335", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 172487.0, "discounted_cash": 129365.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB SC PROTECTA XT VR", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008411", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 122357.0, "discounted_cash": 91767.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB SC VIRTUOSO D154VW", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4000351", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 168083.0, "discounted_cash": 126062.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB SC VITALTY 2 T175", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4000347", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 167205.0, "discounted_cash": 125403.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB SC VITALTY VR T135", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4000349", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 158406.0, "discounted_cash": 118804.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB SECURA DR D224DRG", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4000352", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 170138.0, "discounted_cash": 127603.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB SECURA VR D224VRC", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4000353", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 147509.0, "discounted_cash": 110631.75, "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": 156014.0, "discounted_cash": 117010.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB TELIGEN DR HE E110", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4000356", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 183549.0, "discounted_cash": 137661.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB TELIGEN VR HE E102", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4000355", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 162511.0, "discounted_cash": 121883.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB UNIFY CRT-D DF1/IS1", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4000358", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 163435.0, "discounted_cash": 122576.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB UNIFY CRT-D SJ4 CON", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4000357", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 163435.0, "discounted_cash": 122576.25, "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": 140072.0, "discounted_cash": 105054.0, "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": 147073.0, "discounted_cash": 110304.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DIA-CIR APLAS+IMG+S&I", "code_information": [{"code": "4916907", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 37200.0, "discounted_cash": 27900.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DIA-CIR EMBOL+IMG+S&I", "code_information": [{"code": "4916909", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 21777.0, "discounted_cash": 16332.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DIA-CIR STENT+IMG+S&I", "code_information": [{"code": "4916908", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 81763.0, "discounted_cash": 61322.25, "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": 42848.0, "discounted_cash": 32136.0, "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": 76886.0, "discounted_cash": 57664.5, "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": 112967.0, "discounted_cash": 84725.25, "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": 267.0, "discounted_cash": 200.25, "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": 392.0, "discounted_cash": 294.0, "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": 18473.0, "discounted_cash": 13854.75, "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": 75238.0, "discounted_cash": 56428.5, "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": 107.0, "discounted_cash": 80.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DIALYSATE 3000-3999ML PD", "code_information": [{"code": "A4723", "type": "HCPCS"}, {"code": "5412079", "type": "CDM"}, {"code": "270", "type": "RC"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 83.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DIALYSATE 5000-5999ML PD", "code_information": [{"code": "A4725", "type": "HCPCS"}, {"code": "5412082", "type": "CDM"}, {"code": "270", "type": "RC"}], "standard_charges": [{"gross_charge": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DIATR MEGNASOL66/10 120M", "code_information": [{"code": "5355480", "type": "CDM"}, {"code": "255", "type": "RC"}], "standard_charges": [{"gross_charge": 486.0, "discounted_cash": 364.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DIATR MEGNASOL66/10 30ML", "code_information": [{"code": "5355471", "type": "CDM"}, {"code": "255", "type": "RC"}], "standard_charges": [{"gross_charge": 252.0, "discounted_cash": 189.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DIAZEPAM 10MG R GL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335185", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1446.0, "discounted_cash": 1084.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DIAZEPAM 10MG R GL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335185", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1446.0, "discounted_cash": 1084.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DIAZEPAM 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303716", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DIAZEPAM 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303716", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DIAZEPAM 20MG R GL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335187", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1429.0, "discounted_cash": 1071.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DIAZEPAM 20MG R GL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335187", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1429.0, "discounted_cash": 1071.75, "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": 36.0, "discounted_cash": 27.0, "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": 36.0, "discounted_cash": 27.0, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DIAZEPAM PED 2.5MG R GL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335182", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1518.0, "discounted_cash": 1138.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DIAZEPAM PED 2.5MG R GL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335182", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1518.0, "discounted_cash": 1138.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DIAZEPAM UPTO 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3360", "type": "HCPCS"}, {"code": "5327420", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DIAZEPAM UPTO 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3360", "type": "HCPCS"}, {"code": "5327420", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "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": 55.0, "discounted_cash": 41.25, "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": 55.0, "discounted_cash": 41.25, "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": 84.0, "discounted_cash": 63.0, "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": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DIAZOXIDE50MG/ML 30ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314932", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2607.0, "discounted_cash": 1955.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DIAZOXIDE50MG/ML 30ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314932", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2607.0, "discounted_cash": 1955.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DIBUCAINE 1% 30GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335200", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 123.0, "discounted_cash": 92.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DIBUCAINE 1% 30GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335200", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 123.0, "discounted_cash": 92.25, "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": 445.0, "discounted_cash": 333.75, "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": 445.0, "discounted_cash": 333.75, "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": 320.0, "discounted_cash": 240.0, "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": 320.0, "discounted_cash": 240.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DICLOFENAC 1.3% PATCH TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330759", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DICLOFENAC 1.3% PATCH TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330759", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DICLOFENAC PER 0.5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1130", "type": "HCPCS"}, {"code": "5319976", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DICLOFENAC PER 0.5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1130", "type": "HCPCS"}, {"code": "5319976", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DICLOXACIL 250MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303766", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DICLOXACIL 250MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303766", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DICLOXACIL 500MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303770", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DICLOXACIL 500MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303770", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DICYCLOMINE 10MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314950", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DICYCLOMINE 10MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314950", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DICYCLOMINE 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303824", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DICYCLOMINE 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303824", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "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": 194.0, "discounted_cash": 145.5, "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": 194.0, "discounted_cash": 145.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DIDANOSINE 100MG CTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303452", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DIDANOSINE 100MG CTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303452", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DIDANOSINE 125MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303455", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DIDANOSINE 125MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303455", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DIDANOSINE 200MG CTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303456", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DIDANOSINE 200MG CTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303456", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "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": 1824.0, "discounted_cash": 1368.0, "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": 323.0, "discounted_cash": 242.25, "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": 229.0, "discounted_cash": 171.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DIGOXIN .05MG/1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314965", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DIGOXIN .05MG/1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314965", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "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": 118.0, "discounted_cash": 88.5, "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": 561.0, "discounted_cash": 420.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 561.0, "discounted_cash": 420.75, "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": 144.0, "discounted_cash": 108.0, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "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": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 6505.0, "discounted_cash": 4878.75, "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": 6505.0, "discounted_cash": 4878.75, "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": 583.0, "discounted_cash": 437.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DIGOXIN TOTAL", "code_information": [{"code": "80162", "type": "CPT"}, {"code": "4122643", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DIGOXIN TOTAL", "code_information": [{"code": "80162", "type": "CPT"}, {"code": "4152643", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 160.0, "discounted_cash": 120.0, "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": 206.0, "discounted_cash": 154.5, "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": 206.0, "discounted_cash": 154.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DIGOXIN.05MG/ML 2.5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314966", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DIGOXIN.05MG/ML 2.5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314966", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 365.0, "discounted_cash": 273.75, "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": 365.0, "discounted_cash": 273.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DILAT BILE DUCT EA", "code_information": [{"code": "4917542", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1160.0, "discounted_cash": 870.0, "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": 2460.0, "discounted_cash": 1845.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DILAT XIST TRC NDURLOGIC PROC", "code_information": [{"code": "4910436", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 13665.0, "discounted_cash": 10248.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DILAT XIST TRC NEW ACCESS RCS", "code_information": [{"code": "4910437", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 21339.0, "discounted_cash": 16004.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DILATAT RECTAL STRICT W/ANESTH", "code_information": [{"code": "4914591", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 8111.0, "discounted_cash": 6083.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DILTIAZEM 120MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304039", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DILTIAZEM 120MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304039", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DILTIAZEM 120MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304041", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DILTIAZEM 120MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304041", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "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": 53.0, "discounted_cash": 39.75, "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": 53.0, "discounted_cash": 39.75, "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": 53.0, "discounted_cash": 39.75, "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": 53.0, "discounted_cash": 39.75, "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": 69.0, "discounted_cash": 51.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 69.0, "discounted_cash": 51.75, "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": 77.0, "discounted_cash": 57.75, "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": 77.0, "discounted_cash": 57.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DILTIAZEM 60MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304042", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DILTIAZEM 60MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304042", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DILTIAZEM 90MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304038", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DILTIAZEM 90MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304038", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DILTIAZEM 90MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304040", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DILTIAZEM 90MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304040", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.38, "discounted_cash": 0.29, "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": 0.38, "discounted_cash": 0.29, "setting": "both", "billing_class": "facility"}]}, {"description": "DIMERCAPROL PER 100MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0470", "type": "HCPCS"}, {"code": "5320096", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 314.0, "discounted_cash": 235.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DIMERCAPROL PER 100MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0470", "type": "HCPCS"}, {"code": "5320096", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 314.0, "discounted_cash": 235.5, "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": 3662.0, "discounted_cash": 2746.5, "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": 3662.0, "discounted_cash": 2746.5, "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": 2155.0, "discounted_cash": 1616.25, "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": 2155.0, "discounted_cash": 1616.25, "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": 5346.0, "discounted_cash": 4009.5, "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": 36.0, "discounted_cash": 27.0, "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": 36.0, "discounted_cash": 27.0, "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": 147.0, "discounted_cash": 110.25, "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": 147.0, "discounted_cash": 110.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPHENHYDRA 1%15GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335272", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 144.0, "discounted_cash": 108.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPHENHYDRA 1%15GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335272", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 144.0, "discounted_cash": 108.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPHENHYDRA 2% 30GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335270", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPHENHYDRA 2% 30GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335270", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPHENHYDRA 2.5MG/1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315006", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.23, "discounted_cash": 0.17, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPHENHYDRA 2.5MG/1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315006", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 0.23, "discounted_cash": 0.17, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPHENHYDRA12.5/5 10 LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315001", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPHENHYDRA12.5/5 10 LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315001", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "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": 36.0, "discounted_cash": 27.0, "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": 36.0, "discounted_cash": 27.0, "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": 39.0, "discounted_cash": 29.25, "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": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPHENHYDRAMINE 50MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304091", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPHENHYDRAMINE 50MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304091", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "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": 39.0, "discounted_cash": 29.25, "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": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPHENOXYLATE/ATRP 5 LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315015", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPHENOXYLATE/ATRP 5 LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315015", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPHENOXYLATE/ATRP 60LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315020", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 87.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPHENOXYLATE/ATRP 60LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315020", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 87.75, "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": 386.0, "discounted_cash": 289.5, "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": 386.0, "discounted_cash": 289.5, "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": 352.0, "discounted_cash": 264.0, "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": 352.0, "discounted_cash": 264.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPIVEFRIN .1% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330772", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 261.0, "discounted_cash": 195.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPIVEFRIN .1% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330772", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 261.0, "discounted_cash": 195.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPTHERIA AB", "code_information": [{"code": "86648", "type": "CPT"}, {"code": "7006046", "type": "CDM"}], "standard_charges": [{"gross_charge": 146.0, "discounted_cash": 109.5, "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": 50.0, "discounted_cash": 37.5, "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": 50.0, "discounted_cash": 37.5, "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": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "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": 39.0, "discounted_cash": 29.25, "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": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPYRIDAMOLE 75MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304122", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPYRIDAMOLE 75MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304122", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPYRIDAMOLE PER10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1245", "type": "HCPCS"}, {"code": "5320170", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 133.0, "discounted_cash": 99.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPYRIDAMOLE PER10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1245", "type": "HCPCS"}, {"code": "5320170", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 133.0, "discounted_cash": 99.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DISCOGRAPHY CERV/THOR", "code_information": [{"code": "72285", "type": "CPT"}, {"code": "4902285", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2835.0, "discounted_cash": 2126.25, "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": 2609.0, "discounted_cash": 1956.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DISCOGRAPHY LUMBAR", "code_information": [{"code": "72295", "type": "CPT"}, {"code": "4912290", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2609.0, "discounted_cash": 1956.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DISOPYRAMIDE 100MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304143", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DISOPYRAMIDE 100MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304143", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DISOPYRAMIDE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304145", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DISOPYRAMIDE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304145", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DISOPYRAMIDE 100MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304153", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DISOPYRAMIDE 100MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304153", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DISOPYRAMIDE 150MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304149", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DISOPYRAMIDE 150MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304149", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DISOPYRAMIDE 150MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304157", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DISOPYRAMIDE 150MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304157", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "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": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "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": 36.0, "discounted_cash": 27.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "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": 48.0, "discounted_cash": 36.0, "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": 48.0, "discounted_cash": 36.0, "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": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "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": 23.0, "discounted_cash": 17.25, "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": 23.0, "discounted_cash": 17.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DIVALPROX NA 500MG EC TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304193", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 58.0, "discounted_cash": 43.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DIVALPROX NA 500MG EC TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304193", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 58.0, "discounted_cash": 43.5, "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": 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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DM 30MG/5ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314915", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DM 30MG/5ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314915", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DNA ANTIBODY", "code_information": [{"code": "86215", "type": "CPT"}, {"code": "7006215", "type": "CDM"}], "standard_charges": [{"gross_charge": 857.0, "discounted_cash": 642.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DNA ANTIBODY", "code_information": [{"code": "86215", "type": "CPT"}, {"code": "7256217", "type": "CDM"}], "standard_charges": [{"gross_charge": 857.0, "discounted_cash": 642.75, "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": 1074.0, "discounted_cash": 805.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DNA ANTIBODY DBL STRAND", "code_information": [{"code": "86225", "type": "CPT"}, {"code": "4156220", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 415.0, "discounted_cash": 311.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DNA ANTIBODY DBL STRAND", "code_information": [{"code": "86225", "type": "CPT"}, {"code": "7256220", "type": "CDM"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DNA ANTIBODY SNGL STRAND", "code_information": [{"code": "86226", "type": "CPT"}, {"code": "7006225", "type": "CDM"}], "standard_charges": [{"gross_charge": 194.0, "discounted_cash": 145.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DNA ANTIBODY SNGL STRAND", "code_information": [{"code": "86226", "type": "CPT"}, {"code": "7256225", "type": "CDM"}], "standard_charges": [{"gross_charge": 732.0, "discounted_cash": 549.0, "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": 592.0, "discounted_cash": 444.0, "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": 592.0, "discounted_cash": 444.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1814.0, "discounted_cash": 1360.5, "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": 1814.0, "discounted_cash": 1360.5, "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": 68.0, "discounted_cash": 51.0, "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": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DOCUSATE 10/1 30ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315047", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DOCUSATE 10/1 30ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315047", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "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": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DOCUSATE 250MG CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5304223", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DOCUSATE 250MG CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5304223", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DOCUSATE/CASA100/30MG CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5304246", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DOCUSATE/CASA100/30MG CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5304246", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "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": 36.0, "discounted_cash": 27.0, "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": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DOFETILDE .125MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304230", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DOFETILDE .125MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304230", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DOFETILDE .25MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304231", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DOFETILDE .25MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304231", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DOFETILDE .5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304233", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DOFETILDE .5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304233", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DOLASETRON 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304249", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1687.0, "discounted_cash": 1265.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DOLASETRON 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304249", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1687.0, "discounted_cash": 1265.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DOLASETRON PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1260", "type": "HCPCS"}, {"code": "5320202", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 75.0, "discounted_cash": 56.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DOLASETRON PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1260", "type": "HCPCS"}, {"code": "5320202", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 75.0, "discounted_cash": 56.25, "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": 336.0, "discounted_cash": 252.0, "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": 336.0, "discounted_cash": 252.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DOME PATELLA", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137255", "type": "CDM"}], "standard_charges": [{"gross_charge": 3678.0, "discounted_cash": 2758.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DONEPEZIL 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304251", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DONEPEZIL 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304251", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DONEPEZIL 23MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304256", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DONEPEZIL 23MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304256", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 122.0, "discounted_cash": 91.5, "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": 122.0, "discounted_cash": 91.5, "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": 0.23, "discounted_cash": 0.17, "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": 11.0, "discounted_cash": 8.25, "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": 11.0, "discounted_cash": 8.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "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": 1031.0, "discounted_cash": 773.25, "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": 409.0, "discounted_cash": 306.75, "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": 409.0, "discounted_cash": 306.75, "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": 615.0, "discounted_cash": 461.25, "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": 615.0, "discounted_cash": 461.25, "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": 2548.0, "discounted_cash": 1911.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DOPPLER ECHO COLOR FLOW", "code_information": [{"code": "93325", "type": "CPT"}, {"code": "4613325", "type": "CDM"}, {"code": "483", "type": "RC"}], "standard_charges": [{"gross_charge": 1177.0, "discounted_cash": 882.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DOPPLER ECHO COLOR FLOW", "code_information": [{"code": "93325", "type": "CPT"}, {"code": "4633330", "type": "CDM"}, {"code": "483", "type": "RC"}], "standard_charges": [{"gross_charge": 2548.0, "discounted_cash": 1911.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DOPPLER ECHO PULSE/CONT", "code_information": [{"code": "93320", "type": "CPT"}, {"code": "4603325", "type": "CDM"}, {"code": "483", "type": "RC"}], "standard_charges": [{"gross_charge": 2742.0, "discounted_cash": 2056.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DOPPLER ECHO PULSE/CONT", "code_information": [{"code": "93320", "type": "CPT"}, {"code": "4613320", "type": "CDM"}, {"code": "483", "type": "RC"}], "standard_charges": [{"gross_charge": 1572.0, "discounted_cash": 1179.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DOPPLER ECHO PULSE/CONT", "code_information": [{"code": "93320", "type": "CPT"}, {"code": "4633325", "type": "CDM"}, {"code": "483", "type": "RC"}], "standard_charges": [{"gross_charge": 2742.0, "discounted_cash": 2056.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DORIPENEM PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1267", "type": "HCPCS"}, {"code": "5320229", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DORIPENEM PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1267", "type": "HCPCS"}, {"code": "5320229", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DORNASE ALF2.5MG/2.5MLIS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5330780", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 670.0, "discounted_cash": 502.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DORNASE ALF2.5MG/2.5MLIS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5330780", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 670.0, "discounted_cash": 502.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DORSIFLEXION ASST EA JNT", "code_information": [{"code": "L2210", "type": "HCPCS"}, {"code": "8130051", "type": "CDM"}], "standard_charges": [{"gross_charge": 1766.0, "discounted_cash": 1324.5, "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": 568.0, "discounted_cash": 426.0, "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": 568.0, "discounted_cash": 426.0, "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": 409.0, "discounted_cash": 306.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 409.0, "discounted_cash": 306.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 482.0, "discounted_cash": 361.5, "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": 482.0, "discounted_cash": 361.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DORZOLAMIDE/TIMOLOL5MLOS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330787", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 671.0, "discounted_cash": 503.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DORZOLAMIDE/TIMOLOL5MLOS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330787", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 671.0, "discounted_cash": 503.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DOUCHE FEMININE180MLVTS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336359", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DOUCHE FEMININE180MLVTS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336359", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DOUCHE POVID135ML2PK VTS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336361", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DOUCHE POVID135ML2PK VTS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336361", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXAPRAM 20MG/ML 20ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5320247", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 494.0, "discounted_cash": 370.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXAZOSIN 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304335", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXAZOSIN 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304335", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "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": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXEPIN 100MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304371", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXEPIN 100MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304371", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "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": 34.0, "discounted_cash": 25.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXEPIN 150MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304373", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXEPIN 150MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304373", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXEPIN 75MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304369", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXEPIN 75MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304369", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXERCALCIFERL 2.5MCG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304380", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 149.0, "discounted_cash": 111.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXERCALCIFERL 2.5MCG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304380", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 149.0, "discounted_cash": 111.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXERCALCIFERL PER1MCGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1270", "type": "HCPCS"}, {"code": "5320252", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 59.0, "discounted_cash": 44.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXERCALCIFERL PER1MCGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1270", "type": "HCPCS"}, {"code": "5320252", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 59.0, "discounted_cash": 44.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXERCALCIFEROL .5MCG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304379", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXERCALCIFEROL .5MCG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304379", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXORUBICIN PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9000", "type": "HCPCS"}, {"code": "5320268", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1171.0, "discounted_cash": 878.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXORUBICIN PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9000", "type": "HCPCS"}, {"code": "5320268", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1171.0, "discounted_cash": 878.25, "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": 65.0, "discounted_cash": 48.75, "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": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXYCYCLINE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304396", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXYCYCLINE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304396", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "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": 117.0, "discounted_cash": 87.75, "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": 117.0, "discounted_cash": 87.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXYLAMINE-PYRID10/10 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304260", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXYLAMINE-PYRID10/10 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304260", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DRAIN BLD UNDER NAIL", "code_information": [{"code": "6900135", "type": "CDM"}], "standard_charges": [{"gross_charge": 884.0, "discounted_cash": 663.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRAIN PERITONEAL ABSCESS", "code_information": [{"code": "5057586", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4398.0, "discounted_cash": 3298.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DRAIN PERITONEAL ABSCESS", "code_information": [{"code": "5067590", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4497.0, "discounted_cash": 3372.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DRONABINOL 10MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327432", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 338.0, "discounted_cash": 253.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DRONABINOL 10MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327432", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 338.0, "discounted_cash": 253.5, "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": 94.0, "discounted_cash": 70.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 94.0, "discounted_cash": 70.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DRONABINOL 5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327431", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 152.0, "discounted_cash": 114.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRONABINOL 5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327431", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 152.0, "discounted_cash": 114.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRONEDARONE 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304404", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRONEDARONE 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304404", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "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": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 261.0, "discounted_cash": 195.75, "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": 261.0, "discounted_cash": 195.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DROTRECOGIN ALFA 20MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5320311", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 20599.0, "discounted_cash": 15449.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DROTRECOGIN ALFA 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5320310", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5150.0, "discounted_cash": 3862.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DROXIDOPA 100MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304408", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 150.0, "discounted_cash": 112.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DROXIDOPA 100MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304408", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 150.0, "discounted_cash": 112.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DRSG/DEBRIDE PT BURN LG", "code_information": [{"code": "6900048", "type": "CDM"}], "standard_charges": [{"gross_charge": 2618.0, "discounted_cash": 1963.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DRSG/DEBRIDE PT BURN MD", "code_information": [{"code": "6900047", "type": "CDM"}], "standard_charges": [{"gross_charge": 1425.0, "discounted_cash": 1068.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DRSG/DEBRIDE PT BURN SM", "code_information": [{"code": "6900046", "type": "CDM"}], "standard_charges": [{"gross_charge": 1425.0, "discounted_cash": 1068.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7110016", "type": "CDM"}], "standard_charges": [{"gross_charge": 116.0, "discounted_cash": 87.0, "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": 1180.0, "discounted_cash": 885.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/10", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "4122560", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/10", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7117262", "type": "CDM"}], "standard_charges": [{"gross_charge": 116.0, "discounted_cash": 87.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/11", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7250126", "type": "CDM"}], "standard_charges": [{"gross_charge": 498.0, "discounted_cash": 373.5, "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": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/12", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "4123927", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/12", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7117264", "type": "CDM"}], "standard_charges": [{"gross_charge": 116.0, "discounted_cash": 87.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/12", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7250130", "type": "CDM"}], "standard_charges": [{"gross_charge": 239.0, "discounted_cash": 179.25, "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": 1243.0, "discounted_cash": 932.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/14", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "4124408", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/15", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7117261", "type": "CDM"}], "standard_charges": [{"gross_charge": 116.0, "discounted_cash": 87.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/16", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "4126319", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "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": 883.0, "discounted_cash": 662.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/18", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7110114", "type": "CDM"}], "standard_charges": [{"gross_charge": 116.0, "discounted_cash": 87.0, "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": 883.0, "discounted_cash": 662.25, "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": 928.0, "discounted_cash": 696.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/2", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "4120101", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/20", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7113848", "type": "CDM"}], "standard_charges": [{"gross_charge": 116.0, "discounted_cash": 87.0, "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": 530.0, "discounted_cash": 397.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/21", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7117271", "type": "CDM"}], "standard_charges": [{"gross_charge": 116.0, "discounted_cash": 87.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/22", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7113847", "type": "CDM"}], "standard_charges": [{"gross_charge": 116.0, "discounted_cash": 87.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/24", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7110022", "type": "CDM"}], "standard_charges": [{"gross_charge": 116.0, "discounted_cash": 87.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/26", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7250330", "type": "CDM"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/27", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7250331", "type": "CDM"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 105.75, "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": 883.0, "discounted_cash": 662.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/3", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "4120102", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/31", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7252100", "type": "CDM"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/35", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7253726", "type": "CDM"}], "standard_charges": [{"gross_charge": 1056.0, "discounted_cash": 792.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/36", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7253731", "type": "CDM"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/38", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7253738", "type": "CDM"}], "standard_charges": [{"gross_charge": 322.0, "discounted_cash": 241.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/40", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7253929", "type": "CDM"}], "standard_charges": [{"gross_charge": 204.0, "discounted_cash": 153.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/41", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7254147", "type": "CDM"}], "standard_charges": [{"gross_charge": 347.0, "discounted_cash": 260.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/43", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7254480", "type": "CDM"}], "standard_charges": [{"gross_charge": 197.0, "discounted_cash": 147.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/49", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7258011", "type": "CDM"}], "standard_charges": [{"gross_charge": 862.0, "discounted_cash": 646.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/5", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7116443", "type": "CDM"}], "standard_charges": [{"gross_charge": 116.0, "discounted_cash": 87.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/52", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7258014", "type": "CDM"}], "standard_charges": [{"gross_charge": 625.0, "discounted_cash": 468.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/6", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "4122003", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/6", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7116462", "type": "CDM"}], "standard_charges": [{"gross_charge": 116.0, "discounted_cash": 87.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/6", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7250104", "type": "CDM"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/7", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "4122011", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/7", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "4152003", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 511.0, "discounted_cash": 383.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/7", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7117269", "type": "CDM"}], "standard_charges": [{"gross_charge": 116.0, "discounted_cash": 87.0, "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": 1766.0, "discounted_cash": 1324.5, "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": 29.0, "discounted_cash": 21.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/8", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7110012", "type": "CDM"}], "standard_charges": [{"gross_charge": 116.0, "discounted_cash": 87.0, "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": 1043.0, "discounted_cash": 782.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/9", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "4122213", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/9", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "4152055", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 319.0, "discounted_cash": 239.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/9", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7250108", "type": "CDM"}], "standard_charges": [{"gross_charge": 156.0, "discounted_cash": 117.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUGS NOS 7 OR MORE/3", "code_information": [{"code": "80377", "type": "CPT"}, {"code": "7252541", "type": "CDM"}], "standard_charges": [{"gross_charge": 1666.0, "discounted_cash": 1249.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DTAP VACC <7YR IJ", "code_information": [{"code": "90700", "type": "CPT"}, {"code": "5320146", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 225.0, "discounted_cash": 168.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DTAP VACC <7YR IJ", "code_information": [{"code": "90700", "type": "CPT"}, {"code": "5320146", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 225.0, "discounted_cash": 168.75, "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": 383.0, "discounted_cash": 287.25, "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": 383.0, "discounted_cash": 287.25, "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": 513.0, "discounted_cash": 384.75, "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": 513.0, "discounted_cash": 384.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DUPLEX CAROTID BI/COMP", "code_information": [{"code": "93880", "type": "CPT"}, {"code": "4636015", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 2633.0, "discounted_cash": 1974.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DUPLEX CAROTID BI/COMP", "code_information": [{"code": "93880", "type": "CPT"}, {"code": "5016505", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 1896.0, "discounted_cash": 1422.0, "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": 1577.0, "discounted_cash": 1182.75, "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": 1594.0, "discounted_cash": 1195.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DURVALUMAB PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9173", "type": "HCPCS"}, {"code": "5320316", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 544.0, "discounted_cash": 408.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DURVALUMAB PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9173", "type": "HCPCS"}, {"code": "5320316", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 544.0, "discounted_cash": 408.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC ARTHERET DIRECTIONAL", "code_information": [{"code": "C1714", "type": "HCPCS"}, {"code": "8058299", "type": "CDM"}], "standard_charges": [{"gross_charge": 38614.0, "discounted_cash": 28960.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC ATHER ROTAPRO ROTAT W/BURR", "code_information": [{"code": "C1724", "type": "HCPCS"}, {"code": "8058297", "type": "CDM"}], "standard_charges": [{"gross_charge": 16977.0, "discounted_cash": 12732.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC ATHERECT DIRECTIONAL", "code_information": [{"code": "C1714", "type": "HCPCS"}, {"code": "8058301", "type": "CDM"}], "standard_charges": [{"gross_charge": 38614.0, "discounted_cash": 28960.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC ATHERECT DIRECTONAL", "code_information": [{"code": "C1714", "type": "HCPCS"}, {"code": "8058300", "type": "CDM"}], "standard_charges": [{"gross_charge": 35754.0, "discounted_cash": 26815.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC ATRICLIP FLEX V EXCLUSION", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8195409", "type": "CDM"}], "standard_charges": [{"gross_charge": 19964.0, "discounted_cash": 14973.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC ATRICLIP LAA EXCULSN", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8192019", "type": "CDM"}], "standard_charges": [{"gross_charge": 10366.0, "discounted_cash": 7774.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC CHRONIC TOTL OCCLUSN", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8174016", "type": "CDM"}], "standard_charges": [{"gross_charge": 14558.0, "discounted_cash": 10918.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC CLOSURE PERCLOSE", "code_information": [{"code": "C1760", "type": "HCPCS"}, {"code": "8031997", "type": "CDM"}], "standard_charges": [{"gross_charge": 1440.0, "discounted_cash": 1080.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC EMBOLIC PROTECTION", "code_information": [{"code": "C1884", "type": "HCPCS"}, {"code": "8174014", "type": "CDM"}], "standard_charges": [{"gross_charge": 8382.0, "discounted_cash": 6286.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC EMBOLIZ MSH PIPELINE", "code_information": [{"code": "C2625", "type": "HCPCS"}, {"code": "8174018", "type": "CDM"}], "standard_charges": [{"gross_charge": 178149.0, "discounted_cash": 133611.75, "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": 8091.0, "discounted_cash": 6068.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC HEMOSTAT ENDO HEMOSPRAY", "code_information": [{"code": "C1052", "type": "HCPCS"}, {"code": "8031981", "type": "CDM"}], "standard_charges": [{"gross_charge": 8935.0, "discounted_cash": 6701.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC MENISCL RPR CURV NDL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011108", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5491.0, "discounted_cash": 4118.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC PLATE/STAPLE PLAPLE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131578", "type": "CDM"}], "standard_charges": [{"gross_charge": 7251.0, "discounted_cash": 5438.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC RETRVL MINI SNARE", "code_information": [{"code": "C1773", "type": "HCPCS"}, {"code": "4031886", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 2714.0, "discounted_cash": 2035.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC REVASCULARIZATION", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8174141", "type": "CDM"}], "standard_charges": [{"gross_charge": 81377.0, "discounted_cash": 61032.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC REVASCULARIZATION 3D", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8174146", "type": "CDM"}], "standard_charges": [{"gross_charge": 62494.0, "discounted_cash": 46870.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC SPINAL INTERBD APREVO NTAP", "code_information": [{"code": "C1831", "type": "HCPCS"}, {"code": "8131579", "type": "CDM"}], "standard_charges": [{"gross_charge": 20917.0, "discounted_cash": 15687.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC THROMB FR REVASCULAR", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8174019", "type": "CDM"}], "standard_charges": [{"gross_charge": 75649.0, "discounted_cash": 56736.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC UROLIFT SYS DELIVERY", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8174022", "type": "CDM"}], "standard_charges": [{"gross_charge": 13520.0, "discounted_cash": 10140.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC VAS CLSR MYNX", "code_information": [{"code": "C1760", "type": "HCPCS"}, {"code": "8174113", "type": "CDM"}], "standard_charges": [{"gross_charge": 1911.0, "discounted_cash": 1433.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC VASC CLOSURE CELT ACD", "code_information": [{"code": "C1760", "type": "HCPCS"}, {"code": "8240243", "type": "CDM"}], "standard_charges": [{"gross_charge": 2385.0, "discounted_cash": 1788.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC WATCHMAN FLX PRO", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8174153", "type": "CDM"}], "standard_charges": [{"gross_charge": 227779.0, "discounted_cash": 170834.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DX BONE MARROW BIOPSIES", "code_information": [{"code": "4918221", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2776.0, "discounted_cash": 2082.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DX BONE MARROW BIOPSIES", "code_information": [{"code": "5058221", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2618.0, "discounted_cash": 1963.5, "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": 1222.0, "discounted_cash": 916.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DX MAMMO+CAD BILAT", "code_information": [{"code": "77066", "type": "CPT"}, {"code": "5110204", "type": "CDM"}, {"code": "401", "type": "RC"}], "standard_charges": [{"gross_charge": 1165.0, "discounted_cash": 873.75, "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": 825.0, "discounted_cash": 618.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DX MAMMO+CAD UNILAT", "code_information": [{"code": "77065", "type": "CPT"}, {"code": "5110206", "type": "CDM"}, {"code": "401", "type": "RC"}], "standard_charges": [{"gross_charge": 868.0, "discounted_cash": 651.0, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL I", "code_information": [{"code": "99211", "type": "CPT"}, {"code": "3603079", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 314.0, "discounted_cash": 235.5, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL I", "code_information": [{"code": "99211", "type": "CPT"}, {"code": "3914006", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 322.0, "discounted_cash": 241.5, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL I", "code_information": [{"code": "99211", "type": "CPT"}, {"code": "3914006", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 322.0, "discounted_cash": 241.5, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL I", "code_information": [{"code": "99211", "type": "CPT"}, {"code": "5100911", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 328.0, "discounted_cash": 246.0, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL I", "code_information": [{"code": "99211", "type": "CPT"}, {"code": "5100911", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 328.0, "discounted_cash": 246.0, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL I", "code_information": [{"code": "99211", "type": "CPT"}, {"code": "6120931", "type": "CDM"}, {"code": "516", "type": "RC"}], "standard_charges": [{"gross_charge": 355.0, "discounted_cash": 266.25, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL I", "code_information": [{"code": "99211", "type": "CPT"}, {"code": "6920018", "type": "CDM"}], "standard_charges": [{"gross_charge": 322.0, "discounted_cash": 241.5, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL II", "code_information": [{"code": "99212", "type": "CPT"}, {"code": "3914007", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 370.0, "discounted_cash": 277.5, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL II", "code_information": [{"code": "99212", "type": "CPT"}, {"code": "3914007", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 370.0, "discounted_cash": 277.5, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL II", "code_information": [{"code": "99212", "type": "CPT"}, {"code": "5100912", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 556.0, "discounted_cash": 417.0, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL II", "code_information": [{"code": "99212", "type": "CPT"}, {"code": "5100912", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 556.0, "discounted_cash": 417.0, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL II", "code_information": [{"code": "99212", "type": "CPT"}, {"code": "6120932", "type": "CDM"}, {"code": "516", "type": "RC"}], "standard_charges": [{"gross_charge": 461.0, "discounted_cash": 345.75, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL II", "code_information": [{"code": "99212", "type": "CPT"}, {"code": "6901604", "type": "CDM"}], "standard_charges": [{"gross_charge": 520.0, "discounted_cash": 390.0, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL II", "code_information": [{"code": "99212", "type": "CPT"}, {"code": "6920020", "type": "CDM"}], "standard_charges": [{"gross_charge": 461.0, "discounted_cash": 345.75, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL III", "code_information": [{"code": "99213", "type": "CPT"}, {"code": "3914013", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 1018.0, "discounted_cash": 763.5, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL III", "code_information": [{"code": "99213", "type": "CPT"}, {"code": "3914013", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1018.0, "discounted_cash": 763.5, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL III", "code_information": [{"code": "99213", "type": "CPT"}, {"code": "5100913", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 1018.0, "discounted_cash": 763.5, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL III", "code_information": [{"code": "99213", "type": "CPT"}, {"code": "5100913", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1018.0, "discounted_cash": 763.5, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL III", "code_information": [{"code": "99213", "type": "CPT"}, {"code": "6120933", "type": "CDM"}, {"code": "516", "type": "RC"}], "standard_charges": [{"gross_charge": 461.0, "discounted_cash": 345.75, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL III", "code_information": [{"code": "99213", "type": "CPT"}, {"code": "6906005", "type": "CDM"}], "standard_charges": [{"gross_charge": 654.0, "discounted_cash": 490.5, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL III", "code_information": [{"code": "99213", "type": "CPT"}, {"code": "6920913", "type": "CDM"}], "standard_charges": [{"gross_charge": 461.0, "discounted_cash": 345.75, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL IV", "code_information": [{"code": "99214", "type": "CPT"}, {"code": "3914019", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 625.0, "discounted_cash": 468.75, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL IV", "code_information": [{"code": "99214", "type": "CPT"}, {"code": "3914019", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 625.0, "discounted_cash": 468.75, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL IV", "code_information": [{"code": "99214", "type": "CPT"}, {"code": "5100914", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 702.0, "discounted_cash": 526.5, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL IV", "code_information": [{"code": "99214", "type": "CPT"}, {"code": "5100914", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 702.0, "discounted_cash": 526.5, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL IV", "code_information": [{"code": "99214", "type": "CPT"}, {"code": "6120934", "type": "CDM"}, {"code": "516", "type": "RC"}], "standard_charges": [{"gross_charge": 607.0, "discounted_cash": 455.25, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL IV", "code_information": [{"code": "99214", "type": "CPT"}, {"code": "6906006", "type": "CDM"}], "standard_charges": [{"gross_charge": 863.0, "discounted_cash": 647.25, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL IV", "code_information": [{"code": "99214", "type": "CPT"}, {"code": "6920914", "type": "CDM"}], "standard_charges": [{"gross_charge": 607.0, "discounted_cash": 455.25, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL V", "code_information": [{"code": "99215", "type": "CPT"}, {"code": "3914023", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 1219.0, "discounted_cash": 914.25, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL V", "code_information": [{"code": "99215", "type": "CPT"}, {"code": "3914023", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1219.0, "discounted_cash": 914.25, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL V", "code_information": [{"code": "99215", "type": "CPT"}, {"code": "5100915", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 1161.0, "discounted_cash": 870.75, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL V", "code_information": [{"code": "99215", "type": "CPT"}, {"code": "5100915", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1161.0, "discounted_cash": 870.75, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL V", "code_information": [{"code": "99215", "type": "CPT"}, {"code": "6120935", "type": "CDM"}, {"code": "516", "type": "RC"}], "standard_charges": [{"gross_charge": 806.0, "discounted_cash": 604.5, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL V", "code_information": [{"code": "99215", "type": "CPT"}, {"code": "6906007", "type": "CDM"}], "standard_charges": [{"gross_charge": 825.0, "discounted_cash": 618.75, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL V", "code_information": [{"code": "99215", "type": "CPT"}, {"code": "6920026", "type": "CDM"}], "standard_charges": [{"gross_charge": 806.0, "discounted_cash": 604.5, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL II", "code_information": [{"code": "99202", "type": "CPT"}, {"code": "3910002", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 370.0, "discounted_cash": 277.5, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL II", "code_information": [{"code": "99202", "type": "CPT"}, {"code": "3910002", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 370.0, "discounted_cash": 277.5, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL II", "code_information": [{"code": "99202", "type": "CPT"}, {"code": "5100902", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 516.0, "discounted_cash": 387.0, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL II", "code_information": [{"code": "99202", "type": "CPT"}, {"code": "5100902", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 516.0, "discounted_cash": 387.0, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL II", "code_information": [{"code": "99202", "type": "CPT"}, {"code": "6120535", "type": "CDM"}, {"code": "516", "type": "RC"}], "standard_charges": [{"gross_charge": 460.0, "discounted_cash": 345.0, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL II", "code_information": [{"code": "99202", "type": "CPT"}, {"code": "6901002", "type": "CDM"}], "standard_charges": [{"gross_charge": 516.0, "discounted_cash": 387.0, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL II", "code_information": [{"code": "99202", "type": "CPT"}, {"code": "6920010", "type": "CDM"}], "standard_charges": [{"gross_charge": 460.0, "discounted_cash": 345.0, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL III", "code_information": [{"code": "99203", "type": "CPT"}, {"code": "3910003", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 1383.0, "discounted_cash": 1037.25, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL III", "code_information": [{"code": "99203", "type": "CPT"}, {"code": "3910003", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1383.0, "discounted_cash": 1037.25, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL III", "code_information": [{"code": "99203", "type": "CPT"}, {"code": "5100903", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 671.0, "discounted_cash": 503.25, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL III", "code_information": [{"code": "99203", "type": "CPT"}, {"code": "5100903", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 671.0, "discounted_cash": 503.25, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL III", "code_information": [{"code": "99203", "type": "CPT"}, {"code": "6120537", "type": "CDM"}, {"code": "516", "type": "RC"}], "standard_charges": [{"gross_charge": 607.0, "discounted_cash": 455.25, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL III", "code_information": [{"code": "99203", "type": "CPT"}, {"code": "6901003", "type": "CDM"}], "standard_charges": [{"gross_charge": 627.0, "discounted_cash": 470.25, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL III", "code_information": [{"code": "99203", "type": "CPT"}, {"code": "6920012", "type": "CDM"}], "standard_charges": [{"gross_charge": 607.0, "discounted_cash": 455.25, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL IV", "code_information": [{"code": "99204", "type": "CPT"}, {"code": "3910007", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 625.0, "discounted_cash": 468.75, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL IV", "code_information": [{"code": "99204", "type": "CPT"}, {"code": "3910007", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 625.0, "discounted_cash": 468.75, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL IV", "code_information": [{"code": "99204", "type": "CPT"}, {"code": "5100904", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 968.0, "discounted_cash": 726.0, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL IV", "code_information": [{"code": "99204", "type": "CPT"}, {"code": "5100904", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 968.0, "discounted_cash": 726.0, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL IV", "code_information": [{"code": "99204", "type": "CPT"}, {"code": "6120539", "type": "CDM"}, {"code": "516", "type": "RC"}], "standard_charges": [{"gross_charge": 806.0, "discounted_cash": 604.5, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL IV", "code_information": [{"code": "99204", "type": "CPT"}, {"code": "6901004", "type": "CDM"}], "standard_charges": [{"gross_charge": 1172.0, "discounted_cash": 879.0, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL IV", "code_information": [{"code": "99204", "type": "CPT"}, {"code": "6920014", "type": "CDM"}], "standard_charges": [{"gross_charge": 806.0, "discounted_cash": 604.5, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL V", "code_information": [{"code": "99205", "type": "CPT"}, {"code": "3910005", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 625.0, "discounted_cash": 468.75, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL V", "code_information": [{"code": "99205", "type": "CPT"}, {"code": "3910005", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 625.0, "discounted_cash": 468.75, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL V", "code_information": [{"code": "99205", "type": "CPT"}, {"code": "6120541", "type": "CDM"}, {"code": "516", "type": "RC"}], "standard_charges": [{"gross_charge": 322.0, "discounted_cash": 241.5, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL V", "code_information": [{"code": "99205", "type": "CPT"}, {"code": "6901005", "type": "CDM"}], "standard_charges": [{"gross_charge": 1264.0, "discounted_cash": 948.0, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL V", "code_information": [{"code": "99205", "type": "CPT"}, {"code": "6920016", "type": "CDM"}], "standard_charges": [{"gross_charge": 322.0, "discounted_cash": 241.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EA MLTPLX STAIN MANUAL", "code_information": [{"code": "88377", "type": "CPT"}, {"code": "4308837", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 1320.0, "discounted_cash": 990.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EA MLTPLX STAIN MANUAL/2", "code_information": [{"code": "88377", "type": "CPT"}, {"code": "7058837", "type": "CDM"}], "standard_charges": [{"gross_charge": 1444.0, "discounted_cash": 1083.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EAR TUBE", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8121065", "type": "CDM"}], "standard_charges": [{"gross_charge": 235.0, "discounted_cash": 176.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ECHO 2D LIMITED W/CONTR", "code_information": [{"code": "C8924", "type": "HCPCS"}, {"code": "4608924", "type": "CDM"}, {"code": "483", "type": "RC"}], "standard_charges": [{"gross_charge": 5055.0, "discounted_cash": 3791.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ECHO 2D LIMITED W/CONTR", "code_information": [{"code": "C8924", "type": "HCPCS"}, {"code": "4638924", "type": "CDM"}, {"code": "483", "type": "RC"}], "standard_charges": [{"gross_charge": 5055.0, "discounted_cash": 3791.25, "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": 3372.0, "discounted_cash": 2529.0, "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": 5669.0, "discounted_cash": 4251.75, "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": 5055.0, "discounted_cash": 3791.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ECHO2D DOP/COLFL W/CONTR", "code_information": [{"code": "C8929", "type": "HCPCS"}, {"code": "4608929", "type": "CDM"}, {"code": "483", "type": "RC"}], "standard_charges": [{"gross_charge": 9103.0, "discounted_cash": 6827.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ECHO2D DOP/COLFL W/CONTR", "code_information": [{"code": "C8929", "type": "HCPCS"}, {"code": "4638929", "type": "CDM"}, {"code": "483", "type": "RC"}], "standard_charges": [{"gross_charge": 9103.0, "discounted_cash": 6827.25, "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": 9221.0, "discounted_cash": 6915.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ECHO2D SPECTR/COLOR FLO", "code_information": [{"code": "93306", "type": "CPT"}, {"code": "4633306", "type": "CDM"}, {"code": "483", "type": "RC"}], "standard_charges": [{"gross_charge": 9221.0, "discounted_cash": 6915.75, "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": 6605.0, "discounted_cash": 4953.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ECHOCARDIOGRAM EX STRESS", "code_information": [{"code": "93350", "type": "CPT"}, {"code": "4633350", "type": "CDM"}, {"code": "483", "type": "RC"}], "standard_charges": [{"gross_charge": 6605.0, "discounted_cash": 4953.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ECHOCARDIOGRAM/MMODE/LTD", "code_information": [{"code": "93308", "type": "CPT"}, {"code": "4633303", "type": "CDM"}, {"code": "483", "type": "RC"}], "standard_charges": [{"gross_charge": 5055.0, "discounted_cash": 3791.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ECT SNGL SEIZURE", "code_information": [{"code": "90870", "type": "CPT"}, {"code": "6402020", "type": "CDM"}], "standard_charges": [{"gross_charge": 4067.0, "discounted_cash": 3050.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EDOXABAN 15MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304471", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 83.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EDOXABAN 15MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304471", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 83.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EDOXABAN 30MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304413", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EDOXABAN 30MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304413", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EDOXABAN 60MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304470", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 101.0, "discounted_cash": 75.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EDOXABAN 60MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304470", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 101.0, "discounted_cash": 75.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EDROPHONIUM/ATROP 5ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5320342", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 330.0, "discounted_cash": 247.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EDROPHONIUM10MG/ML15MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5320338", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 455.0, "discounted_cash": 341.25, "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": 2241.0, "discounted_cash": 1680.75, "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": 1851.0, "discounted_cash": 1388.25, "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": 2588.0, "discounted_cash": 1941.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EEG CONT REC W/VID EEG MIN 8CH", "code_information": [{"code": "95700", "type": "CPT"}, {"code": "4805701", "type": "CDM"}, {"code": "740", "type": "RC"}], "standard_charges": [{"gross_charge": 1844.0, "discounted_cash": 1383.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EEG MONITORING 61-119 MINS", "code_information": [{"code": "95813", "type": "CPT"}, {"code": "4805834", "type": "CDM"}, {"code": "740", "type": "RC"}], "standard_charges": [{"gross_charge": 1697.0, "discounted_cash": 1272.75, "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": 1697.0, "discounted_cash": 1272.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EEG SURG NON-INTRACRANL", "code_information": [{"code": "95955", "type": "CPT"}, {"code": "3215955", "type": "CDM"}, {"code": "740", "type": "RC"}], "standard_charges": [{"gross_charge": 3493.0, "discounted_cash": 2619.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EEG SURG NON-INTRACRANL", "code_information": [{"code": "95955", "type": "CPT"}, {"code": "4805949", "type": "CDM"}, {"code": "740", "type": "RC"}], "standard_charges": [{"gross_charge": 3394.0, "discounted_cash": 2545.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EEG W/O VID EA 12-26HR CONT", "code_information": [{"code": "95710", "type": "CPT"}, {"code": "4805706", "type": "CDM"}, {"code": "740", "type": "RC"}], "standard_charges": [{"gross_charge": 5696.0, "discounted_cash": 4272.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EEG W/O VIDEO 2-12HR UNMONITOR", "code_information": [{"code": "95705", "type": "CPT"}, {"code": "4805713", "type": "CDM"}, {"code": "740", "type": "RC"}], "standard_charges": [{"gross_charge": 1697.0, "discounted_cash": 1272.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EEG WO VID 12-26HR UNMNTR", "code_information": [{"code": "95708", "type": "CPT"}, {"code": "4805704", "type": "CDM"}, {"code": "740", "type": "RC"}], "standard_charges": [{"gross_charge": 2892.0, "discounted_cash": 2169.0, "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": 116.0, "discounted_cash": 87.0, "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": 116.0, "discounted_cash": 87.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EFAVIRENZ 600MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304424", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 151.0, "discounted_cash": 113.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EFAVIRENZ 600MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304424", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 151.0, "discounted_cash": 113.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EHRLICHIA AB", "code_information": [{"code": "86666", "type": "CPT"}, {"code": "7006666", "type": "CDM"}], "standard_charges": [{"gross_charge": 3402.0, "discounted_cash": 2551.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EHRLICHIA AB/2", "code_information": [{"code": "86666", "type": "CPT"}, {"code": "7256643", "type": "CDM"}], "standard_charges": [{"gross_charge": 239.0, "discounted_cash": 179.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EHRLICHIA AB/3", "code_information": [{"code": "86666", "type": "CPT"}, {"code": "7256644", "type": "CDM"}], "standard_charges": [{"gross_charge": 239.0, "discounted_cash": 179.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EHRLICHIA AB/4", "code_information": [{"code": "86666", "type": "CPT"}, {"code": "7256649", "type": "CDM"}], "standard_charges": [{"gross_charge": 3402.0, "discounted_cash": 2551.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EKG", "code_information": [{"code": "93005", "type": "CPT"}, {"code": "6120331", "type": "CDM"}, {"code": "730", "type": "RC"}], "standard_charges": [{"gross_charge": 355.0, "discounted_cash": 266.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EKG MNTR SCN W/RPT 48 HR", "code_information": [{"code": "93226", "type": "CPT"}, {"code": "4603277", "type": "CDM"}, {"code": "731", "type": "RC"}], "standard_charges": [{"gross_charge": 9026.0, "discounted_cash": 6769.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EKG MNTR UP TO 48 HRS", "code_information": [{"code": "93225", "type": "CPT"}, {"code": "4603275", "type": "CDM"}, {"code": "731", "type": "RC"}], "standard_charges": [{"gross_charge": 679.0, "discounted_cash": 509.25, "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": 1443.0, "discounted_cash": 1082.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EKG TRACING", "code_information": [{"code": "93005", "type": "CPT"}, {"code": "3914105", "type": "CDM"}, {"code": "730", "type": "RC"}], "standard_charges": [{"gross_charge": 1443.0, "discounted_cash": 1082.25, "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": 1328.0, "discounted_cash": 996.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ELBOW 2 VIEWS", "code_information": [{"code": "73070", "type": "CPT"}, {"code": "5013070", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1095.0, "discounted_cash": 821.25, "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": 1393.0, "discounted_cash": 1044.75, "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": 2810.0, "discounted_cash": 2107.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ELBOW 3 VIEW MINIMUM", "code_information": [{"code": "73080", "type": "CPT"}, {"code": "5013080", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2524.0, "discounted_cash": 1893.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ELBOW ARTHROGRAPHY", "code_information": [{"code": "73085", "type": "CPT"}, {"code": "5113085", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1066.0, "discounted_cash": 799.5, "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": 388.0, "discounted_cash": 291.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ELECTROLYTE PANEL", "code_information": [{"code": "80051", "type": "CPT"}, {"code": "4120004", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ELECTROLYTE PANEL", "code_information": [{"code": "80051", "type": "CPT"}, {"code": "4150004", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "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": 5199.0, "discounted_cash": 3899.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ELECTROPHORETIC TECHNIQ/2", "code_information": [{"code": "82664", "type": "CPT"}, {"code": "7002658", "type": "CDM"}], "standard_charges": [{"gross_charge": 481.0, "discounted_cash": 360.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ELETRIPTAN 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304449", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 222.0, "discounted_cash": 166.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ELETRIPTAN 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304449", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 222.0, "discounted_cash": 166.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ELTROMBOPAG 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304416", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 897.0, "discounted_cash": 672.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ELTROMBOPAG 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304416", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 897.0, "discounted_cash": 672.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ELVIT/COBI/EMTRIC/TEN TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304417", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 668.0, "discounted_cash": 501.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ELVIT/COBI/EMTRIC/TEN TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304417", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 668.0, "discounted_cash": 501.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ELVIT/COBI/EMTRIC/TEN TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304474", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 736.0, "discounted_cash": 552.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ELVIT/COBI/EMTRIC/TEN TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304474", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 736.0, "discounted_cash": 552.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EMB MICROSPHR 300-500MIC", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8032153", "type": "CDM"}], "standard_charges": [{"gross_charge": 3302.0, "discounted_cash": 2476.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EMB MICROSPHR 500-700MIC", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8032146", "type": "CDM"}], "standard_charges": [{"gross_charge": 2842.0, "discounted_cash": 2131.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EMG CRAN BILATERAL", "code_information": [{"code": "95868", "type": "CPT"}, {"code": "3215868", "type": "CDM"}, {"code": "922", "type": "RC"}], "standard_charges": [{"gross_charge": 1112.0, "discounted_cash": 834.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EMG CRAN MUSC(S) UNI", "code_information": [{"code": "95867", "type": "CPT"}, {"code": "3215867", "type": "CDM"}, {"code": "922", "type": "RC"}], "standard_charges": [{"gross_charge": 1037.0, "discounted_cash": 777.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EMG FOUR EXTREMITIES", "code_information": [{"code": "95864", "type": "CPT"}, {"code": "3215864", "type": "CDM"}, {"code": "922", "type": "RC"}], "standard_charges": [{"gross_charge": 10271.0, "discounted_cash": 7703.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EMG FOUR EXTREMITIES", "code_information": [{"code": "95864", "type": "CPT"}, {"code": "4705864", "type": "CDM"}, {"code": "922", "type": "RC"}], "standard_charges": [{"gross_charge": 10475.0, "discounted_cash": 7856.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EMG LARYNX", "code_information": [{"code": "95865", "type": "CPT"}, {"code": "3215865", "type": "CDM"}, {"code": "922", "type": "RC"}], "standard_charges": [{"gross_charge": 1061.0, "discounted_cash": 795.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EMG NEURO MUSC JCT TEST", "code_information": [{"code": "95870", "type": "CPT"}, {"code": "3215870", "type": "CDM"}, {"code": "922", "type": "RC"}], "standard_charges": [{"gross_charge": 544.0, "discounted_cash": 408.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EMG ONE EXTREMITY", "code_information": [{"code": "95860", "type": "CPT"}, {"code": "3215860", "type": "CDM"}, {"code": "922", "type": "RC"}], "standard_charges": [{"gross_charge": 5516.0, "discounted_cash": 4137.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EMG ONE EXTREMITY", "code_information": [{"code": "95860", "type": "CPT"}, {"code": "4705860", "type": "CDM"}, {"code": "922", "type": "RC"}], "standard_charges": [{"gross_charge": 5794.0, "discounted_cash": 4345.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EMG THREE EXTREMITIES", "code_information": [{"code": "95863", "type": "CPT"}, {"code": "3215863", "type": "CDM"}, {"code": "922", "type": "RC"}], "standard_charges": [{"gross_charge": 8979.0, "discounted_cash": 6734.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EMG THREE EXTREMITIES", "code_information": [{"code": "95863", "type": "CPT"}, {"code": "4705863", "type": "CDM"}, {"code": "922", "type": "RC"}], "standard_charges": [{"gross_charge": 9159.0, "discounted_cash": 6869.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EMG TWO EXTREMITIES", "code_information": [{"code": "95861", "type": "CPT"}, {"code": "3215861", "type": "CDM"}, {"code": "922", "type": "RC"}], "standard_charges": [{"gross_charge": 7129.0, "discounted_cash": 5346.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EMG TWO EXTREMITIES", "code_information": [{"code": "95861", "type": "CPT"}, {"code": "4705861", "type": "CDM"}, {"code": "922", "type": "RC"}], "standard_charges": [{"gross_charge": 6925.0, "discounted_cash": 5193.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EMOLLIENT 120GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334220", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EMOLLIENT 120GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334220", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EMOLLIENT 120ML LT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336280", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EMOLLIENT 120ML LT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336280", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EMOLLIENT 240ML LT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335375", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 222.0, "discounted_cash": 166.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EMOLLIENT 240ML LT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335375", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 222.0, "discounted_cash": 166.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EMOLLIENT 360ML LT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335322", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 226.0, "discounted_cash": 169.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EMOLLIENT 360ML LT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335322", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 226.0, "discounted_cash": 169.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EMOLLIENT 420GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336140", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EMOLLIENT 420GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336140", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "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": 50.0, "discounted_cash": 37.5, "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": 50.0, "discounted_cash": 37.5, "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": 39.0, "discounted_cash": 29.25, "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": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EMOLLIENT LUBR 120ML LT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336318", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 128.0, "discounted_cash": 96.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EMOLLIENT LUBR 120ML LT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336318", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 128.0, "discounted_cash": 96.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EMOLLIENT SK CL 120ML LT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335332", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EMOLLIENT SK CL 120ML LT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335332", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "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": 76.0, "discounted_cash": 57.0, "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": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EMPAGLIFLOZIN 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304475", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EMPAGLIFLOZIN 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304475", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EMPAGLIFLOZIN 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304472", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EMPAGLIFLOZIN 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304472", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EMPTY BAG IV 250ML", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5412035", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 354.0, "discounted_cash": 265.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EMPTY BOTTLE IV 150ML", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5412045", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 356.0, "discounted_cash": 267.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EMTRICIT/RILPV/TENFOV CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304473", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 643.0, "discounted_cash": 482.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EMTRICIT/RILPV/TENFOV CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304473", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 643.0, "discounted_cash": 482.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EMTRICIT/RILPV/TENFOV TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304418", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 688.0, "discounted_cash": 516.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EMTRICIT/RILPV/TENFOV TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304418", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 688.0, "discounted_cash": 516.0, "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": 175.0, "discounted_cash": 131.25, "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": 175.0, "discounted_cash": 131.25, "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": 439.0, "discounted_cash": 329.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 439.0, "discounted_cash": 329.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "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": 47.0, "discounted_cash": 35.25, "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": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "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": 980.0, "discounted_cash": 735.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ENALAPRIL 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304440", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ENALAPRIL 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304440", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "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": 980.0, "discounted_cash": 735.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ENCEPHALITIS CA LCROS AB", "code_information": [{"code": "86651", "type": "CPT"}, {"code": "7256205", "type": "CDM"}], "standard_charges": [{"gross_charge": 368.0, "discounted_cash": 276.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ENCEPHALITIS CA LCROS AB/4", "code_information": [{"code": "86651", "type": "CPT"}, {"code": "7256657", "type": "CDM"}], "standard_charges": [{"gross_charge": 368.0, "discounted_cash": 276.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ENCEPHALITIS CA LCROS AB/5", "code_information": [{"code": "86651", "type": "CPT"}, {"code": "7258664", "type": "CDM"}], "standard_charges": [{"gross_charge": 142.0, "discounted_cash": 106.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ENCEPHALITIS EAST EQ AB", "code_information": [{"code": "86652", "type": "CPT"}, {"code": "7006652", "type": "CDM"}], "standard_charges": [{"gross_charge": 360.0, "discounted_cash": 270.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ENCEPHALITIS EAST EQ AB/2", "code_information": [{"code": "86652", "type": "CPT"}, {"code": "7256652", "type": "CDM"}], "standard_charges": [{"gross_charge": 360.0, "discounted_cash": 270.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ENCEPHALITIS ST LOUIS AB", "code_information": [{"code": "86653", "type": "CPT"}, {"code": "7006653", "type": "CDM"}], "standard_charges": [{"gross_charge": 657.0, "discounted_cash": 492.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ENCEPHALITIS WEST EQ AB", "code_information": [{"code": "86654", "type": "CPT"}, {"code": "7256656", "type": "CDM"}], "standard_charges": [{"gross_charge": 703.0, "discounted_cash": 527.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ENCEPHALITIS WEST EQ AB/2", "code_information": [{"code": "86654", "type": "CPT"}, {"code": "7256681", "type": "CDM"}], "standard_charges": [{"gross_charge": 703.0, "discounted_cash": 527.25, "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": 38699.0, "discounted_cash": 29024.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ENDO RPR AORT-BI-ILIAC NO/RUP", "code_information": [{"code": "4914705", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 22407.0, "discounted_cash": 16805.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ENDO RPR THOR AO WO/SCA+S&I", "code_information": [{"code": "75957", "type": "CPT"}, {"code": "4915953", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 4266.0, "discounted_cash": 3199.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ENDOLUM BX BILI TREE", "code_information": [{"code": "4917543", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6948.0, "discounted_cash": 5211.0, "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": 6613.0, "discounted_cash": 4959.75, "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": 6613.0, "discounted_cash": 4959.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ENDOPROSTH BLN VIABAHN V", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "4028387", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 34139.0, "discounted_cash": 25604.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ENDOPROSTH ILIAC BRANCH", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "4028019", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 121045.0, "discounted_cash": 90783.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ENDOPROSTH PERIPH VIABAH", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "4021031", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 19241.0, "discounted_cash": 14430.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ENDOPROSTH THORACIC TAG", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "4021030", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 106859.0, "discounted_cash": 80144.25, "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": 171.0, "discounted_cash": 128.25, "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": 171.0, "discounted_cash": 128.25, "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": 55.0, "discounted_cash": 41.25, "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": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ENTECAVIR .5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304458", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 352.0, "discounted_cash": 264.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ENTECAVIR .5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304458", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 352.0, "discounted_cash": 264.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ENTEROVIRUS AB/10", "code_information": [{"code": "86658", "type": "CPT"}, {"code": "7256665", "type": "CDM"}], "standard_charges": [{"gross_charge": 444.0, "discounted_cash": 333.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ENTEROVIRUS AB/11", "code_information": [{"code": "86658", "type": "CPT"}, {"code": "7006191", "type": "CDM"}], "standard_charges": [{"gross_charge": 360.0, "discounted_cash": 270.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ENTEROVIRUS AB/11", "code_information": [{"code": "86658", "type": "CPT"}, {"code": "7256667", "type": "CDM"}], "standard_charges": [{"gross_charge": 444.0, "discounted_cash": 333.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ENTEROVIRUS AB/12", "code_information": [{"code": "86658", "type": "CPT"}, {"code": "7256668", "type": "CDM"}], "standard_charges": [{"gross_charge": 444.0, "discounted_cash": 333.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ENTEROVIRUS AB/13", "code_information": [{"code": "86658", "type": "CPT"}, {"code": "7256669", "type": "CDM"}], "standard_charges": [{"gross_charge": 444.0, "discounted_cash": 333.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ENTEROVIRUS AB/15", "code_information": [{"code": "86658", "type": "CPT"}, {"code": "7006658", "type": "CDM"}], "standard_charges": [{"gross_charge": 444.0, "discounted_cash": 333.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ENTEROVIRUS AB/15", "code_information": [{"code": "86658", "type": "CPT"}, {"code": "7256673", "type": "CDM"}], "standard_charges": [{"gross_charge": 444.0, "discounted_cash": 333.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ENTEROVIRUS AB/16", "code_information": [{"code": "86658", "type": "CPT"}, {"code": "7256675", "type": "CDM"}], "standard_charges": [{"gross_charge": 444.0, "discounted_cash": 333.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ENTEROVIRUS AB/17", "code_information": [{"code": "86658", "type": "CPT"}, {"code": "7256677", "type": "CDM"}], "standard_charges": [{"gross_charge": 444.0, "discounted_cash": 333.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ENTEROVIRUS AB/18", "code_information": [{"code": "86658", "type": "CPT"}, {"code": "7256678", "type": "CDM"}], "standard_charges": [{"gross_charge": 444.0, "discounted_cash": 333.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ENTEROVIRUS AB/19", "code_information": [{"code": "86658", "type": "CPT"}, {"code": "7256679", "type": "CDM"}], "standard_charges": [{"gross_charge": 444.0, "discounted_cash": 333.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ENTEROVIRUS AB/23", "code_information": [{"code": "86658", "type": "CPT"}, {"code": "7258660", "type": "CDM"}], "standard_charges": [{"gross_charge": 360.0, "discounted_cash": 270.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ENTEROVIRUS AB/26", "code_information": [{"code": "86658", "type": "CPT"}, {"code": "7006776", "type": "CDM"}], "standard_charges": [{"gross_charge": 444.0, "discounted_cash": 333.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ENTEROVIRUS AB/27", "code_information": [{"code": "86658", "type": "CPT"}, {"code": "7258728", "type": "CDM"}], "standard_charges": [{"gross_charge": 194.0, "discounted_cash": 145.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ENTEROVIRUS AB/4", "code_information": [{"code": "86658", "type": "CPT"}, {"code": "7256658", "type": "CDM"}], "standard_charges": [{"gross_charge": 360.0, "discounted_cash": 270.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ENTEROVIRUS AB/7", "code_information": [{"code": "86658", "type": "CPT"}, {"code": "7256661", "type": "CDM"}], "standard_charges": [{"gross_charge": 444.0, "discounted_cash": 333.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ENTEROVIRUS AB/8", "code_information": [{"code": "86658", "type": "CPT"}, {"code": "7256662", "type": "CDM"}], "standard_charges": [{"gross_charge": 444.0, "discounted_cash": 333.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ENTEROVIRUS AB/9", "code_information": [{"code": "86658", "type": "CPT"}, {"code": "7256664", "type": "CDM"}], "standard_charges": [{"gross_charge": 444.0, "discounted_cash": 333.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ENTEROVIRUS AMP PROBE/2", "code_information": [{"code": "87498", "type": "CPT"}, {"code": "7258750", "type": "CDM"}], "standard_charges": [{"gross_charge": 277.0, "discounted_cash": 207.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ENVELOPE ECM IMPLANT DVC", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "4028021", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10988.0, "discounted_cash": 8241.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ENZYME ACTIVITY NES/7", "code_information": [{"code": "82657", "type": "CPT"}, {"code": "7258259", "type": "CDM"}], "standard_charges": [{"gross_charge": 494.0, "discounted_cash": 370.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EP CARDIAC MAPPING", "code_information": [{"code": "93609", "type": "CPT"}, {"code": "4610600", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 12652.0, "discounted_cash": 9489.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EP COMP STUDY W/INDUCTN", "code_information": [{"code": "93620", "type": "CPT"}, {"code": "4610620", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 28340.0, "discounted_cash": 21255.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EP DRUG FOLLOW-UP STUDY", "code_information": [{"code": "93624", "type": "CPT"}, {"code": "4610630", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 7921.0, "discounted_cash": 5940.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EP EVAL AICD SUBSEQ", "code_information": [{"code": "93642", "type": "CPT"}, {"code": "4610642", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 5972.0, "discounted_cash": 4479.0, "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": 12058.0, "discounted_cash": 9043.5, "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": 1082.0, "discounted_cash": 811.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EPHEDRINE 50MG/10ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5320473", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 181.0, "discounted_cash": 135.75, "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": 173.0, "discounted_cash": 129.75, "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": 178.0, "discounted_cash": 133.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EPHEDRINE50MGNS10MLPFSIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5320392", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 62.0, "discounted_cash": 46.5, "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": 213.0, "discounted_cash": 159.75, "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": 213.0, "discounted_cash": 159.75, "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": 1539.0, "discounted_cash": 1154.25, "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": 1539.0, "discounted_cash": 1154.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EPINEPHRIN4MG/NS250MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5320469", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 195.0, "discounted_cash": 146.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EPINEPHRINE .3ML KT IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5320429", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 801.0, "discounted_cash": 600.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EPINEPHRINE .3ML KT IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5320429", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 801.0, "discounted_cash": 600.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EPINEPHRINE 0.1% 10ML NASAL DR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330839", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 542.0, "discounted_cash": 406.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EPINEPHRINE 0.1% 10ML NASAL DR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330839", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 542.0, "discounted_cash": 406.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 687.0, "discounted_cash": 515.25, "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": 687.0, "discounted_cash": 515.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EPINEPHRINE1:1000 30MLTS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330843", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 291.0, "discounted_cash": 218.25, "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": 4.0, "discounted_cash": 3.0, "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": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EPIRUBICIN PER 2MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9178", "type": "HCPCS"}, {"code": "5320420", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 678.0, "discounted_cash": 508.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EPIRUBICIN PER 2MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9178", "type": "HCPCS"}, {"code": "5320420", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 678.0, "discounted_cash": 508.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EPLERENONE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304461", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EPLERENONE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304461", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "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": 11.0, "discounted_cash": 8.25, "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": 11.0, "discounted_cash": 8.25, "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": 472.0, "discounted_cash": 354.0, "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": 472.0, "discounted_cash": 354.0, "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": 12.0, "discounted_cash": 9.0, "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": 12.0, "discounted_cash": 9.0, "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": 112.0, "discounted_cash": 84.0, "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": 112.0, "discounted_cash": 84.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EPOPROSTENOL PER .5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1325", "type": "HCPCS"}, {"code": "5320450", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 194.0, "discounted_cash": 145.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EPOPROSTENOL PER .5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1325", "type": "HCPCS"}, {"code": "5320450", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 194.0, "discounted_cash": 145.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EPSTEIN-BARR VIRUS EA AB", "code_information": [{"code": "86663", "type": "CPT"}, {"code": "7009433", "type": "CDM"}], "standard_charges": [{"gross_charge": 604.0, "discounted_cash": 453.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EPSTEIN-BARR VIRUS EA AB/2", "code_information": [{"code": "86663", "type": "CPT"}, {"code": "7259433", "type": "CDM"}], "standard_charges": [{"gross_charge": 604.0, "discounted_cash": 453.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EPSTEIN-BARR VIRUS NA AB", "code_information": [{"code": "86664", "type": "CPT"}, {"code": "7256663", "type": "CDM"}], "standard_charges": [{"gross_charge": 774.0, "discounted_cash": 580.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EPSTEIN-BARR VIRUS NA AB/2", "code_information": [{"code": "86664", "type": "CPT"}, {"code": "7009434", "type": "CDM"}], "standard_charges": [{"gross_charge": 774.0, "discounted_cash": 580.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EPSTEIN-BARR VIRUS VCA AB", "code_information": [{"code": "86665", "type": "CPT"}, {"code": "7006262", "type": "CDM"}], "standard_charges": [{"gross_charge": 1002.0, "discounted_cash": 751.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EPSTEIN-BARR VIRUS VCA AB", "code_information": [{"code": "86665", "type": "CPT"}, {"code": "7256262", "type": "CDM"}], "standard_charges": [{"gross_charge": 1002.0, "discounted_cash": 751.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EPSTEIN-BARR VIRUS VCA AB/3", "code_information": [{"code": "86665", "type": "CPT"}, {"code": "7258677", "type": "CDM"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EPSTEIN-BARR VIRUS VCA AB/4", "code_information": [{"code": "86665", "type": "CPT"}, {"code": "7009432", "type": "CDM"}], "standard_charges": [{"gross_charge": 927.0, "discounted_cash": 695.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EPSTEIN-BARR VIRUS VCA AB/4", "code_information": [{"code": "86665", "type": "CPT"}, {"code": "7258678", "type": "CDM"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EPSTEIN-BARR VIRUS VCA AB/5", "code_information": [{"code": "86665", "type": "CPT"}, {"code": "7259431", "type": "CDM"}], "standard_charges": [{"gross_charge": 927.0, "discounted_cash": 695.25, "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": 269.0, "discounted_cash": 201.75, "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": 269.0, "discounted_cash": 201.75, "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": 944.0, "discounted_cash": 708.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ER VISIT LVL I", "code_information": [{"code": "99281", "type": "CPT"}, {"code": "6119281", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 785.0, "discounted_cash": 588.75, "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": 1703.0, "discounted_cash": 1277.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ER VISIT LVL II", "code_information": [{"code": "99282", "type": "CPT"}, {"code": "6119282", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1539.0, "discounted_cash": 1154.25, "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": 2389.0, "discounted_cash": 1791.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ER VISIT LVL III", "code_information": [{"code": "99283", "type": "CPT"}, {"code": "6119283", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 2096.0, "discounted_cash": 1572.0, "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": 3970.0, "discounted_cash": 2977.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ER VISIT LVL IV", "code_information": [{"code": "99284", "type": "CPT"}, {"code": "6119284", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 3471.0, "discounted_cash": 2603.25, "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": 5550.0, "discounted_cash": 4162.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ER VISIT LVL V", "code_information": [{"code": "99285", "type": "CPT"}, {"code": "6119285", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 5206.0, "discounted_cash": 3904.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ERAVACYCLINE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0122", "type": "HCPCS"}, {"code": "5320475", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 7.0, "discounted_cash": 5.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ERAVACYCLINE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0122", "type": "HCPCS"}, {"code": "5320475", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 7.0, "discounted_cash": 5.25, "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": 2005.0, "discounted_cash": 1503.75, "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": 969.0, "discounted_cash": 726.75, "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": 969.0, "discounted_cash": 726.75, "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": 28.0, "discounted_cash": 21.0, "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": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ERGOCALCIFEROL 400U TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312383", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.32, "discounted_cash": 0.24, "setting": "both", "billing_class": "facility"}]}, {"description": "ERGOCALCIFEROL 400U TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312383", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 0.32, "discounted_cash": 0.24, "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": 16.0, "discounted_cash": 12.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ERGOCALCIFEROL500MU/MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5320456", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 796.0, "discounted_cash": 597.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ERGOTAMN-CAFF 1/100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304585", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ERGOTAMN-CAFF 1/100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304585", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ERLOTINIB 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8999", "type": "HCPCS"}, {"code": "5304601", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1304.0, "discounted_cash": 978.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ERLOTINIB 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8999", "type": "HCPCS"}, {"code": "5304601", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1304.0, "discounted_cash": 978.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ERLOTINIB 150MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8999", "type": "HCPCS"}, {"code": "5304602", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1547.0, "discounted_cash": 1160.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ERLOTINIB 150MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8999", "type": "HCPCS"}, {"code": "5304602", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1547.0, "discounted_cash": 1160.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ERLOTINIB 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8999", "type": "HCPCS"}, {"code": "5304600", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 497.0, "discounted_cash": 372.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ERLOTINIB 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8999", "type": "HCPCS"}, {"code": "5304600", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 497.0, "discounted_cash": 372.75, "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": 347.0, "discounted_cash": 260.25, "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": 347.0, "discounted_cash": 260.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ERTAPENEM PER500MGIVPBIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1335", "type": "HCPCS"}, {"code": "5320494", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 345.0, "discounted_cash": 258.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ERTAPENEM PER500MGIVPBIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1335", "type": "HCPCS"}, {"code": "5320494", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 345.0, "discounted_cash": 258.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ERYTHROMY LA500MG IVPBIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1364", "type": "HCPCS"}, {"code": "5320509", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 496.0, "discounted_cash": 372.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ERYTHROMY LA500MG IVPBIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1364", "type": "HCPCS"}, {"code": "5320509", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 496.0, "discounted_cash": 372.0, "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": 417.0, "discounted_cash": 312.75, "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": 417.0, "discounted_cash": 312.75, "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": 133.0, "discounted_cash": 99.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 133.0, "discounted_cash": 99.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ERYTHROMYC BASE 250 ECTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304651", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 23.0, "discounted_cash": 17.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ERYTHROMYC BASE 250 ECTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304651", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 23.0, "discounted_cash": 17.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ERYTHROMYC BASE 333 ECTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304649", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ERYTHROMYC BASE 333 ECTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304649", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "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": 36.0, "discounted_cash": 27.0, "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": 36.0, "discounted_cash": 27.0, "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": 147.0, "discounted_cash": 110.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 147.0, "discounted_cash": 110.25, "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": 128.0, "discounted_cash": 96.0, "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": 128.0, "discounted_cash": 96.0, "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": 50.0, "discounted_cash": 37.5, "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": 50.0, "discounted_cash": 37.5, "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": 253.0, "discounted_cash": 189.75, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 253.0, "discounted_cash": 189.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ERYTHROPOIETIN", "code_information": [{"code": "82668", "type": "CPT"}, {"code": "7002668", "type": "CDM"}], "standard_charges": [{"gross_charge": 1368.0, "discounted_cash": 1026.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ERYTHROPOIETIN", "code_information": [{"code": "82668", "type": "CPT"}, {"code": "7252668", "type": "CDM"}], "standard_charges": [{"gross_charge": 1368.0, "discounted_cash": 1026.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 59.0, "discounted_cash": 44.25, "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": 59.0, "discounted_cash": 44.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ESCITALOPRAM 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304668", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ESCITALOPRAM 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304668", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ESCITALOPRAM 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304666", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 59.0, "discounted_cash": 44.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ESCITALOPRAM 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304666", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 59.0, "discounted_cash": 44.25, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "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": 3.0, "discounted_cash": 2.25, "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": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ESOMEPRAZOLE 20MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304658", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ESOMEPRAZOLE 20MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304658", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ESOMEPRAZOLE 40MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304659", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ESOMEPRAZOLE 40MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304659", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ESOMEPRAZOLE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1370", "type": "HCPCS"}, {"code": "5320516", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.19, "discounted_cash": 3.89, "setting": "both", "billing_class": "facility"}]}, {"description": "ESOMEPRAZOLE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1370", "type": "HCPCS"}, {"code": "5320516", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 5.19, "discounted_cash": 3.89, "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": 4008.0, "discounted_cash": 3006.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ESOPH PH TST W ELECT", "code_information": [{"code": "91035", "type": "CPT"}, {"code": "5071254", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 7083.0, "discounted_cash": 5312.25, "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": 6354.0, "discounted_cash": 4765.5, "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": 1518.0, "discounted_cash": 1138.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ESOPHAGUS W/DBL CONTRAST", "code_information": [{"code": "74221", "type": "CPT"}, {"code": "5014221", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1518.0, "discounted_cash": 1138.5, "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": 700.0, "discounted_cash": 525.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTRADIOL", "code_information": [{"code": "82670", "type": "CPT"}, {"code": "4152670", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 542.0, "discounted_cash": 406.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTRADIOL", "code_information": [{"code": "82670", "type": "CPT"}, {"code": "7252670", "type": "CDM"}], "standard_charges": [{"gross_charge": 340.0, "discounted_cash": 255.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTRADIOL .025WEEK EA TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5335358", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 205.0, "discounted_cash": 153.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTRADIOL .025WEEK EA TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5335358", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 205.0, "discounted_cash": 153.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTRADIOL .05BIWK EA TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5335360", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 251.0, "discounted_cash": 188.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTRADIOL .05BIWK EA TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5335360", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 251.0, "discounted_cash": 188.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTRADIOL .05WEEK EA TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5335368", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 162.0, "discounted_cash": 121.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTRADIOL .05WEEK EA TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5335368", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 162.0, "discounted_cash": 121.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTRADIOL .075WEEK EA TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5335372", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 223.0, "discounted_cash": 167.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTRADIOL .075WEEK EA TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5335372", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 223.0, "discounted_cash": 167.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTRADIOL .1BIWK EA TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5335361", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 251.0, "discounted_cash": 188.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTRADIOL .1BIWK EA TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5335361", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 251.0, "discounted_cash": 188.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTRADIOL .1WEEK EA TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5335369", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 179.0, "discounted_cash": 134.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTRADIOL .1WEEK EA TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5335369", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 179.0, "discounted_cash": 134.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTRADIOL 0.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304673", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTRADIOL 0.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304673", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTRADIOL 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304674", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTRADIOL 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304674", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTRADIOL 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304675", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTRADIOL 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304675", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTRADIOL CY UPTO 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1000", "type": "HCPCS"}, {"code": "5320534", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTRADIOL CY UPTO 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1000", "type": "HCPCS"}, {"code": "5320534", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTRADIOL VAL TO 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1380", "type": "HCPCS"}, {"code": "5320536", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 254.0, "discounted_cash": 190.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTRADIOL VAL TO 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1380", "type": "HCPCS"}, {"code": "5320536", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 254.0, "discounted_cash": 190.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTRADIOL.1MG/GM42.5GMCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335363", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1220.0, "discounted_cash": 915.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTRADIOL.1MG/GM42.5GMCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335363", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1220.0, "discounted_cash": 915.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTRAMUSTINE 140MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8999", "type": "HCPCS"}, {"code": "5304697", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTRAMUSTINE 140MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8999", "type": "HCPCS"}, {"code": "5304697", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTRIOL", "code_information": [{"code": "82677", "type": "CPT"}, {"code": "7002677", "type": "CDM"}], "standard_charges": [{"gross_charge": 712.0, "discounted_cash": 534.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTRIOL", "code_information": [{"code": "82677", "type": "CPT"}, {"code": "7252677", "type": "CDM"}], "standard_charges": [{"gross_charge": 712.0, "discounted_cash": 534.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTROG/METH.625/1.25MGTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304712", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTROG/METH.625/1.25MGTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304712", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTROG/METH1.25/2.5MGTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304711", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTROG/METH1.25/2.5MGTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304711", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "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": 903.0, "discounted_cash": 677.25, "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": 903.0, "discounted_cash": 677.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTROGENS TOTAL", "code_information": [{"code": "82672", "type": "CPT"}, {"code": "7252672", "type": "CDM"}], "standard_charges": [{"gross_charge": 382.0, "discounted_cash": 286.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTRONE", "code_information": [{"code": "82679", "type": "CPT"}, {"code": "7002679", "type": "CDM"}], "standard_charges": [{"gross_charge": 264.0, "discounted_cash": 198.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTRONE/2", "code_information": [{"code": "82679", "type": "CPT"}, {"code": "7252679", "type": "CDM"}], "standard_charges": [{"gross_charge": 264.0, "discounted_cash": 198.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ESZOPICLONE 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304720", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ESZOPICLONE 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304720", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ESZOPICLONE 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304721", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ESZOPICLONE 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304721", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ESZOPICLONE 3MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304722", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 69.0, "discounted_cash": 51.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ESZOPICLONE 3MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304722", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 69.0, "discounted_cash": 51.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ETHACRYNIC ACID 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304743", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ETHACRYNIC ACID 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304743", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ETHAMBUTOL 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304770", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ETHAMBUTOL 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304770", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "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": 59.0, "discounted_cash": 44.25, "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": 59.0, "discounted_cash": 44.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ETHANOL98% 1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5320576", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 196.0, "discounted_cash": 147.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ETHANOL99% 5ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5318077", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 894.0, "discounted_cash": 670.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ETHIODIZED OIL48%10MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5355920", "type": "CDM"}, {"code": "255", "type": "RC"}], "standard_charges": [{"gross_charge": 1112.0, "discounted_cash": 834.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ETHOSUXIMIDE", "code_information": [{"code": "80168", "type": "CPT"}, {"code": "7002692", "type": "CDM"}], "standard_charges": [{"gross_charge": 649.0, "discounted_cash": 486.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ETHOSUXIMIDE", "code_information": [{"code": "80168", "type": "CPT"}, {"code": "7252692", "type": "CDM"}], "standard_charges": [{"gross_charge": 649.0, "discounted_cash": 486.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ETHYL CL 100ML SP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338367", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 251.0, "discounted_cash": 188.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ETHYL CL 100ML SP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338367", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 251.0, "discounted_cash": 188.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ETHYLENE GLYCOL", "code_information": [{"code": "82693", "type": "CPT"}, {"code": "7252691", "type": "CDM"}], "standard_charges": [{"gross_charge": 277.0, "discounted_cash": 207.75, "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": 108.0, "discounted_cash": 81.0, "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": 746.0, "discounted_cash": 559.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ETOPOSIDE 50MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8560", "type": "HCPCS"}, {"code": "5304890", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 836.0, "discounted_cash": 627.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ETOPOSIDE 50MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8560", "type": "HCPCS"}, {"code": "5304890", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 836.0, "discounted_cash": 627.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ETOPOSIDE PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9181", "type": "HCPCS"}, {"code": "5320614", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ETOPOSIDE PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9181", "type": "HCPCS"}, {"code": "5320614", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ETRAVIRINE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304892", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ETRAVIRINE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304892", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EUGLOBULIN LYSIS", "code_information": [{"code": "85360", "type": "CPT"}, {"code": "4105360", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 252.0, "discounted_cash": 189.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EUGLOBULIN LYSIS", "code_information": [{"code": "85360", "type": "CPT"}, {"code": "7075360", "type": "CDM"}], "standard_charges": [{"gross_charge": 365.0, "discounted_cash": 273.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EVAL ANTITACH PACEMAKER", "code_information": [{"code": "93724", "type": "CPT"}, {"code": "4613724", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 1218.0, "discounted_cash": 913.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EVAL ANTITACH PACEMAKER", "code_information": [{"code": "93724", "type": "CPT"}, {"code": "4613724", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 1218.0, "discounted_cash": 913.5, "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": 436.0, "discounted_cash": 327.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EVENT MONITOR RECORDING", "code_information": [{"code": "93270", "type": "CPT"}, {"code": "4603270", "type": "CDM"}, {"code": "731", "type": "RC"}], "standard_charges": [{"gross_charge": 1634.0, "discounted_cash": 1225.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EXAM MACRO ARTHROPOD", "code_information": [{"code": "87168", "type": "CPT"}, {"code": "4107141", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 158.0, "discounted_cash": 118.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EXAM MACRO PARASITE", "code_information": [{"code": "87169", "type": "CPT"}, {"code": "4107142", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "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": 17521.0, "discounted_cash": 13140.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EXCH ABSC/CYST DRN CATH", "code_information": [{"code": "5059423", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 16687.0, "discounted_cash": 12515.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EXCH ABSC/CYST DRN CATH", "code_information": [{"code": "5069423", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 16687.0, "discounted_cash": 12515.25, "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": 138.0, "discounted_cash": 103.5, "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": 138.0, "discounted_cash": 103.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EXENATIDE 10MCG 60 DS IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5320608", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2718.0, "discounted_cash": 2038.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EXENATIDE 10MCG 60 DS IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5320608", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2718.0, "discounted_cash": 2038.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EXENATIDE 5MCG 60 DS IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5320607", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2316.0, "discounted_cash": 1737.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EXENATIDE 5MCG 60 DS IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5320607", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2316.0, "discounted_cash": 1737.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EXFX HOF CON ROD", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132125", "type": "CDM"}], "standard_charges": [{"gross_charge": 2772.0, "discounted_cash": 2079.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EXFX WIRE BAYONT PT CORT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132190", "type": "CDM"}], "standard_charges": [{"gross_charge": 250.0, "discounted_cash": 187.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EXPOSE ENDOPROS UNILAT", "code_information": [{"code": "4614812", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 18513.0, "discounted_cash": 13884.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EXT TB GLAUCOMA VALVE", "code_information": [{"code": "C1783", "type": "HCPCS"}, {"code": "8182350", "type": "CDM"}], "standard_charges": [{"gross_charge": 1025.0, "discounted_cash": 768.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EXTERNAL CAROTID ANGIO", "code_information": [{"code": "4917791", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5373.0, "discounted_cash": 4029.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EYE DETECTION OF FOR/BDY", "code_information": [{"code": "70030", "type": "CPT"}, {"code": "5110031", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 992.0, "discounted_cash": 744.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EYE GLAUC IMP", "code_information": [{"code": "C1783", "type": "HCPCS"}, {"code": "8122026", "type": "CDM"}], "standard_charges": [{"gross_charge": 3211.0, "discounted_cash": 2408.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EYE GLAUCOMA MICROSTENT", "code_information": [{"code": "C1783", "type": "HCPCS"}, {"code": "8122030", "type": "CDM"}], "standard_charges": [{"gross_charge": 21769.0, "discounted_cash": 16326.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EYE IOL ASPHERIC", "code_information": [{"code": "C1780", "type": "HCPCS"}, {"code": "8122039", "type": "CDM"}], "standard_charges": [{"gross_charge": 492.0, "discounted_cash": 369.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EYE SCLERAL SLEEVE IMP", "code_information": [{"code": "L8610", "type": "HCPCS"}, {"code": "8122095", "type": "CDM"}], "standard_charges": [{"gross_charge": 161.0, "discounted_cash": 120.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EYE SILIC STRIP IMP", "code_information": [{"code": "L8610", "type": "HCPCS"}, {"code": "8122107", "type": "CDM"}], "standard_charges": [{"gross_charge": 227.0, "discounted_cash": 170.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EYE SILICONE SP", "code_information": [{"code": "L8610", "type": "HCPCS"}, {"code": "8122115", "type": "CDM"}], "standard_charges": [{"gross_charge": 4555.0, "discounted_cash": 3416.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EYE SPHERE", "code_information": [{"code": "V2623", "type": "HCPCS"}, {"code": "8122120", "type": "CDM"}], "standard_charges": [{"gross_charge": 588.0, "discounted_cash": 441.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EYE SPHERE PLSTC", "code_information": [{"code": "V2629", "type": "HCPCS"}, {"code": "8122114", "type": "CDM"}], "standard_charges": [{"gross_charge": 165.0, "discounted_cash": 123.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EYE TIRE/S", "code_information": [{"code": "L8610", "type": "HCPCS"}, {"code": "8122125", "type": "CDM"}], "standard_charges": [{"gross_charge": 206.0, "discounted_cash": 154.5, "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": 60.0, "discounted_cash": 45.0, "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": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "F2 GENE ANLS VARIANT/2", "code_information": [{"code": "81240", "type": "CPT"}, {"code": "7259208", "type": "CDM"}], "standard_charges": [{"gross_charge": 796.0, "discounted_cash": 597.0, "setting": "both", "billing_class": "facility"}]}, {"description": "F5 LEIDEN VARIANT", "code_information": [{"code": "81241", "type": "CPT"}, {"code": "7259207", "type": "CDM"}], "standard_charges": [{"gross_charge": 760.0, "discounted_cash": 570.0, "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": 1385.0, "discounted_cash": 1038.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FACIAL BONES 2VW MAX", "code_information": [{"code": "70140", "type": "CPT"}, {"code": "5010140", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1310.0, "discounted_cash": 982.5, "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": 1586.0, "discounted_cash": 1189.5, "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": 16.0, "discounted_cash": 12.0, "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": 16.0, "discounted_cash": 12.0, "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": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FACTOR 9 NONRC PER IU IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7193", "type": "HCPCS"}, {"code": "5320694", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 11.0, "discounted_cash": 8.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FACTOR 9 RECOM PER IU IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7195", "type": "HCPCS"}, {"code": "5320698", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FACTOR INHIBITOR/3", "code_information": [{"code": "85335", "type": "CPT"}, {"code": "7005335", "type": "CDM"}], "standard_charges": [{"gross_charge": 528.0, "discounted_cash": 396.0, "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": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FACTOR VIIA-JNCW PER 1MCG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7212", "type": "HCPCS"}, {"code": "5320587", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FACTR VIII RISTO CO-FCTR", "code_information": [{"code": "85245", "type": "CPT"}, {"code": "7005245", "type": "CDM"}], "standard_charges": [{"gross_charge": 467.0, "discounted_cash": 350.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FACTR VIII RISTO CO-FCTR/2", "code_information": [{"code": "85245", "type": "CPT"}, {"code": "7255248", "type": "CDM"}], "standard_charges": [{"gross_charge": 467.0, "discounted_cash": 350.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FACTR VIII VW AG CO-FCTR", "code_information": [{"code": "85246", "type": "CPT"}, {"code": "7065246", "type": "CDM"}], "standard_charges": [{"gross_charge": 838.0, "discounted_cash": 628.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FACTR VIII VW AG CO-FCTR", "code_information": [{"code": "85246", "type": "CPT"}, {"code": "7255246", "type": "CDM"}], "standard_charges": [{"gross_charge": 838.0, "discounted_cash": 628.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FACTR VIII VW AG CO-FCTR/3", "code_information": [{"code": "85246", "type": "CPT"}, {"code": "7258525", "type": "CDM"}], "standard_charges": [{"gross_charge": 625.0, "discounted_cash": 468.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FAMCICLOVIR 125MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304897", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 98.0, "discounted_cash": 73.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FAMCICLOVIR 125MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304897", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 98.0, "discounted_cash": 73.5, "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": 172.0, "discounted_cash": 129.0, "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": 172.0, "discounted_cash": 129.0, "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": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "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": 48.0, "discounted_cash": 36.0, "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": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FAMOTIDINE 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304901", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FAMOTIDINE 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304901", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "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": 0.05, "discounted_cash": 0.04, "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": 0.05, "discounted_cash": 0.04, "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": 80.0, "discounted_cash": 60.0, "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": 80.0, "discounted_cash": 60.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FASCIA LATA", "code_information": [{"code": "C1762", "type": "HCPCS"}, {"code": "4021034", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9628.0, "discounted_cash": 7221.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FAT EMULS 10% 250ML TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5413445", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 900.0, "discounted_cash": 675.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FAT EMULS 10% 500ML TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5413450", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 1546.0, "discounted_cash": 1159.5, "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": 158.0, "discounted_cash": 118.5, "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": 962.0, "discounted_cash": 721.5, "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": 2147.0, "discounted_cash": 1610.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FAT EMULS 30% 1ML TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5413477", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 138.0, "discounted_cash": 103.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FAT OR LIPID FECES QUANT", "code_information": [{"code": "82710", "type": "CPT"}, {"code": "7002700", "type": "CDM"}], "standard_charges": [{"gross_charge": 741.0, "discounted_cash": 555.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FAT OR LIPID FECES QUANT", "code_information": [{"code": "82710", "type": "CPT"}, {"code": "7252710", "type": "CDM"}], "standard_charges": [{"gross_charge": 741.0, "discounted_cash": 555.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FAT STAIN FECES/URIN/ETC", "code_information": [{"code": "89125", "type": "CPT"}, {"code": "7258912", "type": "CDM"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FATTY ACIDS NONESTERFIED", "code_information": [{"code": "82725", "type": "CPT"}, {"code": "7252725", "type": "CDM"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FCTR VIII VW MLT CO-FCTR", "code_information": [{"code": "85247", "type": "CPT"}, {"code": "7065247", "type": "CDM"}], "standard_charges": [{"gross_charge": 1233.0, "discounted_cash": 924.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FCTR VIII VW MLT CO-FCTR", "code_information": [{"code": "85247", "type": "CPT"}, {"code": "7255247", "type": "CDM"}], "standard_charges": [{"gross_charge": 1233.0, "discounted_cash": 924.75, "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": 716.0, "discounted_cash": 537.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FDP D-DIMER QNT", "code_information": [{"code": "85379", "type": "CPT"}, {"code": "4125350", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FDP D-DIMER QNT", "code_information": [{"code": "85379", "type": "CPT"}, {"code": "7005379", "type": "CDM"}], "standard_charges": [{"gross_charge": 366.0, "discounted_cash": 274.5, "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": 1168.0, "discounted_cash": 876.0, "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": 574.0, "discounted_cash": 430.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FDP FSP AGGLUTNATN SEMQTY", "code_information": [{"code": "85362", "type": "CPT"}, {"code": "4125362", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "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": 197.0, "discounted_cash": 147.75, "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": 197.0, "discounted_cash": 147.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FEBUXOSTAT 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304911", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FEBUXOSTAT 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304911", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FEBUXOSTAT 80MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304910", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FEBUXOSTAT 80MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304910", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FEM AUGMENT COMP", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8132503", "type": "CDM"}], "standard_charges": [{"gross_charge": 8551.0, "discounted_cash": 6413.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FEM COMP", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8132505", "type": "CDM"}], "standard_charges": [{"gross_charge": 51251.0, "discounted_cash": 38438.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FEM COMPONENT", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8132500", "type": "CDM"}], "standard_charges": [{"gross_charge": 12576.0, "discounted_cash": 9432.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FEM NAIL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132510", "type": "CDM"}], "standard_charges": [{"gross_charge": 16980.0, "discounted_cash": 12735.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FEM STEM", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8132535", "type": "CDM"}], "standard_charges": [{"gross_charge": 16208.0, "discounted_cash": 12156.0, "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": 1668.0, "discounted_cash": 1251.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FEMUR 2 VIEWS MIN", "code_information": [{"code": "73552", "type": "CPT"}, {"code": "5013550", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1417.0, "discounted_cash": 1062.75, "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": 1700.0, "discounted_cash": 1275.0, "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": 19273.0, "discounted_cash": 14454.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FEMUR SHAFT SPLIT", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "4011004", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5224.0, "discounted_cash": 3918.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "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": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FENOFIBRATE 160MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304937", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 82.0, "discounted_cash": 61.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FENOFIBRATE 160MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304937", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 82.0, "discounted_cash": 61.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FENOFIBRATE 54MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304935", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FENOFIBRATE 54MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304935", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FENOLDOPAM 10MG/1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5320666", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5108.0, "discounted_cash": 3831.0, "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": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FENT/ROPIV EPID PER1MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5320707", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FENT/ROPIV EPID PER1MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5320707", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FENTANYL", "code_information": [{"code": "80354", "type": "CPT"}, {"code": "7253936", "type": "CDM"}], "standard_charges": [{"gross_charge": 1031.0, "discounted_cash": 773.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FENTANYL 1000MCG 100MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5320628", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "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": 627.0, "discounted_cash": 470.25, "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": 627.0, "discounted_cash": 470.25, "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": 238.0, "discounted_cash": 178.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FENTANYL 12MCG/HR TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5327504", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 177.0, "discounted_cash": 132.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FENTANYL 12MCG/HR TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5327504", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 177.0, "discounted_cash": 132.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FENTANYL 200MCG LZ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5327517", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 223.0, "discounted_cash": 167.25, "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": 258.0, "discounted_cash": 193.5, "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": 258.0, "discounted_cash": 193.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FENTANYL 400MCG LZ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5327518", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 280.0, "discounted_cash": 210.0, "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": 350.0, "discounted_cash": 262.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 350.0, "discounted_cash": 262.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FENTANYL 600MCG LZ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5327519", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 319.0, "discounted_cash": 239.25, "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": 528.0, "discounted_cash": 396.0, "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": 528.0, "discounted_cash": 396.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FENTANYL 800MCG LZ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5327520", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 392.0, "discounted_cash": 294.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FENTANYL PER .1MG PCA IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3010", "type": "HCPCS"}, {"code": "5327531", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FENTANYL PER .1MG PCA IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3010", "type": "HCPCS"}, {"code": "5327531", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 204.0, "discounted_cash": 153.0, "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": 204.0, "discounted_cash": 153.0, "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": 116.0, "discounted_cash": 87.0, "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": 116.0, "discounted_cash": 87.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FERRIC SUBSULF 100ML TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335389", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 428.0, "discounted_cash": 321.0, "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": 325.0, "discounted_cash": 243.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FERRIC SUBSULF 8GM TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335382", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 143.0, "discounted_cash": 107.25, "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": 494.0, "discounted_cash": 370.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FERRITIN", "code_information": [{"code": "82728", "type": "CPT"}, {"code": "4122726", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FERRITIN", "code_information": [{"code": "82728", "type": "CPT"}, {"code": "4152726", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 187.0, "discounted_cash": 140.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FERROUS GLUCONT 300MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5305017", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FERROUS GLUCONT 300MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5305017", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "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": 0.75, "discounted_cash": 0.56, "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": 0.75, "discounted_cash": 0.56, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 36.0, "discounted_cash": 27.0, "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": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FERROUS SULF75/.6 50 LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315200", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 264.0, "discounted_cash": 198.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FERROUS SULF75/.6 50 LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315200", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 264.0, "discounted_cash": 198.0, "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": 36.0, "discounted_cash": 27.0, "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": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FERUMOXSIL 300ML", "code_information": [{"code": "5355935", "type": "CDM"}, {"code": "255", "type": "RC"}], "standard_charges": [{"gross_charge": 900.0, "discounted_cash": 675.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FERUMOXYTOL NONESRD1MGIJ", "code_information": [{"code": "Q0138", "type": "HCPCS"}, {"code": "5320600", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FERUMOXYTOL NONESRD1MGIJ", "code_information": [{"code": "Q0138", "type": "HCPCS"}, {"code": "5320600", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FETAL BIOPHYS PROFLE NST", "code_information": [{"code": "76818", "type": "CPT"}, {"code": "5016818", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1518.0, "discounted_cash": 1138.5, "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": 1254.0, "discounted_cash": 940.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FETAL BIOPHYS PROFLE NST", "code_information": [{"code": "76818", "type": "CPT"}, {"code": "5116818", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1594.0, "discounted_cash": 1195.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FETAL BIOPHYS W/O STRESS", "code_information": [{"code": "76819", "type": "CPT"}, {"code": "5016180", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 673.0, "discounted_cash": 504.75, "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": 673.0, "discounted_cash": 504.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FETAL FIBRONECTIN", "code_information": [{"code": "82731", "type": "CPT"}, {"code": "4102731", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1113.0, "discounted_cash": 834.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FETAL FIBRONECTIN", "code_information": [{"code": "82731", "type": "CPT"}, {"code": "4122731", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 173.0, "discounted_cash": 129.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FETAL LUNG MAT L/S RATIO", "code_information": [{"code": "83661", "type": "CPT"}, {"code": "7073663", "type": "CDM"}], "standard_charges": [{"gross_charge": 901.0, "discounted_cash": 675.75, "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": 651.0, "discounted_cash": 488.25, "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": 48.0, "discounted_cash": 36.0, "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": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FFP QUICK FREEZE 8 24 HR", "code_information": [{"code": "P9059", "type": "HCPCS"}, {"code": "4500003", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 424.0, "discounted_cash": 318.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FFP THAW EA UNIT", "code_information": [{"code": "86927", "type": "CPT"}, {"code": "4206264", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1711.0, "discounted_cash": 1283.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FIBER 4GM PWLQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314338", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FIBER 4GM PWLQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314338", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FIBER BN DEMINRLZ GRAFTON", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4021254", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8944.0, "discounted_cash": 6708.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FIBER BN DEMINRLZ GRAFTON 1CC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4021249", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3578.0, "discounted_cash": 2683.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FIBER BN DEMINRLZ GRAFTON 6CC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4021253", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16587.0, "discounted_cash": 12440.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FIBER DEMINERALIZED BONE 10CC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4021056", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9384.0, "discounted_cash": 7038.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FIBERS DBM", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132582", "type": "CDM"}], "standard_charges": [{"gross_charge": 8688.0, "discounted_cash": 6516.0, "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": 4811.0, "discounted_cash": 3608.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FIBRIN SEALANT 2ML KT TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5335396", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5256.0, "discounted_cash": 3942.0, "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": 2203.0, "discounted_cash": 1652.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FIBRIN SEALANT 5ML TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335405", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 6252.0, "discounted_cash": 4689.0, "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": 425.0, "discounted_cash": 318.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FIBRINOGEN ACTIVITY", "code_information": [{"code": "85384", "type": "CPT"}, {"code": "4125384", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FIBRINOGEN ACTIVITY", "code_information": [{"code": "85384", "type": "CPT"}, {"code": "4155384", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 173.0, "discounted_cash": 129.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FIBRINOGEN ANTIGEN", "code_information": [{"code": "85385", "type": "CPT"}, {"code": "7002730", "type": "CDM"}], "standard_charges": [{"gross_charge": 528.0, "discounted_cash": 396.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FIBRINOGEN ANTIGEN", "code_information": [{"code": "85385", "type": "CPT"}, {"code": "7252730", "type": "CDM"}], "standard_charges": [{"gross_charge": 528.0, "discounted_cash": 396.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FIBRNOLTIC PLSMNOGEN ACT", "code_information": [{"code": "85415", "type": "CPT"}, {"code": "7005415", "type": "CDM"}], "standard_charges": [{"gross_charge": 1077.0, "discounted_cash": 807.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FIBRNOLTIC PLSMNOGEN ACT", "code_information": [{"code": "85415", "type": "CPT"}, {"code": "7255415", "type": "CDM"}], "standard_charges": [{"gross_charge": 1077.0, "discounted_cash": 807.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FIBRNOLTIC PLSMNOGEN XCPT AG", "code_information": [{"code": "85420", "type": "CPT"}, {"code": "4105420", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 643.0, "discounted_cash": 482.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FIBRNOLTIC PLSMNOGEN XCPT AG", "code_information": [{"code": "85420", "type": "CPT"}, {"code": "7255420", "type": "CDM"}], "standard_charges": [{"gross_charge": 482.0, "discounted_cash": 361.5, "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": 1321.0, "discounted_cash": 990.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1321.0, "discounted_cash": 990.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "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": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FILTER VENA CAVA", "code_information": [{"code": "C1880", "type": "HCPCS"}, {"code": "8240143", "type": "CDM"}], "standard_charges": [{"gross_charge": 16183.0, "discounted_cash": 12137.25, "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": 71.0, "discounted_cash": 53.25, "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": 71.0, "discounted_cash": 53.25, "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": 573.0, "discounted_cash": 429.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FINGOLIMOD 0.5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305071", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1755.0, "discounted_cash": 1316.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FINGOLIMOD 0.5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305071", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1755.0, "discounted_cash": 1316.25, "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": 1452.0, "discounted_cash": 1089.0, "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": 1657.0, "discounted_cash": 1242.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FIX MOD GLENOID ZIMMER CL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4012964", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3507.0, "discounted_cash": 2630.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLAVORING AGENT 30ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315888", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLAVORING AGENT 30ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315888", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLECAINIDE", "code_information": [{"code": "80299", "type": "CPT"}, {"code": "7000300", "type": "CDM"}], "standard_charges": [{"gross_charge": 689.0, "discounted_cash": 516.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "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": 55.0, "discounted_cash": 41.25, "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": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLECAINIDE/2", "code_information": [{"code": "80181", "type": "CPT"}, {"code": "7250300", "type": "CDM"}], "standard_charges": [{"gross_charge": 689.0, "discounted_cash": 516.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLETCHER FACTOR ASSAY", "code_information": [{"code": "85292", "type": "CPT"}, {"code": "7005292", "type": "CDM"}], "standard_charges": [{"gross_charge": 504.0, "discounted_cash": 378.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLEX LARYNGOSCOPY", "code_information": [{"code": "5100015", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLEXHD PLIABLE PERF PER SQ CM", "code_information": [{"code": "Q4128", "type": "HCPCS"}, {"code": "4021061", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 150.0, "discounted_cash": 112.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLEXHD PLIABLE PERF PER SQ CM", "code_information": [{"code": "Q4128", "type": "HCPCS"}, {"code": "4021061", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 150.0, "discounted_cash": 112.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLEXHD STRUCTURAL THK 16X20CM", "code_information": [{"code": "Q4128", "type": "HCPCS"}, {"code": "4021251", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 33919.88, "discounted_cash": 25439.91, "setting": "both", "billing_class": "facility"}]}, {"description": "FLEXHD STRUCTURAL THK 16X20CM", "code_information": [{"code": "Q4128", "type": "HCPCS"}, {"code": "4021251", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 33919.88, "discounted_cash": 25439.91, "setting": "both", "billing_class": "facility"}]}, {"description": "FLOW CYTO ADD MARKER", "code_information": [{"code": "88185", "type": "CPT"}, {"code": "7050076", "type": "CDM"}], "standard_charges": [{"gross_charge": 98.0, "discounted_cash": 73.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLOW CYTO ADD MARKER/2", "code_information": [{"code": "88185", "type": "CPT"}, {"code": "7250076", "type": "CDM"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLOW CYTO CEL FIRST MRKR", "code_information": [{"code": "88184", "type": "CPT"}, {"code": "7050009", "type": "CDM"}], "standard_charges": [{"gross_charge": 347.0, "discounted_cash": 260.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLOW CYTO CELL CYCLE/DNA", "code_information": [{"code": "88182", "type": "CPT"}, {"code": "7038183", "type": "CDM"}], "standard_charges": [{"gross_charge": 1460.0, "discounted_cash": 1095.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLOW CYTO CELL CYCLE/DNA", "code_information": [{"code": "88182", "type": "CPT"}, {"code": "7058182", "type": "CDM"}], "standard_charges": [{"gross_charge": 638.0, "discounted_cash": 478.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLOW CYTO INTERP 16+ MARK", "code_information": [{"code": "88189", "type": "CPT"}, {"code": "7058189", "type": "CDM"}], "standard_charges": [{"gross_charge": 821.0, "discounted_cash": 615.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLOW CYTO INTERP 2-8 MARK", "code_information": [{"code": "88187", "type": "CPT"}, {"code": "7058187", "type": "CDM"}], "standard_charges": [{"gross_charge": 621.0, "discounted_cash": 465.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLOW CYTO INTERP 2-8 MARK", "code_information": [{"code": "88187", "type": "CPT"}, {"code": "7258187", "type": "CDM"}], "standard_charges": [{"gross_charge": 495.0, "discounted_cash": 371.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLT3 GENE ANALYSIS", "code_information": [{"code": "81245", "type": "CPT"}, {"code": "7050063", "type": "CDM"}], "standard_charges": [{"gross_charge": 798.0, "discounted_cash": 598.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLT3 GENE ANALYSIS TKD", "code_information": [{"code": "81246", "type": "CPT"}, {"code": "7050064", "type": "CDM"}], "standard_charges": [{"gross_charge": 584.0, "discounted_cash": 438.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLTR VENA CAVA", "code_information": [{"code": "C1880", "type": "HCPCS"}, {"code": "8174690", "type": "CDM"}], "standard_charges": [{"gross_charge": 7256.0, "discounted_cash": 5442.0, "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": 147.0, "discounted_cash": 110.25, "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": 143.0, "discounted_cash": 107.25, "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": 216.0, "discounted_cash": 162.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLU VAC>3Y FLUZONE IM IJ", "code_information": [{"code": "Q2038", "type": "HCPCS"}, {"code": "5320704", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 216.0, "discounted_cash": 162.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLU VACC NOS IJ", "code_information": [{"code": "Q2039", "type": "HCPCS"}, {"code": "5320672", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 216.0, "discounted_cash": 162.0, "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": 1825.0, "discounted_cash": 1368.75, "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": 1825.0, "discounted_cash": 1368.75, "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": 143.0, "discounted_cash": 107.25, "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": 143.0, "discounted_cash": 107.25, "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": 165.0, "discounted_cash": 123.75, "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": 165.0, "discounted_cash": 123.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUCONAZOLE 150MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305098", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 268.0, "discounted_cash": 201.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUCONAZOLE 150MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305098", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 268.0, "discounted_cash": 201.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUCONAZOLE 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305097", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 270.0, "discounted_cash": 202.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUCONAZOLE 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305097", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 270.0, "discounted_cash": 202.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUCONAZOLE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305095", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUCONAZOLE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305095", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUCONIZOLE", "code_information": [{"code": "80299", "type": "CPT"}, {"code": "7250227", "type": "CDM"}], "standard_charges": [{"gross_charge": 520.0, "discounted_cash": 390.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUCYTOSINE 250MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305102", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 558.0, "discounted_cash": 418.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUCYTOSINE 250MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305102", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 558.0, "discounted_cash": 418.5, "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": 134.0, "discounted_cash": 100.5, "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": 134.0, "discounted_cash": 100.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUDARABINE PH PER50MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9185", "type": "HCPCS"}, {"code": "5320680", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 4507.0, "discounted_cash": 3380.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUDARABINE PH PER50MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9185", "type": "HCPCS"}, {"code": "5320680", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 4507.0, "discounted_cash": 3380.25, "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": 39.0, "discounted_cash": 29.25, "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": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUDROCORTISONE.05MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305128", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUDROCORTISONE.05MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305128", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 822.0, "discounted_cash": 616.5, "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": 1366.0, "discounted_cash": 1024.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUNISOLIDE 250MCG7GM IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330948", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1163.0, "discounted_cash": 872.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUNISOLIDE 250MCG7GM IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330948", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1163.0, "discounted_cash": 872.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUOCINONIDE .05%15GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335498", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 221.0, "discounted_cash": 165.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUOCINONIDE .05%15GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335498", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 221.0, "discounted_cash": 165.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORES/PROPAR .25/.5 DOSE OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330963", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 291.0, "discounted_cash": 218.25, "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": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORESCENT AB TITER EA", "code_information": [{"code": "86256", "type": "CPT"}, {"code": "7003946", "type": "CDM"}], "standard_charges": [{"gross_charge": 880.0, "discounted_cash": 660.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORESCENT AB TITER EA/10", "code_information": [{"code": "86256", "type": "CPT"}, {"code": "7256255", "type": "CDM"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORESCENT AB TITER EA/13", "code_information": [{"code": "86256", "type": "CPT"}, {"code": "7008620", "type": "CDM"}], "standard_charges": [{"gross_charge": 1109.0, "discounted_cash": 831.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORESCENT AB TITER EA/14", "code_information": [{"code": "86256", "type": "CPT"}, {"code": "7256261", "type": "CDM"}], "standard_charges": [{"gross_charge": 481.0, "discounted_cash": 360.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORESCENT AB TITER EA/2", "code_information": [{"code": "86256", "type": "CPT"}, {"code": "7003947", "type": "CDM"}], "standard_charges": [{"gross_charge": 629.0, "discounted_cash": 471.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORESCENT AB TITER EA/20", "code_information": [{"code": "86256", "type": "CPT"}, {"code": "7258638", "type": "CDM"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORESCNT SCRN EA AB", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "4106252", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 388.0, "discounted_cash": 291.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORESCNT SCRN EA AB", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "7258627", "type": "CDM"}], "standard_charges": [{"gross_charge": 6384.0, "discounted_cash": 4788.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORIMETHANE 120ML SP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335544", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 304.0, "discounted_cash": 228.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORIMETHANE 120ML SP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335544", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 304.0, "discounted_cash": 228.0, "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": 4302.0, "discounted_cash": 3226.5, "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": 3388.0, "discounted_cash": 2541.0, "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": 3388.0, "discounted_cash": 2541.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORO BX/ASP/INJ/GUIDE", "code_information": [{"code": "77002", "type": "CPT"}, {"code": "5016010", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 4183.0, "discounted_cash": 3137.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORO BX/ASP/INJ/GUIDE", "code_information": [{"code": "77002", "type": "CPT"}, {"code": "5117002", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 4302.0, "discounted_cash": 3226.5, "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": 2338.0, "discounted_cash": 1753.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORO GUIDE SPINE INJ", "code_information": [{"code": "77003", "type": "CPT"}, {"code": "4916011", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2338.0, "discounted_cash": 1753.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUOROGUID FOR VEIN DVCE", "code_information": [{"code": "77001", "type": "CPT"}, {"code": "4615997", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1925.0, "discounted_cash": 1443.75, "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": 1663.0, "discounted_cash": 1247.25, "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": 1663.0, "discounted_cash": 1247.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUOROMETHALONE.1%5MLOS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330983", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUOROMETHALONE.1%5MLOS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330983", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUOROMETHALONE.25%5MLOS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330990", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 292.0, "discounted_cash": 219.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUOROMETHALONE.25%5MLOS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330990", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 292.0, "discounted_cash": 219.0, "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": 3054.0, "discounted_cash": 2290.5, "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": 2398.0, "discounted_cash": 1798.5, "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": 2398.0, "discounted_cash": 1798.5, "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": 175.0, "discounted_cash": 131.25, "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": 175.0, "discounted_cash": 131.25, "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": 69.0, "discounted_cash": 51.75, "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": 69.0, "discounted_cash": 51.75, "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 90MG XRCP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305162", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 510.0, "discounted_cash": 382.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUOXETINE 90MG XRCP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305162", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 510.0, "discounted_cash": 382.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "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": 93.0, "discounted_cash": 69.75, "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": 251.0, "discounted_cash": 188.25, "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": 251.0, "discounted_cash": 188.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUPHENAZINE 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305206", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUPHENAZINE 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305206", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUPHENAZINE 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305204", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUPHENAZINE 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305204", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "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": 49.0, "discounted_cash": 36.75, "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": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUPHENAZINE QUAN", "code_information": [{"code": "80342", "type": "CPT"}, {"code": "7252739", "type": "CDM"}], "standard_charges": [{"gross_charge": 473.0, "discounted_cash": 354.75, "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": 227.0, "discounted_cash": 170.25, "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": 227.0, "discounted_cash": 170.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUT/SALM 100/50 14DS IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5332006", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 888.0, "discounted_cash": 666.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUT/SALM 100/50 14DS IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5332006", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 888.0, "discounted_cash": 666.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUT/SALM 100/50 28DS IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5332285", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1543.0, "discounted_cash": 1157.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUT/SALM 100/50 28DS IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5332285", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1543.0, "discounted_cash": 1157.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUT/SALM 250/50 14DS IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5332008", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 996.0, "discounted_cash": 747.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUT/SALM 250/50 14DS IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5332008", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 996.0, "discounted_cash": 747.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUT/SALM 250/50 28DS IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5332287", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1904.0, "discounted_cash": 1428.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUT/SALM 250/50 28DS IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5332287", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1904.0, "discounted_cash": 1428.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUT/SALM 500/50 14DS IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5332007", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1285.0, "discounted_cash": 963.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUT/SALM 500/50 14DS IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5332007", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1285.0, "discounted_cash": 963.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUT/SALM 500/50 28DS IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5332289", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2008.0, "discounted_cash": 1506.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUT/SALM 500/50 28DS IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5332289", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2008.0, "discounted_cash": 1506.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUT/VILA 100/25 14DS IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5332305", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 916.0, "discounted_cash": 687.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUT/VILA 100/25 14DS IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5332305", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 916.0, "discounted_cash": 687.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUT/VILA 200/25 14DS IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5331022", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 950.0, "discounted_cash": 712.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUT/VILA 200/25 14DS IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5331022", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 950.0, "discounted_cash": 712.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUTAMIDE 125MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305228", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 75.0, "discounted_cash": 56.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUTAMIDE 125MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305228", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 75.0, "discounted_cash": 56.25, "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": 737.0, "discounted_cash": 552.75, "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": 737.0, "discounted_cash": 552.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "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": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUTICASONE100MCG14DS IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330972", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 525.0, "discounted_cash": 393.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUTICASONE100MCG14DS IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330972", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 525.0, "discounted_cash": 393.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUTICASONE110MCG13GM IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330998", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 755.0, "discounted_cash": 566.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUTICASONE110MCG13GM IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330998", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 755.0, "discounted_cash": 566.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUTICASONE200MCG14DS IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330967", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 809.0, "discounted_cash": 606.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUTICASONE200MCG14DS IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330967", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 809.0, "discounted_cash": 606.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUTICASONE220MCG13GM IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330999", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1371.0, "discounted_cash": 1028.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUTICASONE220MCG13GM IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330999", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1371.0, "discounted_cash": 1028.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUTICASONE44MCG7.9GM IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5331001", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 601.0, "discounted_cash": 450.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUTICASONE44MCG7.9GM IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5331001", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 601.0, "discounted_cash": 450.75, "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": 77.0, "discounted_cash": 57.75, "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": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FMLY THRPY 30 MIN", "code_information": [{"code": "90847", "type": "CPT"}, {"code": "6401970", "type": "CDM"}], "standard_charges": [{"gross_charge": 702.0, "discounted_cash": 526.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FMLY THRPY 60 MIN", "code_information": [{"code": "90847", "type": "CPT"}, {"code": "6401974", "type": "CDM"}], "standard_charges": [{"gross_charge": 801.0, "discounted_cash": 600.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FMLY THRPY W/O PT 50MIN", "code_information": [{"code": "90846", "type": "CPT"}, {"code": "6401960", "type": "CDM"}], "standard_charges": [{"gross_charge": 525.0, "discounted_cash": 393.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FMR1 ABNL ALLELES/2", "code_information": [{"code": "81243", "type": "CPT"}, {"code": "7259206", "type": "CDM"}], "standard_charges": [{"gross_charge": 1622.0, "discounted_cash": 1216.5, "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": 10320.0, "discounted_cash": 7740.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FNA BX CT GUIDANCE EA ADL LES", "code_information": [{"code": "5050115", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 10320.0, "discounted_cash": 7740.0, "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": 3099.0, "discounted_cash": 2324.25, "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": 5998.0, "discounted_cash": 4498.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FNA BX US GUIDANCE EA ADD LES", "code_information": [{"code": "5060111", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5995.0, "discounted_cash": 4496.25, "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": 528.0, "discounted_cash": 396.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FOLIC ACID", "code_information": [{"code": "82746", "type": "CPT"}, {"code": "4122746", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FOLIC ACID", "code_information": [{"code": "82746", "type": "CPT"}, {"code": "4152746", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 219.0, "discounted_cash": 164.25, "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": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FOLIC ACID 400MCG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5305229", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.21, "discounted_cash": 0.16, "setting": "both", "billing_class": "facility"}]}, {"description": "FOLIC ACID 400MCG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5305229", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 0.21, "discounted_cash": 0.16, "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": 0.81, "discounted_cash": 0.61, "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": 0.81, "discounted_cash": 0.61, "setting": "both", "billing_class": "facility"}]}, {"description": "FOLIC ACID RBC", "code_information": [{"code": "82747", "type": "CPT"}, {"code": "7002747", "type": "CDM"}], "standard_charges": [{"gross_charge": 328.0, "discounted_cash": 246.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FOLIC ACID RBC", "code_information": [{"code": "82747", "type": "CPT"}, {"code": "7252747", "type": "CDM"}], "standard_charges": [{"gross_charge": 328.0, "discounted_cash": 246.0, "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": 545.0, "discounted_cash": 408.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FOLLICLE STIMLAT HORMONE", "code_information": [{"code": "83001", "type": "CPT"}, {"code": "4153001", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 165.0, "discounted_cash": 123.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FOLLICLE STIMLAT HORMONE", "code_information": [{"code": "83001", "type": "CPT"}, {"code": "7253001", "type": "CDM"}], "standard_charges": [{"gross_charge": 227.0, "discounted_cash": 170.25, "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": 92.0, "discounted_cash": 69.0, "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": 92.0, "discounted_cash": 69.0, "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": 98.0, "discounted_cash": 73.5, "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": 98.0, "discounted_cash": 73.5, "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": 1417.0, "discounted_cash": 1062.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FOOT 2 VIEWS", "code_information": [{"code": "73620", "type": "CPT"}, {"code": "5013620", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1417.0, "discounted_cash": 1062.75, "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": 1526.0, "discounted_cash": 1144.5, "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": 1639.0, "discounted_cash": 1229.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FOOT 3 VIEWS MINIMUM", "code_information": [{"code": "73630", "type": "CPT"}, {"code": "5013630", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1252.0, "discounted_cash": 939.0, "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": 1591.0, "discounted_cash": 1193.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FORCEP MINI PULMONARY", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8081022", "type": "CDM"}], "standard_charges": [{"gross_charge": 5903.0, "discounted_cash": 4427.25, "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": 1427.0, "discounted_cash": 1070.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FOREARM 2 VIEWS", "code_information": [{"code": "73090", "type": "CPT"}, {"code": "5013090", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1427.0, "discounted_cash": 1070.25, "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": 1530.0, "discounted_cash": 1147.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FORMOTER12MCG EACH IH CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5331008", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FORMOTER12MCG EACH IH CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5331008", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FORMOTEROL 20MCG/2ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5331017", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 171.0, "discounted_cash": 128.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FORMOTEROL 20MCG/2ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5331017", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 171.0, "discounted_cash": 128.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FOSAMPRENAVIR 700MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305245", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 147.0, "discounted_cash": 110.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FOSAMPRENAVIR 700MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305245", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 147.0, "discounted_cash": 110.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FOSAPREPITANT PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1453", "type": "HCPCS"}, {"code": "5320772", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 15.0, "discounted_cash": 11.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FOSAPREPITANT PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1453", "type": "HCPCS"}, {"code": "5320772", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 15.0, "discounted_cash": 11.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FOSCARNET PER 1000MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1455", "type": "HCPCS"}, {"code": "5320743", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 221.0, "discounted_cash": 165.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FOSCARNET PER 1000MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1455", "type": "HCPCS"}, {"code": "5320743", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 221.0, "discounted_cash": 165.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FOSFOMYCIN 3GM PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305239", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 462.0, "discounted_cash": 346.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FOSFOMYCIN 3GM PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305239", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 462.0, "discounted_cash": 346.5, "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": 266.0, "discounted_cash": 199.5, "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": 266.0, "discounted_cash": 199.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FRANCISELLA TULARENS AB", "code_information": [{"code": "86668", "type": "CPT"}, {"code": "7006668", "type": "CDM"}], "standard_charges": [{"gross_charge": 240.0, "discounted_cash": 180.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FULVESTRANT PER 25MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9395", "type": "HCPCS"}, {"code": "5320762", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1531.0, "discounted_cash": 1148.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FULVESTRANT PER 25MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9395", "type": "HCPCS"}, {"code": "5320762", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1531.0, "discounted_cash": 1148.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FUNGUS AB NES", "code_information": [{"code": "86671", "type": "CPT"}, {"code": "7000351", "type": "CDM"}], "standard_charges": [{"gross_charge": 557.0, "discounted_cash": 417.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FUNGUS AB NES", "code_information": [{"code": "86671", "type": "CPT"}, {"code": "7256671", "type": "CDM"}], "standard_charges": [{"gross_charge": 557.0, "discounted_cash": 417.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FUNGUS AB NES/2", "code_information": [{"code": "86671", "type": "CPT"}, {"code": "7256672", "type": "CDM"}], "standard_charges": [{"gross_charge": 557.0, "discounted_cash": 417.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FUROSEMIDE", "code_information": [{"code": "80375", "type": "CPT"}, {"code": "7252488", "type": "CDM"}], "standard_charges": [{"gross_charge": 457.0, "discounted_cash": 342.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FUROSEMIDE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305278", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.63, "discounted_cash": 0.47, "setting": "both", "billing_class": "facility"}]}, {"description": "FUROSEMIDE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305278", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 0.63, "discounted_cash": 0.47, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "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": 39.0, "discounted_cash": 29.25, "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": 39.0, "discounted_cash": 29.25, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FUROSEMIDE PED DS LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315246", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FUROSEMIDE PED DS LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315246", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": 0.33, "discounted_cash": 0.25, "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": 0.33, "discounted_cash": 0.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FUROSEMIDE PER 1MG NEO IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1938", "type": "HCPCS"}, {"code": "5320823", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.33, "discounted_cash": 0.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FUROSEMIDE PER 1MG NEO IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1938", "type": "HCPCS"}, {"code": "5320823", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 0.33, "discounted_cash": 0.25, "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": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FUROSEMIDE10MG/ML10ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315247", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 276.0, "discounted_cash": 207.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FUROSEMIDE10MG/ML10ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315247", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 276.0, "discounted_cash": 207.0, "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": 98.0, "discounted_cash": 73.5, "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": 98.0, "discounted_cash": 73.5, "setting": "both", "billing_class": "facility"}]}, {"description": "G6PD QUANT", "code_information": [{"code": "82955", "type": "CPT"}, {"code": "7002955", "type": "CDM"}], "standard_charges": [{"gross_charge": 138.0, "discounted_cash": 103.5, "setting": "both", "billing_class": "facility"}]}, {"description": "G6PD QUANT", "code_information": [{"code": "82955", "type": "CPT"}, {"code": "7252955", "type": "CDM"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 87.75, "setting": "both", "billing_class": "facility"}]}, {"description": "G6PD SREEN", "code_information": [{"code": "82960", "type": "CPT"}, {"code": "4102960", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 325.0, "discounted_cash": 243.75, "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": 189.0, "discounted_cash": 141.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GABAPENTIN", "code_information": [{"code": "80171", "type": "CPT"}, {"code": "7000250", "type": "CDM"}], "standard_charges": [{"gross_charge": 407.0, "discounted_cash": 305.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GABAPENTIN", "code_information": [{"code": "80171", "type": "CPT"}, {"code": "7250250", "type": "CDM"}], "standard_charges": [{"gross_charge": 407.0, "discounted_cash": 305.25, "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": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GABAPENTIN 250/5 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315264", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GABAPENTIN 250/5 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315264", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GABAPENTIN 250MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315249", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GABAPENTIN 250MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315249", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "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": 53.0, "discounted_cash": 39.75, "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": 53.0, "discounted_cash": 39.75, "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": 52.0, "discounted_cash": 39.0, "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": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GABAPENTIN 600MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305288", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GABAPENTIN 600MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305288", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GABAPENTIN 800MGTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305289", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GABAPENTIN 800MGTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305289", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "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": 55.0, "discounted_cash": 41.25, "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": 55.0, "discounted_cash": 41.25, "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": 3.0, "discounted_cash": 2.25, "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": 3.0, "discounted_cash": 2.25, "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": 59.0, "discounted_cash": 44.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 59.0, "discounted_cash": 44.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GALANTAMINE 8MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305300", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GALANTAMINE 8MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305300", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GALLIUM NITRATE PER1MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1457", "type": "HCPCS"}, {"code": "5320802", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GALLIUM NITRATE PER1MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1457", "type": "HCPCS"}, {"code": "5320802", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMAGLOBULIN EA", "code_information": [{"code": "82784", "type": "CPT"}, {"code": "4123512", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMAGLOBULIN EA", "code_information": [{"code": "82784", "type": "CPT"}, {"code": "7252782", "type": "CDM"}], "standard_charges": [{"gross_charge": 23.0, "discounted_cash": 17.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMAGLOBULIN EA/10", "code_information": [{"code": "82784", "type": "CPT"}, {"code": "7003521", "type": "CDM"}], "standard_charges": [{"gross_charge": 227.0, "discounted_cash": 170.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMAGLOBULIN EA/10", "code_information": [{"code": "82784", "type": "CPT"}, {"code": "7253564", "type": "CDM"}], "standard_charges": [{"gross_charge": 23.0, "discounted_cash": 17.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMAGLOBULIN EA/13", "code_information": [{"code": "82784", "type": "CPT"}, {"code": "7007468", "type": "CDM"}], "standard_charges": [{"gross_charge": 403.0, "discounted_cash": 302.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMAGLOBULIN EA/2", "code_information": [{"code": "82784", "type": "CPT"}, {"code": "4123514", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMAGLOBULIN EA/2", "code_information": [{"code": "82784", "type": "CPT"}, {"code": "7252783", "type": "CDM"}], "standard_charges": [{"gross_charge": 403.0, "discounted_cash": 302.25, "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": 686.0, "discounted_cash": 514.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMAGLOBULIN EA/3", "code_information": [{"code": "82784", "type": "CPT"}, {"code": "4123515", "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": "7252784", "type": "CDM"}], "standard_charges": [{"gross_charge": 227.0, "discounted_cash": 170.25, "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": 686.0, "discounted_cash": 514.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMAGLOBULIN EA/4", "code_information": [{"code": "82784", "type": "CPT"}, {"code": "7252786", "type": "CDM"}], "standard_charges": [{"gross_charge": 403.0, "discounted_cash": 302.25, "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": 686.0, "discounted_cash": 514.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMAGLOBULIN EA/5", "code_information": [{"code": "82784", "type": "CPT"}, {"code": "7252787", "type": "CDM"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMAGLOBULIN EA/6", "code_information": [{"code": "82784", "type": "CPT"}, {"code": "7253512", "type": "CDM"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMAGLOBULIN EA/7", "code_information": [{"code": "82784", "type": "CPT"}, {"code": "7253514", "type": "CDM"}], "standard_charges": [{"gross_charge": 227.0, "discounted_cash": 170.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMAGLOBULIN EA/8", "code_information": [{"code": "82784", "type": "CPT"}, {"code": "7253515", "type": "CDM"}], "standard_charges": [{"gross_charge": 23.0, "discounted_cash": 17.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMAGLOBULIN EA/9", "code_information": [{"code": "82784", "type": "CPT"}, {"code": "7253521", "type": "CDM"}], "standard_charges": [{"gross_charge": 227.0, "discounted_cash": 170.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GANCICLOVIR 250MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305295", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GANCICLOVIR 250MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305295", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GANCICLOVIR 500MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1570", "type": "HCPCS"}, {"code": "5320830", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 839.0, "discounted_cash": 629.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GANCICLOVIR 500MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1570", "type": "HCPCS"}, {"code": "5320830", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 839.0, "discounted_cash": 629.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GANGLIOSIDE AB/3", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7253535", "type": "CDM"}], "standard_charges": [{"gross_charge": 716.0, "discounted_cash": 537.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GANGLIOSIDE AB/6", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7258359", "type": "CDM"}], "standard_charges": [{"gross_charge": 226.0, "discounted_cash": 169.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GANGLIOSIDE AB/7", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7258362", "type": "CDM"}], "standard_charges": [{"gross_charge": 80.0, "discounted_cash": 60.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GANGLIOSIDE AB/8", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7258372", "type": "CDM"}], "standard_charges": [{"gross_charge": 253.0, "discounted_cash": 189.75, "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": 360.0, "discounted_cash": 270.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GAS BLD ANY COMB W/CALO2", "code_information": [{"code": "82803", "type": "CPT"}, {"code": "4122803", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GAS BLD O2 SAT X PULSE", "code_information": [{"code": "82810", "type": "CPT"}, {"code": "4102810", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 173.0, "discounted_cash": 129.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GAS BLOOD PH ONLY", "code_information": [{"code": "82800", "type": "CPT"}, {"code": "4102800", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 283.0, "discounted_cash": 212.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GASTRIC EMPTYING STUDY", "code_information": [{"code": "78264", "type": "CPT"}, {"code": "5018276", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 6281.0, "discounted_cash": 4710.75, "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": 6439.0, "discounted_cash": 4829.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GASTRIN", "code_information": [{"code": "82941", "type": "CPT"}, {"code": "7002941", "type": "CDM"}], "standard_charges": [{"gross_charge": 1032.0, "discounted_cash": 774.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GASTRIN", "code_information": [{"code": "82941", "type": "CPT"}, {"code": "7252941", "type": "CDM"}], "standard_charges": [{"gross_charge": 1032.0, "discounted_cash": 774.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GATED HEART PLANAR SNGL", "code_information": [{"code": "78472", "type": "CPT"}, {"code": "5018402", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 8791.0, "discounted_cash": 6593.25, "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": 1917.0, "discounted_cash": 1437.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GC DNA AMP PROBE", "code_information": [{"code": "87591", "type": "CPT"}, {"code": "7007592", "type": "CDM"}], "standard_charges": [{"gross_charge": 149.0, "discounted_cash": 111.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GC DNA AMP PROBE", "code_information": [{"code": "87591", "type": "CPT"}, {"code": "7257592", "type": "CDM"}], "standard_charges": [{"gross_charge": 149.0, "discounted_cash": 111.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GC DNA DIR PROBE", "code_information": [{"code": "87590", "type": "CPT"}, {"code": "7007191", "type": "CDM"}], "standard_charges": [{"gross_charge": 611.0, "discounted_cash": 458.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GC DNA DIR PROBE", "code_information": [{"code": "87590", "type": "CPT"}, {"code": "7257191", "type": "CDM"}], "standard_charges": [{"gross_charge": 611.0, "discounted_cash": 458.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GCATH CRAGG-MCNAMARA", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8241069", "type": "CDM"}], "standard_charges": [{"gross_charge": 789.0, "discounted_cash": 591.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GCATH CRDS VISTABRITE", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8241074", "type": "CDM"}], "standard_charges": [{"gross_charge": 419.0, "discounted_cash": 314.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GCATH CRDS VISTABRT TP10", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8241070", "type": "CDM"}], "standard_charges": [{"gross_charge": 1348.0, "discounted_cash": 1011.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GCATH LGL CORDIS ENVOY 6", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8246402", "type": "CDM"}], "standard_charges": [{"gross_charge": 4134.0, "discounted_cash": 3100.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GCATH MACH 1", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8241085", "type": "CDM"}], "standard_charges": [{"gross_charge": 625.0, "discounted_cash": 468.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GCATH RUNWAY 6F", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8241097", "type": "CDM"}], "standard_charges": [{"gross_charge": 360.0, "discounted_cash": 270.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GDE LUNDERQUIST", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8073027", "type": "CDM"}], "standard_charges": [{"gross_charge": 735.0, "discounted_cash": 551.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GDE PRESSURE OMNIWIRE", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8073026", "type": "CDM"}], "standard_charges": [{"gross_charge": 840.0, "discounted_cash": 630.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GDE SINUS CORON WORLEY", "code_information": [{"code": "C1892", "type": "HCPCS"}, {"code": "8182407", "type": "CDM"}], "standard_charges": [{"gross_charge": 1949.0, "discounted_cash": 1461.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GEL VOICE INJ", "code_information": [{"code": "C1878", "type": "HCPCS"}, {"code": "8032293", "type": "CDM"}], "standard_charges": [{"gross_charge": 3974.0, "discounted_cash": 2980.5, "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": 804.0, "discounted_cash": 603.0, "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": 531.0, "discounted_cash": 398.25, "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": 207.0, "discounted_cash": 155.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GELATIN SPONGE ABS1GM PW", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5335708", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1005.0, "discounted_cash": 753.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GELATIN SPONGE8CMX3CM EA", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5337372", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 356.0, "discounted_cash": 267.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GEMCITABINE (ACCORD) 200MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9196", "type": "HCPCS"}, {"code": "5320839", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 251.0, "discounted_cash": 188.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GEMCITABINE (ACCORD) 200MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9196", "type": "HCPCS"}, {"code": "5320839", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 251.0, "discounted_cash": 188.25, "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": 2556.0, "discounted_cash": 1917.0, "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": 2556.0, "discounted_cash": 1917.0, "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": 47.0, "discounted_cash": 35.25, "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": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GEMTUZUMAB OZOG PER 0.1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9203", "type": "HCPCS"}, {"code": "5320836", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1073.0, "discounted_cash": 804.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GEMTUZUMAB OZOG PER 0.1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9203", "type": "HCPCS"}, {"code": "5320836", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1073.0, "discounted_cash": 804.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GEN NEURO INTERSTIM X", "code_information": [{"code": "L8679", "type": "HCPCS"}, {"code": "4008538", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 113425.0, "discounted_cash": 85068.75, "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": 78333.0, "discounted_cash": 58749.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GEN NSTIM PROCLAIM 3660", "code_information": [{"code": "C1767", "type": "HCPCS"}, {"code": "4008502", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 133075.0, "discounted_cash": 99806.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GEN NSTIM PRODIGY MRI", "code_information": [{"code": "C1767", "type": "HCPCS"}, {"code": "4008499", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 127018.0, "discounted_cash": 95263.5, "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": 184367.0, "discounted_cash": 138275.25, "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": 180077.0, "discounted_cash": 135057.75, "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": 314.0, "discounted_cash": 235.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GENTAMICIN", "code_information": [{"code": "80170", "type": "CPT"}, {"code": "4153004", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 134.0, "discounted_cash": 100.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 116.0, "discounted_cash": 87.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 116.0, "discounted_cash": 87.0, "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": 191.0, "discounted_cash": 143.25, "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": 191.0, "discounted_cash": 143.25, "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": 177.0, "discounted_cash": 132.75, "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": 177.0, "discounted_cash": 132.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "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": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GENTAMICIN OPTH DOSE OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331034", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 120.0, "discounted_cash": 90.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GENTAMICIN OPTH DOSE OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331034", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 120.0, "discounted_cash": 90.0, "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": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "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": 20.0, "discounted_cash": 15.0, "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": 209.0, "discounted_cash": 156.75, "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": 222.0, "discounted_cash": 166.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GENTAMICIN/3", "code_information": [{"code": "80170", "type": "CPT"}, {"code": "4123004", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "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": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GF/DEXTR1200MG/60MGXRTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305484", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GF/DEXTR1200MG/60MGXRTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305484", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "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": 39.0, "discounted_cash": 29.25, "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": 39.0, "discounted_cash": 29.25, "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": 48.0, "discounted_cash": 36.0, "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": 48.0, "discounted_cash": 36.0, "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": 340.0, "discounted_cash": 255.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GGT", "code_information": [{"code": "82977", "type": "CPT"}, {"code": "4122980", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GGT", "code_information": [{"code": "82977", "type": "CPT"}, {"code": "4152980", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "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": 82.0, "discounted_cash": 61.5, "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": 82.0, "discounted_cash": 61.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GI PATHOGEN 12-15 AMP PROBE", "code_information": [{"code": "87507", "type": "CPT"}, {"code": "7257508", "type": "CDM"}], "standard_charges": [{"gross_charge": 1716.0, "discounted_cash": 1287.0, "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": 1118.0, "discounted_cash": 838.5, "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": 4179.0, "discounted_cash": 3134.25, "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": 2100.0, "discounted_cash": 1575.0, "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": 7268.0, "discounted_cash": 5451.0, "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": 3707.0, "discounted_cash": 2780.25, "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": 11508.0, "discounted_cash": 8631.0, "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": 1178.0, "discounted_cash": 883.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GIARDIA IA", "code_information": [{"code": "87329", "type": "CPT"}, {"code": "7002934", "type": "CDM"}], "standard_charges": [{"gross_charge": 230.0, "discounted_cash": 172.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GIARDIA IA", "code_information": [{"code": "87329", "type": "CPT"}, {"code": "7252934", "type": "CDM"}], "standard_charges": [{"gross_charge": 230.0, "discounted_cash": 172.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GINTRO CPS DIRECT", "code_information": [{"code": "C1893", "type": "HCPCS"}, {"code": "8241101", "type": "CDM"}], "standard_charges": [{"gross_charge": 996.0, "discounted_cash": 747.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GINTRO FASTCATH", "code_information": [{"code": "C1893", "type": "HCPCS"}, {"code": "8241110", "type": "CDM"}], "standard_charges": [{"gross_charge": 845.0, "discounted_cash": 633.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GINTRO RAMP", "code_information": [{"code": "C1893", "type": "HCPCS"}, {"code": "8241160", "type": "CDM"}], "standard_charges": [{"gross_charge": 1365.0, "discounted_cash": 1023.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GINTRO SWARTZ", "code_information": [{"code": "C1893", "type": "HCPCS"}, {"code": "8241178", "type": "CDM"}], "standard_charges": [{"gross_charge": 1587.0, "discounted_cash": 1190.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GLATIRAMR ACET PER20MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1595", "type": "HCPCS"}, {"code": "5320884", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 789.0, "discounted_cash": 591.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GLATIRAMR ACET PER20MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1595", "type": "HCPCS"}, {"code": "5320884", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 789.0, "discounted_cash": 591.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GLEN PEG/KEEL/HYBRD TORNIER CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013500", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12248.0, "discounted_cash": 9186.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GLENOID BASEPLATE EXACT CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012835", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 14615.0, "discounted_cash": 10961.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GLENOID CAGED AUGMNT EXACT CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012833", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11692.0, "discounted_cash": 8769.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GLENOID GLENOSPHERE TORNIER CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013498", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 15355.0, "discounted_cash": 11516.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GLENOSPHERE EXACT CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012836", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12861.0, "discounted_cash": 9645.75, "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": 10508.0, "discounted_cash": 7881.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GLENOSPHERE STRYKER CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013022", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10763.0, "discounted_cash": 8072.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GLENOSPHERE ZIMMER CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012933", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11982.0, "discounted_cash": 8986.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GLIADIN AB", "code_information": [{"code": "86258", "type": "CPT"}, {"code": "7253508", "type": "CDM"}], "standard_charges": [{"gross_charge": 368.0, "discounted_cash": 276.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GLIADIN AB/2", "code_information": [{"code": "86258", "type": "CPT"}, {"code": "7254213", "type": "CDM"}], "standard_charges": [{"gross_charge": 368.0, "discounted_cash": 276.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GLIMEPIRIDE 0.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305319", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GLIMEPIRIDE 0.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305319", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GLIMEPIRIDE 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305320", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GLIMEPIRIDE 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305320", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "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": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GLIPIZIDE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305347", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GLIPIZIDE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305347", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "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": 17.0, "discounted_cash": 12.75, "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": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GLIPIZIDE 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305343", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GLIPIZIDE 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305343", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": 36.0, "discounted_cash": 27.0, "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": 36.0, "discounted_cash": 27.0, "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": 36.0, "discounted_cash": 27.0, "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": 36.0, "discounted_cash": 27.0, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GLNOID LAT/TITN CTD TORNIER CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013499", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 18767.0, "discounted_cash": 14075.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCAGON", "code_information": [{"code": "82943", "type": "CPT"}, {"code": "7002943", "type": "CDM"}], "standard_charges": [{"gross_charge": 1393.0, "discounted_cash": 1044.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCAGON", "code_information": [{"code": "82943", "type": "CPT"}, {"code": "7252943", "type": "CDM"}], "standard_charges": [{"gross_charge": 1393.0, "discounted_cash": 1044.75, "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": 856.0, "discounted_cash": 642.0, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 856.0, "discounted_cash": 642.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCARPIDASE PER 10U IJ", "code_information": [{"code": "C9293", "type": "HCPCS"}, {"code": "5320900", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2009.0, "discounted_cash": 1506.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCARPIDASE PER 10U IJ", "code_information": [{"code": "C9293", "type": "HCPCS"}, {"code": "5320900", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 2009.0, "discounted_cash": 1506.75, "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": 354.0, "discounted_cash": 265.5, "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": 354.0, "discounted_cash": 265.5, "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": 109.0, "discounted_cash": 81.75, "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": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCOSE 40% 25GM GL LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315256", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCOSE 40% 25GM GL LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315256", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCOSE 40% 37.5GM GL LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315263", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCOSE 40% 37.5GM GL LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315263", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "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": 98.0, "discounted_cash": 73.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCOSE BLD BY MONIT DEV", "code_information": [{"code": "82962", "type": "CPT"}, {"code": "4122962", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "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": 339.0, "discounted_cash": 254.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCOSE BODY FLUID", "code_information": [{"code": "82945", "type": "CPT"}, {"code": "4122945", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCOSE BODY FLUID", "code_information": [{"code": "82945", "type": "CPT"}, {"code": "7252945", "type": "CDM"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "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": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCOSE BODY FLUID/2", "code_information": [{"code": "82945", "type": "CPT"}, {"code": "4122954", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCOSE BODY FLUID/3", "code_information": [{"code": "82945", "type": "CPT"}, {"code": "4102954", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 59.0, "discounted_cash": 44.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCOSE BODY FLUID/3", "code_information": [{"code": "82945", "type": "CPT"}, {"code": "4122958", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCOSE BODY FLUID/3", "code_information": [{"code": "82945", "type": "CPT"}, {"code": "4152954", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "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": 71.0, "discounted_cash": 53.25, "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": 514.0, "discounted_cash": 385.5, "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": 371.0, "discounted_cash": 278.25, "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": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCOSE QUANTITATIVE", "code_information": [{"code": "82947", "type": "CPT"}, {"code": "4152947", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "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": 425.0, "discounted_cash": 318.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCOSE TOLERANCE 3SPEC", "code_information": [{"code": "82951", "type": "CPT"}, {"code": "4152951", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 270.0, "discounted_cash": 202.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCOSE TOLERANCE 3SPEC/2", "code_information": [{"code": "82951", "type": "CPT"}, {"code": "4103633", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 980.0, "discounted_cash": 735.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCOSE TOLERANCE 3SPEC/2", "code_information": [{"code": "82951", "type": "CPT"}, {"code": "4153633", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 511.0, "discounted_cash": 383.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUTAMIC ACID AB", "code_information": [{"code": "83519", "type": "CPT"}, {"code": "7253538", "type": "CDM"}], "standard_charges": [{"gross_charge": 716.0, "discounted_cash": 537.0, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "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": 36.0, "discounted_cash": 27.0, "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": 36.0, "discounted_cash": 27.0, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GLYCATED PROTEIN", "code_information": [{"code": "82985", "type": "CPT"}, {"code": "7252985", "type": "CDM"}], "standard_charges": [{"gross_charge": 535.0, "discounted_cash": 401.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GLYCER/WITCH HAZ PAD12EA", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334371", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GLYCER/WITCH HAZ PAD12EA", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334371", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GLYCER/WITCHHAZ PAD100EA", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335782", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GLYCER/WITCHHAZ PAD100EA", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335782", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GLYCERIN 120ML TS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335776", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GLYCERIN 120ML TS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335776", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GLYCERIN 50% 220ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315276", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 600.0, "discounted_cash": 450.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GLYCERIN 50% 220ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315276", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 600.0, "discounted_cash": 450.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GLYCERIN 7.5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331059", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 432.0, "discounted_cash": 324.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GLYCERIN 7.5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331059", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 432.0, "discounted_cash": 324.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GLYCERIN 99% 180ML TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5335779", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GLYCERIN 99% 180ML TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5335779", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "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": 39.0, "discounted_cash": 29.25, "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": 39.0, "discounted_cash": 29.25, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GLYCINE 1.5% 1500ML IRR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5414036", "type": "CDM"}, {"code": "270", "type": "RC"}], "standard_charges": [{"gross_charge": 535.0, "discounted_cash": 401.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GLYCINE 1.5% 2000ML IRR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5414040", "type": "CDM"}, {"code": "270", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GLYCINE 1.5% 3000ML IRR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5414041", "type": "CDM"}, {"code": "270", "type": "RC"}], "standard_charges": [{"gross_charge": 128.0, "discounted_cash": 96.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GLYCINE 1.5% 4000ML IRR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5414045", "type": "CDM"}, {"code": "270", "type": "RC"}], "standard_charges": [{"gross_charge": 473.0, "discounted_cash": 354.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GLYCOP/NEOSTIG 0.6/3 3ML PFSIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5320925", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 121.0, "discounted_cash": 90.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "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": 9.0, "discounted_cash": 6.75, "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": 9.0, "discounted_cash": 6.75, "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": 1625.0, "discounted_cash": 1218.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GONADTOPN CHORNC(HCG)QNT", "code_information": [{"code": "84702", "type": "CPT"}, {"code": "4123014", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GONADTOPN CHORNC(HCG)QNT", "code_information": [{"code": "84702", "type": "CPT"}, {"code": "4153014", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 350.0, "discounted_cash": 262.5, "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": 724.0, "discounted_cash": 543.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GONADTOPN CHRONC(HCG)QL", "code_information": [{"code": "84703", "type": "CPT"}, {"code": "4153013", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 402.0, "discounted_cash": 301.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GONADTOPN CHRONC(HCG)QL/2", "code_information": [{"code": "84703", "type": "CPT"}, {"code": "4126023", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GOSERELIN IMP PER3.6MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9202", "type": "HCPCS"}, {"code": "5320965", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3703.0, "discounted_cash": 2777.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GOSERELIN IMP PER3.6MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9202", "type": "HCPCS"}, {"code": "5320965", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 3703.0, "discounted_cash": 2777.25, "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": 741.0, "discounted_cash": 555.75, "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": 741.0, "discounted_cash": 555.75, "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": 528.0, "discounted_cash": 396.0, "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": 528.0, "discounted_cash": 396.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GRAFT STNT AAA BIFURCATD", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "4011500", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 76001.0, "discounted_cash": 57000.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GRAFT VASC ARTEGRAFT", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8142136", "type": "CDM"}], "standard_charges": [{"gross_charge": 29506.0, "discounted_cash": 22129.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GRAFTJACKET PER SQ CM", "code_information": [{"code": "Q4107", "type": "HCPCS"}, {"code": "4032506", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 694.0, "discounted_cash": 520.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GRAFTJACKET PER SQ CM", "code_information": [{"code": "Q4107", "type": "HCPCS"}, {"code": "4032506", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 694.0, "discounted_cash": 520.5, "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": 300.0, "discounted_cash": 225.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GRAM STAIN SMEAR", "code_information": [{"code": "87205", "type": "CPT"}, {"code": "4127205", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GRAM STAIN SMEAR", "code_information": [{"code": "87205", "type": "CPT"}, {"code": "4157205", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 126.0, "discounted_cash": 94.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GRAM STAIN SMEAR/3", "code_information": [{"code": "87205", "type": "CPT"}, {"code": "4107221", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 62.0, "discounted_cash": 46.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GRAM STAIN SMEAR/3", "code_information": [{"code": "87205", "type": "CPT"}, {"code": "4127212", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "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": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GRANISETRON 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305440", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1061.0, "discounted_cash": 795.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GRANISETRON 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305440", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1061.0, "discounted_cash": 795.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GRANISETRON PER .1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1626", "type": "HCPCS"}, {"code": "5320968", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GRANISETRON PER .1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1626", "type": "HCPCS"}, {"code": "5320968", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT ALLOMAX 5X8CM", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4021488", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 13048.0, "discounted_cash": 9786.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT ALLOMAX 6CMX16CM", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4021492", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 20924.0, "discounted_cash": 15693.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT ALLOMAX 8CM X 16CM", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4021493", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 30684.0, "discounted_cash": 23013.0, "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": 28009.0, "discounted_cash": 21006.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT AORTIC EXTENDER", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "4028399", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 21405.0, "discounted_cash": 16053.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT AORTIC VALVED", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "4028395", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 41799.0, "discounted_cash": 31349.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT BONE AUGMENT INJECT", "code_information": [{"code": "C1734", "type": "HCPCS"}, {"code": "4028838", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 27229.0, "discounted_cash": 20421.75, "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": 32393.0, "discounted_cash": 24294.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT CV FELT 4IN", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8142040", "type": "CDM"}], "standard_charges": [{"gross_charge": 3011.0, "discounted_cash": 2258.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT CV PLEDGET", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8142055", "type": "CDM"}], "standard_charges": [{"gross_charge": 195.0, "discounted_cash": 146.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT DURAMATRIX SUTURABLE", "code_information": [{"code": "C1763", "type": "HCPCS"}, {"code": "4023872", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1666.0, "discounted_cash": 1249.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT DVF WOVN HEMASHIELD", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8246550", "type": "CDM"}], "standard_charges": [{"gross_charge": 2395.0, "discounted_cash": 1796.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT ENDOV PROX EXT PRF", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "4028411", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 35923.0, "discounted_cash": 26942.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT ENDOV THORC PRX CMP", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "4028404", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 197965.0, "discounted_cash": 148473.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT ENDOVS AAA CONVERTR", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "4028409", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 47267.0, "discounted_cash": 35450.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT FEMORAL ARTERY", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "4021498", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 48385.0, "discounted_cash": 36288.75, "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": 54911.0, "discounted_cash": 41183.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT NERVE AVANCE", "code_information": [{"code": "C1763", "type": "HCPCS"}, {"code": "4021702", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 71660.0, "discounted_cash": 53745.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT OCULAR AMNIO MEMBRN", "code_information": [{"code": "V2790", "type": "HCPCS"}, {"code": "8122167", "type": "CDM"}], "standard_charges": [{"gross_charge": 4877.0, "discounted_cash": 3657.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT PERICARDIAL", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8142118", "type": "CDM"}], "standard_charges": [{"gross_charge": 8949.0, "discounted_cash": 6711.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT PTCH", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8142125", "type": "CDM"}], "standard_charges": [{"gross_charge": 1353.0, "discounted_cash": 1014.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT RECTOPEXY BIODESIGN", "code_information": [{"code": "C1763", "type": "HCPCS"}, {"code": "4021706", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16748.0, "discounted_cash": 12561.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT SAPHNOUS UP TO 60CM", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8141770", "type": "CDM"}], "standard_charges": [{"gross_charge": 54395.0, "discounted_cash": 40796.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT SAPHNOUS UP TO 70CM", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8141773", "type": "CDM"}], "standard_charges": [{"gross_charge": 59005.0, "discounted_cash": 44253.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT SAPHNOUS UP TO 80CM", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8141771", "type": "CDM"}], "standard_charges": [{"gross_charge": 62858.0, "discounted_cash": 47143.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT STNT AAA BIFURCATED", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "4028445", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 92233.0, "discounted_cash": 69174.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT STNT ABD ALTO CAP 3PC CSE", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "4028443", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 140752.0, "discounted_cash": 105564.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT STNT ABD AORT BIFUR", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "4025600", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 70211.0, "discounted_cash": 52658.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT STNT AFX LIMB EXTN", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "4028454", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 24527.0, "discounted_cash": 18395.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT STNT BIFUR AAA AFX2", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "4028467", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 142272.0, "discounted_cash": 106704.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT STNT BIFURCATED AAA", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "4028455", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 84028.0, "discounted_cash": 63021.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT STNT THOR CONFRM TAG ACTV", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "4021996", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 212276.0, "discounted_cash": 159207.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT STNT THORACIC", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "4022005", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 109123.0, "discounted_cash": 81842.25, "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": 78059.0, "discounted_cash": 58544.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT TALUS FRESH", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "4024012", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 42782.0, "discounted_cash": 32086.5, "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": 23001.0, "discounted_cash": 17250.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT VASC CAROTID", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "4022327", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3512.0, "discounted_cash": 2634.0, "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": 21906.0, "discounted_cash": 16429.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT VASCULAR", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8240177", "type": "CDM"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT VSC STNT EX CUFF", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "4022323", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 26827.0, "discounted_cash": 20120.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GRIP TROCHANTERIC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132706", "type": "CDM"}], "standard_charges": [{"gross_charge": 24556.0, "discounted_cash": 18417.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GROWTH HORMONE(HGH)", "code_information": [{"code": "83003", "type": "CPT"}, {"code": "7003003", "type": "CDM"}], "standard_charges": [{"gross_charge": 880.0, "discounted_cash": 660.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GROWTH HORMONE(HGH)", "code_information": [{"code": "83003", "type": "CPT"}, {"code": "7253003", "type": "CDM"}], "standard_charges": [{"gross_charge": 880.0, "discounted_cash": 660.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GRP PSYCHTHRPY 30 MIN", "code_information": [{"code": "90853", "type": "CPT"}, {"code": "6401940", "type": "CDM"}], "standard_charges": [{"gross_charge": 547.0, "discounted_cash": 410.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GRP PSYCHTHRPY 45 MIN", "code_information": [{"code": "90853", "type": "CPT"}, {"code": "6401942", "type": "CDM"}], "standard_charges": [{"gross_charge": 547.0, "discounted_cash": 410.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GRP PSYCHTHRPY 60 MIN", "code_information": [{"code": "90853", "type": "CPT"}, {"code": "6401944", "type": "CDM"}], "standard_charges": [{"gross_charge": 635.0, "discounted_cash": 476.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GRP RECREATIONAL TX 30MI", "code_information": [{"code": "90899", "type": "CPT"}, {"code": "6402058", "type": "CDM"}], "standard_charges": [{"gross_charge": 433.0, "discounted_cash": 324.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GRP RECREATIONAL TX 45MI", "code_information": [{"code": "90899", "type": "CPT"}, {"code": "6402060", "type": "CDM"}], "standard_charges": [{"gross_charge": 433.0, "discounted_cash": 324.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GRP RECREATIONAL TX 60MI", "code_information": [{"code": "90899", "type": "CPT"}, {"code": "6402062", "type": "CDM"}], "standard_charges": [{"gross_charge": 501.0, "discounted_cash": 375.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GSHTH PREFACE BRAIDED", "code_information": [{"code": "C1893", "type": "HCPCS"}, {"code": "8241200", "type": "CDM"}], "standard_charges": [{"gross_charge": 1384.0, "discounted_cash": 1038.0, "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": 147.0, "discounted_cash": 110.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GTT EA ADD >3SPEC", "code_information": [{"code": "82952", "type": "CPT"}, {"code": "4152952", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 137.0, "discounted_cash": 102.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GUAF 100MG/5ML 10ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315282", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GUAF 100MG/5ML 10ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315282", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GUAF 100MG/5ML 15ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315281", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GUAF 100MG/5ML 15ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315281", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "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": 4.0, "discounted_cash": 3.0, "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": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GUAF DAC 100MG/5ML 5MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315297", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GUAF DAC 100MG/5ML 5MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315297", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "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": 36.0, "discounted_cash": 27.0, "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": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GUAIFENESIN DM 5ML SF LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315356", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GUAIFENESIN DM 5ML SF LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315356", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": 3.0, "discounted_cash": 2.25, "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": 3.0, "discounted_cash": 2.25, "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": 11.0, "discounted_cash": 8.25, "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": 11.0, "discounted_cash": 8.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GUIDANCE RAD TX DLVR", "code_information": [{"code": "77387", "type": "CPT"}, {"code": "5107387", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 138.0, "discounted_cash": 103.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GUIDE CATH FLUID DRAINAG", "code_information": [{"code": "5051030", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4833.0, "discounted_cash": 3624.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GUIDE CATH FLUID DRAINAG", "code_information": [{"code": "5061030", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4866.0, "discounted_cash": 3649.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GUIDEWIRE", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8240179", "type": "CDM"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GUIDEWIRE II", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8240163", "type": "CDM"}], "standard_charges": [{"gross_charge": 584.0, "discounted_cash": 438.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GUIDEWIRE III", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8240167", "type": "CDM"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GUIDEWIRE V", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8246599", "type": "CDM"}], "standard_charges": [{"gross_charge": 1998.0, "discounted_cash": 1498.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GUIDEWIRE VI", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8246598", "type": "CDM"}], "standard_charges": [{"gross_charge": 1240.0, "discounted_cash": 930.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GW", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8073055", "type": "CDM"}], "standard_charges": [{"gross_charge": 2712.0, "discounted_cash": 2034.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GW", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8073075", "type": "CDM"}], "standard_charges": [{"gross_charge": 611.0, "discounted_cash": 458.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GW", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8073080", "type": "CDM"}], "standard_charges": [{"gross_charge": 1545.0, "discounted_cash": 1158.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GW", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8073085", "type": "CDM"}], "standard_charges": [{"gross_charge": 144.0, "discounted_cash": 108.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GW", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8073086", "type": "CDM"}], "standard_charges": [{"gross_charge": 4704.0, "discounted_cash": 3528.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GW ASAHI CONFLANZA PRO", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8246597", "type": "CDM"}], "standard_charges": [{"gross_charge": 978.0, "discounted_cash": 733.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GW ASAHI MIRACLEBROS", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8246595", "type": "CDM"}], "standard_charges": [{"gross_charge": 2517.0, "discounted_cash": 1887.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GW ATTAIN HYBRID", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8073087", "type": "CDM"}], "standard_charges": [{"gross_charge": 1370.0, "discounted_cash": 1027.5, "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": 916.0, "discounted_cash": 687.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GW DRILL TIP", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8073144", "type": "CDM"}], "standard_charges": [{"gross_charge": 1038.0, "discounted_cash": 778.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GW EMB PROT ANGIOGARDRX", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "4032520", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 14158.0, "discounted_cash": 10618.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GW FLOWIRE DOPPLER", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8241274", "type": "CDM"}], "standard_charges": [{"gross_charge": 3382.0, "discounted_cash": 2536.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GW GLIDEWIRE STD ANGLE", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8246666", "type": "CDM"}], "standard_charges": [{"gross_charge": 604.0, "discounted_cash": 453.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GW GLIDEWIRE STIFF", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8246669", "type": "CDM"}], "standard_charges": [{"gross_charge": 424.0, "discounted_cash": 318.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GW GLIDEWIRE STIFF ANG", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8246664", "type": "CDM"}], "standard_charges": [{"gross_charge": 255.0, "discounted_cash": 191.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GW HI-TORQ BALANCE MW", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8241254", "type": "CDM"}], "standard_charges": [{"gross_charge": 408.0, "discounted_cash": 306.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GW HI-TORQ PILOT", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8241281", "type": "CDM"}], "standard_charges": [{"gross_charge": 615.0, "discounted_cash": 461.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GW HI-TORQ SPARTACORE 14", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8241290", "type": "CDM"}], "standard_charges": [{"gross_charge": 706.0, "discounted_cash": 529.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GW HI-TORQ STEELCORE 18", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8241294", "type": "CDM"}], "standard_charges": [{"gross_charge": 749.0, "discounted_cash": 561.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GW HI-TORQ SUPRACORE 35", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8241298", "type": "CDM"}], "standard_charges": [{"gross_charge": 582.0, "discounted_cash": 436.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GW HITORQ EX SUPPORT", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8246672", "type": "CDM"}], "standard_charges": [{"gross_charge": 393.0, "discounted_cash": 294.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GW HITORQ FLOPPY II", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8246676", "type": "CDM"}], "standard_charges": [{"gross_charge": 1790.0, "discounted_cash": 1342.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GW HITORQ WHOLY J SYS175", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8246692", "type": "CDM"}], "standard_charges": [{"gross_charge": 1047.0, "discounted_cash": 785.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GW HITORQ WHOLY J SYS260", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8246694", "type": "CDM"}], "standard_charges": [{"gross_charge": 862.0, "discounted_cash": 646.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GW HP JAGWIRE SNGL USE", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8246725", "type": "CDM"}], "standard_charges": [{"gross_charge": 1615.0, "discounted_cash": 1211.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GW IABP IMPELLA", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8073106", "type": "CDM"}], "standard_charges": [{"gross_charge": 2098.0, "discounted_cash": 1573.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GW PERIPH THRUWAY STR", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8073505", "type": "CDM"}], "standard_charges": [{"gross_charge": 873.0, "discounted_cash": 654.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GW ROTOBLADER", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8182522", "type": "CDM"}], "standard_charges": [{"gross_charge": 1690.0, "discounted_cash": 1267.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GW SAFARI ALL CURVES", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8073036", "type": "CDM"}], "standard_charges": [{"gross_charge": 5396.0, "discounted_cash": 4047.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GW SINUS", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8073186", "type": "CDM"}], "standard_charges": [{"gross_charge": 1746.0, "discounted_cash": 1309.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GW ST/HC", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8073215", "type": "CDM"}], "standard_charges": [{"gross_charge": 607.0, "discounted_cash": 455.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GW ST/SD", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8073245", "type": "CDM"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GW STTIP", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8073250", "type": "CDM"}], "standard_charges": [{"gross_charge": 954.0, "discounted_cash": 715.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GW SUPER STIFF", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8073247", "type": "CDM"}], "standard_charges": [{"gross_charge": 462.0, "discounted_cash": 346.5, "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": 2931.0, "discounted_cash": 2198.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GW SYS WHOLEY HITORQ+300", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8241320", "type": "CDM"}], "standard_charges": [{"gross_charge": 1119.0, "discounted_cash": 839.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GW TRANSCAROTID ENROUTE STRT", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8073056", "type": "CDM"}], "standard_charges": [{"gross_charge": 608.0, "discounted_cash": 456.0, "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": 300.0, "discounted_cash": 225.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GYLCER/WITCH HAZ PAD40EA", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337744", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 105.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GYLCER/WITCH HAZ PAD40EA", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337744", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 105.75, "setting": "both", "billing_class": "facility"}]}, {"description": "H EPIDIDYMIS PROTEIN 4/2", "code_information": [{"code": "86305", "type": "CPT"}, {"code": "7256309", "type": "CDM"}], "standard_charges": [{"gross_charge": 1648.0, "discounted_cash": 1236.0, "setting": "both", "billing_class": "facility"}]}, {"description": "H PYLORI BRTH TST", "code_information": [{"code": "83013", "type": "CPT"}, {"code": "7253007", "type": "CDM"}], "standard_charges": [{"gross_charge": 475.0, "discounted_cash": 356.25, "setting": "both", "billing_class": "facility"}]}, {"description": "H. PYLORI STOOL IA", "code_information": [{"code": "87338", "type": "CPT"}, {"code": "7007338", "type": "CDM"}], "standard_charges": [{"gross_charge": 205.0, "discounted_cash": 153.75, "setting": "both", "billing_class": "facility"}]}, {"description": "H. PYLORI STOOL IA", "code_information": [{"code": "87338", "type": "CPT"}, {"code": "7257338", "type": "CDM"}], "standard_charges": [{"gross_charge": 205.0, "discounted_cash": 153.75, "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": 251.0, "discounted_cash": 188.25, "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": 251.0, "discounted_cash": 188.25, "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": 252.0, "discounted_cash": 189.0, "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": 252.0, "discounted_cash": 189.0, "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": 730.0, "discounted_cash": 547.5, "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": 730.0, "discounted_cash": 547.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HALOPERIDOL", "code_information": [{"code": "80173", "type": "CPT"}, {"code": "7040304", "type": "CDM"}], "standard_charges": [{"gross_charge": 303.0, "discounted_cash": 227.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HALOPERIDOL", "code_information": [{"code": "80173", "type": "CPT"}, {"code": "7250304", "type": "CDM"}], "standard_charges": [{"gross_charge": 303.0, "discounted_cash": 227.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HALOPERIDOL .25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305608", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HALOPERIDOL .25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305608", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": 34.0, "discounted_cash": 25.5, "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": 34.0, "discounted_cash": 25.5, "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": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HALOPERIDOL 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305628", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 58.0, "discounted_cash": 43.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HALOPERIDOL 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305628", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 58.0, "discounted_cash": 43.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HALOPERIDOL 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305618", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HALOPERIDOL 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305618", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "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": 268.0, "discounted_cash": 201.0, "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": 268.0, "discounted_cash": 201.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HALOPERIDOL2MG/ML 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315312", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HALOPERIDOL2MG/ML 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315312", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HALOPERIDOL2MG/ML120MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315313", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1341.0, "discounted_cash": 1005.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HALOPERIDOL2MG/ML120MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315313", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1341.0, "discounted_cash": 1005.75, "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": 1347.0, "discounted_cash": 1010.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HAND 2 VIEWS", "code_information": [{"code": "73120", "type": "CPT"}, {"code": "5013120", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1274.0, "discounted_cash": 955.5, "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": 1441.0, "discounted_cash": 1080.75, "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": 1633.0, "discounted_cash": 1224.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HAND 3 VIEWS MINIMUM", "code_information": [{"code": "73130", "type": "CPT"}, {"code": "5013130", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1385.0, "discounted_cash": 1038.75, "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": 1585.0, "discounted_cash": 1188.75, "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": 303.0, "discounted_cash": 227.25, "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": 700.0, "discounted_cash": 525.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HAPTOGLOBIN QUANT", "code_information": [{"code": "83010", "type": "CPT"}, {"code": "4123011", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HBA 1/2 DELETES/VARIANTS/2", "code_information": [{"code": "81257", "type": "CPT"}, {"code": "7259209", "type": "CDM"}], "standard_charges": [{"gross_charge": 2872.0, "discounted_cash": 2154.0, "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": 1717.0, "discounted_cash": 1287.75, "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": 29.0, "discounted_cash": 21.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HBS IA", "code_information": [{"code": "87467", "type": "CPT"}, {"code": "4156287", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 450.0, "discounted_cash": 337.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HBS IA", "code_information": [{"code": "87467", "type": "CPT"}, {"code": "7256287", "type": "CDM"}], "standard_charges": [{"gross_charge": 23.0, "discounted_cash": 17.25, "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": 268.0, "discounted_cash": 201.0, "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": 268.0, "discounted_cash": 201.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTS .5% 15GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335899", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTS .5% 15GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335899", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "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": 34.0, "discounted_cash": 25.5, "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": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTS 1% 15GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335907", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 116.0, "discounted_cash": 87.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTS 1% 15GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335907", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 116.0, "discounted_cash": 87.0, "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": 71.0, "discounted_cash": 53.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTS 1% 30GM R CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338484", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 590.0, "discounted_cash": 442.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTS 1% 30GM R CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338484", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 590.0, "discounted_cash": 442.5, "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": 274.0, "discounted_cash": 205.5, "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": 274.0, "discounted_cash": 205.5, "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": 225.0, "discounted_cash": 168.75, "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": 225.0, "discounted_cash": 168.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTS 2.5% 30GM R CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338485", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 593.0, "discounted_cash": 444.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTS 2.5% 30GM R CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338485", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 593.0, "discounted_cash": 444.75, "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": 13.0, "discounted_cash": 9.75, "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": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTS 30MG SU", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338455", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 504.0, "discounted_cash": 378.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTS 30MG SU", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338455", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 504.0, "discounted_cash": 378.0, "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": 178.0, "discounted_cash": 133.5, "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": 178.0, "discounted_cash": 133.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTS/LIDOCAINE 7GM R CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335923", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 75.0, "discounted_cash": 56.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTS/LIDOCAINE 7GM R CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335923", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 75.0, "discounted_cash": 56.25, "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": 348.0, "discounted_cash": 261.0, "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": 348.0, "discounted_cash": 261.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTZ 12.5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305714", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTZ 12.5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305714", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "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": 53.0, "discounted_cash": 39.75, "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": 53.0, "discounted_cash": 39.75, "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": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTZ 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305719", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTZ 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305719", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTZ 6.25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305712", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTZ 6.25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305712", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HCV GENOTYPE", "code_information": [{"code": "87902", "type": "CPT"}, {"code": "7257523", "type": "CDM"}], "standard_charges": [{"gross_charge": 995.0, "discounted_cash": 746.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HD HUM STD OFFS/TECC TRNIER CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013505", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 13255.0, "discounted_cash": 9941.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HDR192 NOSTRND EA SOURCE", "code_information": [{"code": "C1717", "type": "HCPCS"}, {"code": "5191717", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1336.0, "discounted_cash": 1002.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEAD CERAM SLEEVES ZIMMER CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012952", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1221.0, "discounted_cash": 915.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEAD FEM ALL METAL MICROPRT CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013256", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 7155.0, "discounted_cash": 5366.25, "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": 6830.0, "discounted_cash": 5122.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEAD FEM CERAM ANY SZ STRY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013053", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8492.0, "discounted_cash": 6369.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEAD FEM CERAM ANY SZ ZIMM CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012968", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8973.0, "discounted_cash": 6729.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEAD FEM CERAMC INC OXI SN CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012895", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10248.0, "discounted_cash": 7686.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEAD FEM MAGNUM HD ZIMMER CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012969", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4272.0, "discounted_cash": 3204.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEAD FEM METAL UNIPOLAR SN CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012894", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4556.0, "discounted_cash": 3417.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEAD FEM UNIPOLAR ZIMMER CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012970", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4272.0, "discounted_cash": 3204.0, "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": 3589.0, "discounted_cash": 2691.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEAD FEMORAL UNIPOLR STRYK CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013054", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3589.0, "discounted_cash": 2691.75, "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": 3589.0, "discounted_cash": 2691.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEAD HIP MOD OSTEOREMEDIES CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013356", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 19273.0, "discounted_cash": 14454.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEAD HIP RESURFCING BHR SN CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012904", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 55495.0, "discounted_cash": 41621.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEAD HIP RM SPCT OSTEOREMED CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013358", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 17061.0, "discounted_cash": 12795.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEAD HUM STD OFFST ECC ZIM CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012935", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12861.0, "discounted_cash": 9645.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEAVY METAL QUAN/4", "code_information": [{"code": "83018", "type": "CPT"}, {"code": "7253018", "type": "CDM"}], "standard_charges": [{"gross_charge": 382.0, "discounted_cash": 286.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEAVY METAL QUAN/5", "code_information": [{"code": "83018", "type": "CPT"}, {"code": "7253019", "type": "CDM"}], "standard_charges": [{"gross_charge": 226.0, "discounted_cash": 169.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEAVY METAL QUAN/7", "code_information": [{"code": "83018", "type": "CPT"}, {"code": "7003028", "type": "CDM"}], "standard_charges": [{"gross_charge": 382.0, "discounted_cash": 286.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEAVY METAL QUAN/9", "code_information": [{"code": "83018", "type": "CPT"}, {"code": "7253028", "type": "CDM"}], "standard_charges": [{"gross_charge": 382.0, "discounted_cash": 286.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HELICOBACTER PYLORI AB", "code_information": [{"code": "86677", "type": "CPT"}, {"code": "7256057", "type": "CDM"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "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": 670.0, "discounted_cash": 502.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HELICOBACTER PYLORI AB/2", "code_information": [{"code": "86677", "type": "CPT"}, {"code": "4126056", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HELICOBACTER PYLORI AB/2", "code_information": [{"code": "86677", "type": "CPT"}, {"code": "7256074", "type": "CDM"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HELICOBACTER PYLORI AB/3", "code_information": [{"code": "86677", "type": "CPT"}, {"code": "7256076", "type": "CDM"}], "standard_charges": [{"gross_charge": 429.0, "discounted_cash": 321.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HELICOBACTER PYLORI AB/5", "code_information": [{"code": "86677", "type": "CPT"}, {"code": "7006075", "type": "CDM"}], "standard_charges": [{"gross_charge": 568.0, "discounted_cash": 426.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HELMINTH AB NES", "code_information": [{"code": "86682", "type": "CPT"}, {"code": "7250050", "type": "CDM"}], "standard_charges": [{"gross_charge": 450.0, "discounted_cash": 337.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HELMINTH AB NES/12", "code_information": [{"code": "86682", "type": "CPT"}, {"code": "7008663", "type": "CDM"}], "standard_charges": [{"gross_charge": 360.0, "discounted_cash": 270.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HELMINTH AB NES/2", "code_information": [{"code": "86682", "type": "CPT"}, {"code": "7254183", "type": "CDM"}], "standard_charges": [{"gross_charge": 450.0, "discounted_cash": 337.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HELMINTH AB NES/3", "code_information": [{"code": "86682", "type": "CPT"}, {"code": "7255605", "type": "CDM"}], "standard_charges": [{"gross_charge": 450.0, "discounted_cash": 337.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HELMINTH AB NES/7", "code_information": [{"code": "86682", "type": "CPT"}, {"code": "7006263", "type": "CDM"}], "standard_charges": [{"gross_charge": 450.0, "discounted_cash": 337.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HELMINTH AB NES/7", "code_information": [{"code": "86682", "type": "CPT"}, {"code": "7256680", "type": "CDM"}], "standard_charges": [{"gross_charge": 360.0, "discounted_cash": 270.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HELMINTH AB NES/8", "code_information": [{"code": "86682", "type": "CPT"}, {"code": "7256684", "type": "CDM"}], "standard_charges": [{"gross_charge": 300.0, "discounted_cash": 225.0, "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": 234.0, "discounted_cash": 175.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMATOCRIT", "code_information": [{"code": "85014", "type": "CPT"}, {"code": "4125014", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMATOCRIT", "code_information": [{"code": "85014", "type": "CPT"}, {"code": "4155014", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMATOCRIT", "code_information": [{"code": "85014", "type": "CPT"}, {"code": "7255014", "type": "CDM"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "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": 652.0, "discounted_cash": 489.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMOCHROM COMMON VARIANT/2", "code_information": [{"code": "81256", "type": "CPT"}, {"code": "7259211", "type": "CDM"}], "standard_charges": [{"gross_charge": 871.0, "discounted_cash": 653.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMOGLOBIN FRAC & QNT", "code_information": [{"code": "83021", "type": "CPT"}, {"code": "7003024", "type": "CDM"}], "standard_charges": [{"gross_charge": 674.0, "discounted_cash": 505.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMOGLOBIN FRAC & QNT", "code_information": [{"code": "83021", "type": "CPT"}, {"code": "7253021", "type": "CDM"}], "standard_charges": [{"gross_charge": 632.0, "discounted_cash": 474.0, "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": 683.0, "discounted_cash": 512.25, "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": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMOGLOBIN GLYCATED", "code_information": [{"code": "83036", "type": "CPT"}, {"code": "4152994", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 355.0, "discounted_cash": 266.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMOGLOBIN PLASMA", "code_information": [{"code": "83051", "type": "CPT"}, {"code": "7003051", "type": "CDM"}], "standard_charges": [{"gross_charge": 737.0, "discounted_cash": 552.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMOGLOBIN PLASMA", "code_information": [{"code": "83051", "type": "CPT"}, {"code": "7253051", "type": "CDM"}], "standard_charges": [{"gross_charge": 737.0, "discounted_cash": 552.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMOGLOBN ELECTRPHORESIS", "code_information": [{"code": "83020", "type": "CPT"}, {"code": "7253023", "type": "CDM"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMOGLOBN FETAL CHEMICAL", "code_information": [{"code": "83030", "type": "CPT"}, {"code": "4103030", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 128.0, "discounted_cash": 96.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMOGLOBN FETAL CHEMICAL", "code_information": [{"code": "83030", "type": "CPT"}, {"code": "4123030", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMOLYSINS ACID(HAM)", "code_information": [{"code": "85475", "type": "CPT"}, {"code": "4106281", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 927.0, "discounted_cash": 695.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMOSIDERIN QUAL", "code_information": [{"code": "83070", "type": "CPT"}, {"code": "7003070", "type": "CDM"}], "standard_charges": [{"gross_charge": 98.0, "discounted_cash": 73.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMOSIDERIN QUAL", "code_information": [{"code": "83070", "type": "CPT"}, {"code": "7253070", "type": "CDM"}], "standard_charges": [{"gross_charge": 98.0, "discounted_cash": 73.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMOSTAT SURG VITAGEL", "code_information": [{"code": "A6010", "type": "HCPCS"}, {"code": "8174814", "type": "CDM"}], "standard_charges": [{"gross_charge": 3992.0, "discounted_cash": 2994.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEP B AMP PROBE", "code_information": [{"code": "87516", "type": "CPT"}, {"code": "7007518", "type": "CDM"}], "standard_charges": [{"gross_charge": 1595.0, "discounted_cash": 1196.25, "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": 1086.0, "discounted_cash": 814.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEP B CORE AB IGM", "code_information": [{"code": "86705", "type": "CPT"}, {"code": "4126294", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "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": 683.0, "discounted_cash": 512.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEP B CORE AB TOTAL", "code_information": [{"code": "86704", "type": "CPT"}, {"code": "7256289", "type": "CDM"}], "standard_charges": [{"gross_charge": 286.0, "discounted_cash": 214.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEP B CORE AB TOTAL/2", "code_information": [{"code": "86704", "type": "CPT"}, {"code": "7256704", "type": "CDM"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEP B SURFACE AB", "code_information": [{"code": "86706", "type": "CPT"}, {"code": "4106290", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 234.0, "discounted_cash": 175.5, "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": 29.0, "discounted_cash": 21.75, "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": 2484.0, "discounted_cash": 1863.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEP B SURFACE AB/2", "code_information": [{"code": "86706", "type": "CPT"}, {"code": "4156292", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 642.0, "discounted_cash": 481.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEP B VAC ADULT IJ", "code_information": [{"code": "90746", "type": "CPT"}, {"code": "5321114", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1345.0, "discounted_cash": 1008.75, "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": 722.0, "discounted_cash": 541.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEP C AMPLIFIED PROBE/2", "code_information": [{"code": "87521", "type": "CPT"}, {"code": "7253504", "type": "CDM"}], "standard_charges": [{"gross_charge": 222.0, "discounted_cash": 166.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEP C QUANT", "code_information": [{"code": "87522", "type": "CPT"}, {"code": "7007522", "type": "CDM"}], "standard_charges": [{"gross_charge": 366.0, "discounted_cash": 274.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEP C QUANT", "code_information": [{"code": "87522", "type": "CPT"}, {"code": "7253933", "type": "CDM"}], "standard_charges": [{"gross_charge": 366.0, "discounted_cash": 274.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEP C QUANT/2", "code_information": [{"code": "87522", "type": "CPT"}, {"code": "7253934", "type": "CDM"}], "standard_charges": [{"gross_charge": 954.0, "discounted_cash": 715.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEP G AMP PROBE", "code_information": [{"code": "87526", "type": "CPT"}, {"code": "7258752", "type": "CDM"}], "standard_charges": [{"gross_charge": 918.0, "discounted_cash": 688.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPARIN ANTIBODY", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7072321", "type": "CDM"}], "standard_charges": [{"gross_charge": 615.0, "discounted_cash": 461.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPARIN ASSAY", "code_information": [{"code": "85520", "type": "CPT"}, {"code": "4105520", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 380.0, "discounted_cash": 285.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPARIN ASSAY", "code_information": [{"code": "85520", "type": "CPT"}, {"code": "4125520", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "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": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "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": 0.32, "discounted_cash": 0.24, "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": 12.0, "discounted_cash": 9.0, "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": 12.0, "discounted_cash": 9.0, "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": 21.0, "discounted_cash": 15.75, "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": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPARIN SOD FLUSH PER 10U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1642", "type": "HCPCS"}, {"code": "5320994", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPARIN SOD FLUSH PER 10U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1642", "type": "HCPCS"}, {"code": "5320994", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPAT A ADULT 1440U/MLIJ", "code_information": [{"code": "90632", "type": "CPT"}, {"code": "5321125", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1279.0, "discounted_cash": 959.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPAT A ADULT 1440U/MLIJ", "code_information": [{"code": "90632", "type": "CPT"}, {"code": "5321125", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1279.0, "discounted_cash": 959.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPAT A ADULT 50U/MLIJ", "code_information": [{"code": "90632", "type": "CPT"}, {"code": "5321128", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 535.0, "discounted_cash": 401.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPAT A ADULT 50U/MLIJ", "code_information": [{"code": "90632", "type": "CPT"}, {"code": "5321128", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 535.0, "discounted_cash": 401.25, "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": 1542.0, "discounted_cash": 1156.5, "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": 23.0, "discounted_cash": 17.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATIC FUNCTION PANEL", "code_information": [{"code": "80076", "type": "CPT"}, {"code": "4150109", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "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": 22422.0, "discounted_cash": 16816.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS A AB", "code_information": [{"code": "86708", "type": "CPT"}, {"code": "7006291", "type": "CDM"}], "standard_charges": [{"gross_charge": 549.0, "discounted_cash": 411.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS A AB", "code_information": [{"code": "86708", "type": "CPT"}, {"code": "7256291", "type": "CDM"}], "standard_charges": [{"gross_charge": 549.0, "discounted_cash": 411.75, "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": 1283.0, "discounted_cash": 962.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS A AB IGM", "code_information": [{"code": "86709", "type": "CPT"}, {"code": "4126297", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS A+B ADUL IM IJ", "code_information": [{"code": "90636", "type": "CPT"}, {"code": "5321129", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2223.0, "discounted_cash": 1667.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS A+B ADUL IM IJ", "code_information": [{"code": "90636", "type": "CPT"}, {"code": "5321129", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 2223.0, "discounted_cash": 1667.25, "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": 717.0, "discounted_cash": 537.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS B IG IM 1MLIJ", "code_information": [{"code": "90371", "type": "CPT"}, {"code": "5321113", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3140.0, "discounted_cash": 2355.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS B IG IM 1MLIJ", "code_information": [{"code": "90371", "type": "CPT"}, {"code": "5321113", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 3140.0, "discounted_cash": 2355.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS B QUANT", "code_information": [{"code": "87517", "type": "CPT"}, {"code": "7008675", "type": "CDM"}], "standard_charges": [{"gross_charge": 1040.0, "discounted_cash": 780.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS B QUANT/3", "code_information": [{"code": "87517", "type": "CPT"}, {"code": "7258675", "type": "CDM"}], "standard_charges": [{"gross_charge": 1040.0, "discounted_cash": 780.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS B VACC ADMIN", "code_information": [{"code": "G0010", "type": "HCPCS"}, {"code": "3110471", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 204.0, "discounted_cash": 153.0, "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": 258.0, "discounted_cash": 193.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS B VACC ADMIN", "code_information": [{"code": "G0010", "type": "HCPCS"}, {"code": "6120471", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 255.0, "discounted_cash": 191.25, "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": 258.0, "discounted_cash": 193.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS B VACC ADMIN", "code_information": [{"code": "G0010", "type": "HCPCS"}, {"code": "6290010", "type": "CDM"}], "standard_charges": [{"gross_charge": 204.0, "discounted_cash": 153.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS BE ANTIBODY", "code_information": [{"code": "86707", "type": "CPT"}, {"code": "7006296", "type": "CDM"}], "standard_charges": [{"gross_charge": 719.0, "discounted_cash": 539.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS BE ANTIBODY", "code_information": [{"code": "86707", "type": "CPT"}, {"code": "7256296", "type": "CDM"}], "standard_charges": [{"gross_charge": 719.0, "discounted_cash": 539.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS BE IA", "code_information": [{"code": "87350", "type": "CPT"}, {"code": "7006293", "type": "CDM"}], "standard_charges": [{"gross_charge": 719.0, "discounted_cash": 539.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS BE IA", "code_information": [{"code": "87350", "type": "CPT"}, {"code": "7256293", "type": "CDM"}], "standard_charges": [{"gross_charge": 719.0, "discounted_cash": 539.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS C AB CONFIRM TST", "code_information": [{"code": "86804", "type": "CPT"}, {"code": "7256804", "type": "CDM"}], "standard_charges": [{"gross_charge": 720.0, "discounted_cash": 540.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS C AB CONFIRM TST/2", "code_information": [{"code": "86804", "type": "CPT"}, {"code": "7006803", "type": "CDM"}], "standard_charges": [{"gross_charge": 720.0, "discounted_cash": 540.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS C AB CONFIRM TST/2", "code_information": [{"code": "86804", "type": "CPT"}, {"code": "7256805", "type": "CDM"}], "standard_charges": [{"gross_charge": 760.0, "discounted_cash": 570.0, "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": 633.0, "discounted_cash": 474.75, "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": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS C ANTIBODY", "code_information": [{"code": "86803", "type": "CPT"}, {"code": "7256304", "type": "CDM"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS DELTA AGENT AB", "code_information": [{"code": "86692", "type": "CPT"}, {"code": "7006297", "type": "CDM"}], "standard_charges": [{"gross_charge": 1215.0, "discounted_cash": 911.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS DELTA AGENT AB", "code_information": [{"code": "86692", "type": "CPT"}, {"code": "7256297", "type": "CDM"}], "standard_charges": [{"gross_charge": 299.0, "discounted_cash": 224.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS E AB", "code_information": [{"code": "86790", "type": "CPT"}, {"code": "7256790", "type": "CDM"}], "standard_charges": [{"gross_charge": 403.0, "discounted_cash": 302.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS E AB/2", "code_information": [{"code": "86790", "type": "CPT"}, {"code": "7256795", "type": "CDM"}], "standard_charges": [{"gross_charge": 473.0, "discounted_cash": 354.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITS B IMM GLOB .5ML", "code_information": [{"code": "90371", "type": "CPT"}, {"code": "6121109", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 900.0, "discounted_cash": 675.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATOBIL IMAGE W/DRUG", "code_information": [{"code": "78227", "type": "CPT"}, {"code": "5018227", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 8098.0, "discounted_cash": 6073.5, "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": 1415.0, "discounted_cash": 1061.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATOBILIARY SYSTEM IMG", "code_information": [{"code": "78226", "type": "CPT"}, {"code": "5018226", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 6497.0, "discounted_cash": 4872.75, "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": 1415.0, "discounted_cash": 1061.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HERPES AB SMPLX", "code_information": [{"code": "86694", "type": "CPT"}, {"code": "7006690", "type": "CDM"}], "standard_charges": [{"gross_charge": 368.0, "discounted_cash": 276.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HERPES AB SMPLX TYPE 1", "code_information": [{"code": "86695", "type": "CPT"}, {"code": "7006298", "type": "CDM"}], "standard_charges": [{"gross_charge": 673.0, "discounted_cash": 504.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HERPES AB SMPLX TYPE 1", "code_information": [{"code": "86695", "type": "CPT"}, {"code": "7256298", "type": "CDM"}], "standard_charges": [{"gross_charge": 673.0, "discounted_cash": 504.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HERPES AB SMPLX TYPE 1/2", "code_information": [{"code": "86695", "type": "CPT"}, {"code": "7006300", "type": "CDM"}], "standard_charges": [{"gross_charge": 367.0, "discounted_cash": 275.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HERPES AB SMPLX TYPE 2", "code_information": [{"code": "86696", "type": "CPT"}, {"code": "7006299", "type": "CDM"}], "standard_charges": [{"gross_charge": 673.0, "discounted_cash": 504.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HERPES AB SMPLX TYPE 2/2", "code_information": [{"code": "86696", "type": "CPT"}, {"code": "7006301", "type": "CDM"}], "standard_charges": [{"gross_charge": 895.0, "discounted_cash": 671.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HERPES AB SMPLX TYPE 2/2", "code_information": [{"code": "86696", "type": "CPT"}, {"code": "7256299", "type": "CDM"}], "standard_charges": [{"gross_charge": 673.0, "discounted_cash": 504.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HERPES AB SMPLX/2", "code_information": [{"code": "86694", "type": "CPT"}, {"code": "7256695", "type": "CDM"}], "standard_charges": [{"gross_charge": 895.0, "discounted_cash": 671.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HERPES AB SMPLX/5", "code_information": [{"code": "86694", "type": "CPT"}, {"code": "7258686", "type": "CDM"}], "standard_charges": [{"gross_charge": 175.0, "discounted_cash": 131.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HERPES AB SMPLX/6", "code_information": [{"code": "86694", "type": "CPT"}, {"code": "7258701", "type": "CDM"}], "standard_charges": [{"gross_charge": 175.0, "discounted_cash": 131.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HERPES HUMAN HHV/3", "code_information": [{"code": "86790", "type": "CPT"}, {"code": "7258722", "type": "CDM"}], "standard_charges": [{"gross_charge": 196.0, "discounted_cash": 147.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HERPES SIMPLX AMP PRB", "code_information": [{"code": "87529", "type": "CPT"}, {"code": "7007529", "type": "CDM"}], "standard_charges": [{"gross_charge": 219.0, "discounted_cash": 164.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HERPES SIMPLX AMP PRB/3", "code_information": [{"code": "87529", "type": "CPT"}, {"code": "7257529", "type": "CDM"}], "standard_charges": [{"gross_charge": 219.0, "discounted_cash": 164.25, "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": 1461.0, "discounted_cash": 1095.75, "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": 213.0, "discounted_cash": 159.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HETEROPHILE AB SCREEN", "code_information": [{"code": "86308", "type": "CPT"}, {"code": "4126003", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HETEROPHILE AB SCREEN", "code_information": [{"code": "86308", "type": "CPT"}, {"code": "4156003", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEXACHLOROPHENE3%150MLTS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335875", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 288.0, "discounted_cash": 216.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEXACHLOROPHENE3%150MLTS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335875", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 288.0, "discounted_cash": 216.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEXACHLOROPHENE3%473MLTS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335872", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 289.0, "discounted_cash": 216.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEXACHLOROPHENE3%473MLTS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335872", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 289.0, "discounted_cash": 216.75, "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": 7501.0, "discounted_cash": 5625.75, "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": 7501.0, "discounted_cash": 5625.75, "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": 498.0, "discounted_cash": 373.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HIGH RISK OBSTETRICS", "code_information": [{"code": "1990098", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 5310.0, "discounted_cash": 3982.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HIGH RISK OBSTETRICS", "code_information": [{"code": "2500098", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 5310.0, "discounted_cash": 3982.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HIGH RISK OBSTETRICS", "code_information": [{"code": "2510098", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 5310.0, "discounted_cash": 3982.5, "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": 1960.0, "discounted_cash": 1470.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HIP ARTHROGRAPHY", "code_information": [{"code": "73525", "type": "CPT"}, {"code": "5013525", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 3315.0, "discounted_cash": 2486.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HIP ARTHROGRAPHY", "code_information": [{"code": "73525", "type": "CPT"}, {"code": "5113525", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 3690.0, "discounted_cash": 2767.5, "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": 1830.0, "discounted_cash": 1372.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HIP BI W/PEL 2WS", "code_information": [{"code": "73521", "type": "CPT"}, {"code": "5013520", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1976.0, "discounted_cash": 1482.0, "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": 2076.0, "discounted_cash": 1557.0, "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": 1873.0, "discounted_cash": 1404.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HIP BI W/PEL 3-4 VWS", "code_information": [{"code": "73522", "type": "CPT"}, {"code": "5013522", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1873.0, "discounted_cash": 1404.75, "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": 1873.0, "discounted_cash": 1404.75, "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": 3469.0, "discounted_cash": 2601.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HIP BI W/PEL 5VWS", "code_information": [{"code": "73523", "type": "CPT"}, {"code": "5013523", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 3469.0, "discounted_cash": 2601.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HIP BI W/PEL 5VWS", "code_information": [{"code": "73523", "type": "CPT"}, {"code": "5113523", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 3469.0, "discounted_cash": 2601.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HIP PART SLF CENTR COMP SN CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012914", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2846.0, "discounted_cash": 2134.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HIP PART SLF CNT COMP ZIM CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012993", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5798.0, "discounted_cash": 4348.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HIP SCREWS ZIMMER CL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4012950", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 609.0, "discounted_cash": 456.75, "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": 451.0, "discounted_cash": 338.25, "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": 526.0, "discounted_cash": 394.5, "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": 2692.0, "discounted_cash": 2019.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HIP UNI W/PELV 2-3 VWS", "code_information": [{"code": "73502", "type": "CPT"}, {"code": "5013505", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2227.0, "discounted_cash": 1670.25, "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": 625.0, "discounted_cash": 468.75, "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": 1130.0, "discounted_cash": 847.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HIP UNILATERAL 2-3VWS", "code_information": [{"code": "73502", "type": "CPT"}, {"code": "5013510", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1020.0, "discounted_cash": 765.0, "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": 1031.0, "discounted_cash": 773.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HISTAMINE", "code_information": [{"code": "83088", "type": "CPT"}, {"code": "7253087", "type": "CDM"}], "standard_charges": [{"gross_charge": 303.0, "discounted_cash": 227.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HISTAMINE/2", "code_information": [{"code": "83088", "type": "CPT"}, {"code": "7003088", "type": "CDM"}], "standard_charges": [{"gross_charge": 303.0, "discounted_cash": 227.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HISTAMINE/3", "code_information": [{"code": "83088", "type": "CPT"}, {"code": "7253092", "type": "CDM"}], "standard_charges": [{"gross_charge": 303.0, "discounted_cash": 227.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HISTONE AB", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "7258673", "type": "CDM"}], "standard_charges": [{"gross_charge": 122.0, "discounted_cash": 91.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HISTOPLASMA IA", "code_information": [{"code": "87385", "type": "CPT"}, {"code": "7007386", "type": "CDM"}], "standard_charges": [{"gross_charge": 171.0, "discounted_cash": 128.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HISTOPLASMA IA", "code_information": [{"code": "87385", "type": "CPT"}, {"code": "7077386", "type": "CDM"}], "standard_charges": [{"gross_charge": 1996.0, "discounted_cash": 1497.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HISTOPLASMA IA", "code_information": [{"code": "87385", "type": "CPT"}, {"code": "7257386", "type": "CDM"}], "standard_charges": [{"gross_charge": 162.0, "discounted_cash": 121.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HISTOPLASMA IA/2", "code_information": [{"code": "87385", "type": "CPT"}, {"code": "7077385", "type": "CDM"}], "standard_charges": [{"gross_charge": 1996.0, "discounted_cash": 1497.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HISTOPLASMA IA/3", "code_information": [{"code": "87385", "type": "CPT"}, {"code": "7253507", "type": "CDM"}], "standard_charges": [{"gross_charge": 304.0, "discounted_cash": 228.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HISTOPLASMOSIS AB", "code_information": [{"code": "86698", "type": "CPT"}, {"code": "4106176", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 751.0, "discounted_cash": 563.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HISTOPLASMOSIS AB", "code_information": [{"code": "86698", "type": "CPT"}, {"code": "7256176", "type": "CDM"}], "standard_charges": [{"gross_charge": 512.0, "discounted_cash": 384.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HISTOPLASMOSIS AB/2", "code_information": [{"code": "86698", "type": "CPT"}, {"code": "7256682", "type": "CDM"}], "standard_charges": [{"gross_charge": 189.0, "discounted_cash": 141.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HISTOPLASMOSIS AB/3", "code_information": [{"code": "86698", "type": "CPT"}, {"code": "7256683", "type": "CDM"}], "standard_charges": [{"gross_charge": 58.0, "discounted_cash": 43.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV 1 AB", "code_information": [{"code": "86701", "type": "CPT"}, {"code": "7256701", "type": "CDM"}], "standard_charges": [{"gross_charge": 288.0, "discounted_cash": 216.0, "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": 956.0, "discounted_cash": 717.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV 1/HIV 2 SNGL RESULT", "code_information": [{"code": "86703", "type": "CPT"}, {"code": "4156703", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 486.0, "discounted_cash": 364.5, "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": 292.0, "discounted_cash": 219.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV 2 AB", "code_information": [{"code": "86702", "type": "CPT"}, {"code": "7256702", "type": "CDM"}], "standard_charges": [{"gross_charge": 288.0, "discounted_cash": 216.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV GENO PROTEAS REGION", "code_information": [{"code": "87901", "type": "CPT"}, {"code": "7257902", "type": "CDM"}], "standard_charges": [{"gross_charge": 1053.0, "discounted_cash": 789.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV I AG HIV I HIV II AB", "code_information": [{"code": "87389", "type": "CPT"}, {"code": "4127389", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 59.0, "discounted_cash": 44.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV I AG HIV I HIV II AB/2", "code_information": [{"code": "87389", "type": "CPT"}, {"code": "7257389", "type": "CDM"}], "standard_charges": [{"gross_charge": 233.0, "discounted_cash": 174.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV I IA", "code_information": [{"code": "87390", "type": "CPT"}, {"code": "7056311", "type": "CDM"}], "standard_charges": [{"gross_charge": 1139.0, "discounted_cash": 854.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV PHENOSENSE 1-10 DRU", "code_information": [{"code": "87903", "type": "CPT"}, {"code": "7017903", "type": "CDM"}], "standard_charges": [{"gross_charge": 1963.0, "discounted_cash": 1472.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV PHENOSENSE 1-10 DRU", "code_information": [{"code": "87903", "type": "CPT"}, {"code": "7257903", "type": "CDM"}], "standard_charges": [{"gross_charge": 656.0, "discounted_cash": 492.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV PHENOSEUSE ADD DRUGS", "code_information": [{"code": "87904", "type": "CPT"}, {"code": "7257904", "type": "CDM"}], "standard_charges": [{"gross_charge": 656.0, "discounted_cash": 492.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV-1 QUANT", "code_information": [{"code": "87536", "type": "CPT"}, {"code": "7013908", "type": "CDM"}], "standard_charges": [{"gross_charge": 1971.0, "discounted_cash": 1478.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV-1 QUANT", "code_information": [{"code": "87536", "type": "CPT"}, {"code": "7257536", "type": "CDM"}], "standard_charges": [{"gross_charge": 862.0, "discounted_cash": 646.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV-1 QUANT/5", "code_information": [{"code": "87536", "type": "CPT"}, {"code": "7257537", "type": "CDM"}], "standard_charges": [{"gross_charge": 1971.0, "discounted_cash": 1478.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HLA CLASS I HIGH DEF", "code_information": [{"code": "86832", "type": "CPT"}, {"code": "7146832", "type": "CDM"}], "standard_charges": [{"gross_charge": 1709.0, "discounted_cash": 1281.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HLA I AG EQUIV EACH LOW/2", "code_information": [{"code": "81374", "type": "CPT"}, {"code": "7259200", "type": "CDM"}], "standard_charges": [{"gross_charge": 205.0, "discounted_cash": 153.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HLA I ONE ALELE/GRP HIGH", "code_information": [{"code": "81381", "type": "CPT"}, {"code": "7251381", "type": "CDM"}], "standard_charges": [{"gross_charge": 541.0, "discounted_cash": 405.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HLA I ONE LOCUS LOW", "code_information": [{"code": "81373", "type": "CPT"}, {"code": "7141373", "type": "CDM"}], "standard_charges": [{"gross_charge": 1233.0, "discounted_cash": 924.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HLA I ONE LOCUS LOW", "code_information": [{"code": "81373", "type": "CPT"}, {"code": "7251373", "type": "CDM"}], "standard_charges": [{"gross_charge": 372.0, "discounted_cash": 279.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HLA TYPING ABC MULTI AG/2", "code_information": [{"code": "86813", "type": "CPT"}, {"code": "7006813", "type": "CDM"}], "standard_charges": [{"gross_charge": 2211.0, "discounted_cash": 1658.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HLA TYPING ABC SNGL AG/2", "code_information": [{"code": "86812", "type": "CPT"}, {"code": "7006598", "type": "CDM"}], "standard_charges": [{"gross_charge": 1400.0, "discounted_cash": 1050.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HLA TYPING DR/DQ MULTI AG", "code_information": [{"code": "86817", "type": "CPT"}, {"code": "7006817", "type": "CDM"}], "standard_charges": [{"gross_charge": 1513.0, "discounted_cash": 1134.75, "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": 1037.0, "discounted_cash": 777.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HOCM 250-299MG/ML ID 1ML", "code_information": [{"code": "Q9961", "type": "HCPCS"}, {"code": "5356184", "type": "CDM"}, {"code": "255", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HOCM 250-299MG/ML ID 1ML", "code_information": [{"code": "Q9961", "type": "HCPCS"}, {"code": "5356184", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HOCM 300-349MG/ML ID 1ML", "code_information": [{"code": "Q9962", "type": "HCPCS"}, {"code": "5356185", "type": "CDM"}, {"code": "255", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HOCM 300-349MG/ML ID 1ML", "code_information": [{"code": "Q9962", "type": "HCPCS"}, {"code": "5356185", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HOCM 350-399MG/ML ID 1ML", "code_information": [{"code": "Q9963", "type": "HCPCS"}, {"code": "5356186", "type": "CDM"}, {"code": "255", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HOCM 350-399MG/ML ID 1ML", "code_information": [{"code": "Q9963", "type": "HCPCS"}, {"code": "5356186", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HOMATROPINE 2% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331131", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 259.0, "discounted_cash": 194.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HOMATROPINE 2% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331131", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 259.0, "discounted_cash": 194.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HOMATROPINE 5% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331136", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 230.0, "discounted_cash": 172.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HOMATROPINE 5% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331136", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 230.0, "discounted_cash": 172.5, "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": 1574.0, "discounted_cash": 1180.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HOMOCYSTEINE QUANT", "code_information": [{"code": "83090", "type": "CPT"}, {"code": "7253086", "type": "CDM"}], "standard_charges": [{"gross_charge": 1074.0, "discounted_cash": 805.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HOMOCYSTEINE QUANT/2", "code_information": [{"code": "83090", "type": "CPT"}, {"code": "7253089", "type": "CDM"}], "standard_charges": [{"gross_charge": 258.0, "discounted_cash": 193.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HOMOVNLLC ACID(HVA)", "code_information": [{"code": "83150", "type": "CPT"}, {"code": "7003150", "type": "CDM"}], "standard_charges": [{"gross_charge": 511.0, "discounted_cash": 383.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HOMOVNLLC ACID(HVA)", "code_information": [{"code": "83150", "type": "CPT"}, {"code": "7253150", "type": "CDM"}], "standard_charges": [{"gross_charge": 511.0, "discounted_cash": 383.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HSV CUL W/ID NON IMMUNO", "code_information": [{"code": "87255", "type": "CPT"}, {"code": "7257260", "type": "CDM"}], "standard_charges": [{"gross_charge": 1239.0, "discounted_cash": 929.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HTLV ANTIBODY/2", "code_information": [{"code": "86790", "type": "CPT"}, {"code": "7256791", "type": "CDM"}], "standard_charges": [{"gross_charge": 403.0, "discounted_cash": 302.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HTLV/HIV CONFIRM AB", "code_information": [{"code": "86689", "type": "CPT"}, {"code": "7056322", "type": "CDM"}], "standard_charges": [{"gross_charge": 1215.0, "discounted_cash": 911.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HTLV/HIV CONFIRM AB", "code_information": [{"code": "86689", "type": "CPT"}, {"code": "7256322", "type": "CDM"}], "standard_charges": [{"gross_charge": 1215.0, "discounted_cash": 911.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HTLV/HIV CONFIRM AB/2", "code_information": [{"code": "86689", "type": "CPT"}, {"code": "7076322", "type": "CDM"}], "standard_charges": [{"gross_charge": 654.0, "discounted_cash": 490.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HU ANTIBODY SCREEN", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "7254193", "type": "CDM"}], "standard_charges": [{"gross_charge": 1092.0, "discounted_cash": 819.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HUM HD STM FR SHOULD EXACT CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013142", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 15199.0, "discounted_cash": 11399.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HUMAN GRWTH HORMONE AB", "code_information": [{"code": "86277", "type": "CPT"}, {"code": "7253171", "type": "CDM"}], "standard_charges": [{"gross_charge": 295.0, "discounted_cash": 221.25, "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": 1449.0, "discounted_cash": 1086.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HUMERUS 2 VIEW MINIMUM", "code_information": [{"code": "73060", "type": "CPT"}, {"code": "5013060", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1270.0, "discounted_cash": 952.5, "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": 1615.0, "discounted_cash": 1211.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HYALUR/CHONDRO DEVICE KT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331154", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 4067.0, "discounted_cash": 3050.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HYALURO/CHONDR.35MLKTIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335850", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1691.0, "discounted_cash": 1268.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HYALURON 14MG/1ML SGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331158", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2006.0, "discounted_cash": 1504.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HYALURON 23M/M .6MLPFSIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321190", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1377.0, "discounted_cash": 1032.75, "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": 1591.0, "discounted_cash": 1193.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HYALURON/CHONDR .75ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321199", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1286.0, "discounted_cash": 964.5, "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": 1633.0, "discounted_cash": 1224.75, "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": 2742.0, "discounted_cash": 2056.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HYALURONIDA OV PER 1U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3471", "type": "HCPCS"}, {"code": "5321178", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HYALURONIDA OV PER 1U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3471", "type": "HCPCS"}, {"code": "5321178", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 267.0, "discounted_cash": 200.25, "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": 267.0, "discounted_cash": 200.25, "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": 39.0, "discounted_cash": 29.25, "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": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDRALAZINE 12.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305675", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDRALAZINE 12.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305675", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 39.0, "discounted_cash": 29.25, "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": 39.0, "discounted_cash": 29.25, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDRALAZINE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305671", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDRALAZINE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305671", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": 365.0, "discounted_cash": 273.75, "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": 365.0, "discounted_cash": 273.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "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": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROCOD/APAP 10/500 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327576", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROCOD/APAP 10/500 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327576", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROCOD/APAP 10ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327577", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROCOD/APAP 10ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327577", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "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": 33.0, "discounted_cash": 24.75, "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": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROCOD/APAP 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327574", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROCOD/APAP 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327574", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "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": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROCOD/APAP 5/500 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327578", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROCOD/APAP 5/500 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327578", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROCOD/APAP 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327570", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROCOD/APAP 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327570", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "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": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "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": 48.0, "discounted_cash": 36.0, "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": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROCOD/CPM 1ML XR LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327541", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROCOD/CPM 1ML XR LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327541", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROCOD/CPM 5ML XR LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327544", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROCOD/CPM 5ML XR LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327544", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROCOD/HOMAT 10ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327551", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROCOD/HOMAT 10ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327551", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROCOD/HOMAT 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327553", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 11.0, "discounted_cash": 8.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROCOD/HOMAT 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327553", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 11.0, "discounted_cash": 8.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROCODONE/GF 10ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327582", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROCODONE/GF 10ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327582", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROCORTISONE 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305745", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROCORTISONE 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305745", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROCORTISONE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305739", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROCORTISONE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305739", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 0.33, "discounted_cash": 0.25, "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": 0.33, "discounted_cash": 0.25, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROMORPHONE 3MG SU", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5327590", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROMORPHONE 3MG SU", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5327590", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROMORPHONE 4MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327593", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROMORPHONE 4MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327593", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "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": 211.0, "discounted_cash": 158.25, "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": 211.0, "discounted_cash": 158.25, "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": 52.0, "discounted_cash": 39.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROXYETH STRCH 6%500ML", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412452", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 432.0, "discounted_cash": 324.0, "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": 50.0, "discounted_cash": 37.5, "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": 50.0, "discounted_cash": 37.5, "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": 36.0, "discounted_cash": 27.0, "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": 36.0, "discounted_cash": 27.0, "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": 21.0, "discounted_cash": 15.75, "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": 21.0, "discounted_cash": 15.75, "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": 36.0, "discounted_cash": 27.0, "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": 36.0, "discounted_cash": 27.0, "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": 39.0, "discounted_cash": 29.25, "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": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROXYZINE 50MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305838", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROXYZINE 50MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305838", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROXYZINE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305836", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROXYZINE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305836", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "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": 141.0, "discounted_cash": 105.75, "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": 141.0, "discounted_cash": 105.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDRXINDOL ACD5(HIAA)QT", "code_information": [{"code": "83497", "type": "CPT"}, {"code": "7003497", "type": "CDM"}], "standard_charges": [{"gross_charge": 810.0, "discounted_cash": 607.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDRXINDOL ACD5(HIAA)QT", "code_information": [{"code": "83497", "type": "CPT"}, {"code": "7253497", "type": "CDM"}], "standard_charges": [{"gross_charge": 810.0, "discounted_cash": 607.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDRXYPRGSTRONE 17-D", "code_information": [{"code": "83498", "type": "CPT"}, {"code": "7003498", "type": "CDM"}], "standard_charges": [{"gross_charge": 1055.0, "discounted_cash": 791.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDRXYPRGSTRONE 17-D/2", "code_information": [{"code": "83498", "type": "CPT"}, {"code": "7253498", "type": "CDM"}], "standard_charges": [{"gross_charge": 1055.0, "discounted_cash": 791.25, "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": 365.0, "discounted_cash": 273.75, "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": 365.0, "discounted_cash": 273.75, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HYOSCYAMINE .375MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305893", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HYOSCYAMINE .375MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305893", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HYOSCYAMINE UPTO.25MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1980", "type": "HCPCS"}, {"code": "5321307", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 171.0, "discounted_cash": 128.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HYOSCYAMINE UPTO.25MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1980", "type": "HCPCS"}, {"code": "5321307", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 171.0, "discounted_cash": 128.25, "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": 3054.0, "discounted_cash": 2290.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HYSTEROSONOGRAPHY", "code_information": [{"code": "76831", "type": "CPT"}, {"code": "5066831", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2960.0, "discounted_cash": 2220.0, "setting": "both", "billing_class": "facility"}]}, {"description": "I 123 DIAGNOSTIC PER MCI", "code_information": [{"code": "A9509", "type": "HCPCS"}, {"code": "5199509", "type": "CDM"}, {"code": "343", "type": "RC"}], "standard_charges": [{"gross_charge": 621.0, "discounted_cash": 465.75, "setting": "both", "billing_class": "facility"}]}, {"description": "I 123 MIBG DOSE", "code_information": [{"code": "A9582", "type": "HCPCS"}, {"code": "5192180", "type": "CDM"}, {"code": "343", "type": "RC"}], "standard_charges": [{"gross_charge": 19355.0, "discounted_cash": 14516.25, "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": 327.0, "discounted_cash": 245.25, "setting": "both", "billing_class": "facility"}]}, {"description": "I&D ABSCESS SIMP/SNGL", "code_information": [{"code": "5060060", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1616.0, "discounted_cash": 1212.0, "setting": "both", "billing_class": "facility"}]}, {"description": "I&D ABSCESS SIMP/SNGL", "code_information": [{"code": "6900051", "type": "CDM"}], "standard_charges": [{"gross_charge": 1463.0, "discounted_cash": 1097.25, "setting": "both", "billing_class": "facility"}]}, {"description": "I&D COMPLEX DRAIN WOUND", "code_information": [{"code": "6900133", "type": "CDM"}], "standard_charges": [{"gross_charge": 19591.0, "discounted_cash": 14693.25, "setting": "both", "billing_class": "facility"}]}, {"description": "I&D HEMA SEROMA FL", "code_information": [{"code": "4610135", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2018.0, "discounted_cash": 1513.5, "setting": "both", "billing_class": "facility"}]}, {"description": "I&D HEMA SEROMA FL", "code_information": [{"code": "6909896", "type": "CDM"}], "standard_charges": [{"gross_charge": 11360.0, "discounted_cash": 8520.0, "setting": "both", "billing_class": "facility"}]}, {"description": "I&D SKIN ABSCESS COMPLEX", "code_information": [{"code": "6900052", "type": "CDM"}], "standard_charges": [{"gross_charge": 2618.0, "discounted_cash": 1963.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IA INFECT AGENT AB QN NOS/3", "code_information": [{"code": "86317", "type": "CPT"}, {"code": "7006008", "type": "CDM"}], "standard_charges": [{"gross_charge": 1122.0, "discounted_cash": 841.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IA INFECTIOUS AGENT QL", "code_information": [{"code": "86318", "type": "CPT"}, {"code": "4106315", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 209.0, "discounted_cash": 156.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IA NFCT AB SARSCOV2 MULT", "code_information": [{"code": "86769", "type": "CPT"}, {"code": "4106522", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 335.0, "discounted_cash": 251.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IA TUMOR AG NES QUAN", "code_information": [{"code": "86316", "type": "CPT"}, {"code": "7002399", "type": "CDM"}], "standard_charges": [{"gross_charge": 523.0, "discounted_cash": 392.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IA TUMOR AG NES QUAN", "code_information": [{"code": "86316", "type": "CPT"}, {"code": "7252399", "type": "CDM"}], "standard_charges": [{"gross_charge": 523.0, "discounted_cash": 392.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IA TUMOR AG NES QUAN/2", "code_information": [{"code": "86316", "type": "CPT"}, {"code": "7252401", "type": "CDM"}], "standard_charges": [{"gross_charge": 262.0, "discounted_cash": 196.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IA TUMOR AG NES QUAN/3", "code_information": [{"code": "86316", "type": "CPT"}, {"code": "7253883", "type": "CDM"}], "standard_charges": [{"gross_charge": 242.0, "discounted_cash": 181.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IA TUMOR CA 125 QUAN", "code_information": [{"code": "86304", "type": "CPT"}, {"code": "7006900", "type": "CDM"}], "standard_charges": [{"gross_charge": 944.0, "discounted_cash": 708.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IA TUMOR CA 125 QUAN", "code_information": [{"code": "86304", "type": "CPT"}, {"code": "7256900", "type": "CDM"}], "standard_charges": [{"gross_charge": 944.0, "discounted_cash": 708.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IA TUMOR CA 15-3 QUAN", "code_information": [{"code": "86300", "type": "CPT"}, {"code": "7254898", "type": "CDM"}], "standard_charges": [{"gross_charge": 921.0, "discounted_cash": 690.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IA TUMOR CA 15-3 QUAN/2", "code_information": [{"code": "86300", "type": "CPT"}, {"code": "7004998", "type": "CDM"}], "standard_charges": [{"gross_charge": 921.0, "discounted_cash": 690.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IA TUMOR CA 15-3 QUAN/2", "code_information": [{"code": "86300", "type": "CPT"}, {"code": "7254998", "type": "CDM"}], "standard_charges": [{"gross_charge": 921.0, "discounted_cash": 690.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IA TUMOR CA 19-9 QUAN", "code_information": [{"code": "86301", "type": "CPT"}, {"code": "7004900", "type": "CDM"}], "standard_charges": [{"gross_charge": 703.0, "discounted_cash": 527.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IA TUMOR CA 19-9 QUAN", "code_information": [{"code": "86301", "type": "CPT"}, {"code": "7254900", "type": "CDM"}], "standard_charges": [{"gross_charge": 703.0, "discounted_cash": 527.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IBANDRONATE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1740", "type": "HCPCS"}, {"code": "5321309", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1757.0, "discounted_cash": 1317.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IBANDRONATE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1740", "type": "HCPCS"}, {"code": "5321309", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1757.0, "discounted_cash": 1317.75, "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": 99.0, "discounted_cash": 74.25, "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": 99.0, "discounted_cash": 74.25, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "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": 39.0, "discounted_cash": 29.25, "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": 39.0, "discounted_cash": 29.25, "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": 47.0, "discounted_cash": 35.25, "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": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IBUPROFEN 800MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305920", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IBUPROFEN 800MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305920", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "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": 19.0, "discounted_cash": 14.25, "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": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IBUPROFEN PER 100MG PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1741", "type": "HCPCS"}, {"code": "5321292", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 23.0, "discounted_cash": 17.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IBUPROFEN PER 100MG PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1741", "type": "HCPCS"}, {"code": "5321292", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 23.0, "discounted_cash": 17.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IBUPROFEN QUANT", "code_information": [{"code": "80329", "type": "CPT"}, {"code": "7253541", "type": "CDM"}], "standard_charges": [{"gross_charge": 549.0, "discounted_cash": 411.75, "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": 3811.0, "discounted_cash": 2858.25, "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": 3811.0, "discounted_cash": 2858.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ICD DUAL CHMB EVAL W PRG", "code_information": [{"code": "93283", "type": "CPT"}, {"code": "4613282", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 133.0, "discounted_cash": 99.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ICD EVAL IN PERSN NO PRG", "code_information": [{"code": "93289", "type": "CPT"}, {"code": "4613289", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 133.0, "discounted_cash": 99.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ICD MULTILEAD EVAL W PRO", "code_information": [{"code": "93284", "type": "CPT"}, {"code": "4613293", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 673.0, "discounted_cash": 504.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ICD PERIPROC EVAL/PRGRM", "code_information": [{"code": "93287", "type": "CPT"}, {"code": "4613287", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 137.0, "discounted_cash": 102.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IDARUBICIN PER 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9211", "type": "HCPCS"}, {"code": "5321321", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5572.0, "discounted_cash": 4179.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IDARUBICIN PER 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9211", "type": "HCPCS"}, {"code": "5321321", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 5572.0, "discounted_cash": 4179.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IDARUCIZUMAB 5GM IJ", "code_information": [{"code": "C9399", "type": "HCPCS"}, {"code": "5321249", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 11591.0, "discounted_cash": 8693.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IDARUCIZUMAB 5GM IJ", "code_information": [{"code": "C9399", "type": "HCPCS"}, {"code": "5321249", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 11591.0, "discounted_cash": 8693.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IDH1 COMMON VARIANTS", "code_information": [{"code": "81120", "type": "CPT"}, {"code": "7050050", "type": "CDM"}], "standard_charges": [{"gross_charge": 1029.0, "discounted_cash": 771.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IDH2 COMMON VARIANTS", "code_information": [{"code": "81121", "type": "CPT"}, {"code": "7050055", "type": "CDM"}], "standard_charges": [{"gross_charge": 1276.0, "discounted_cash": 957.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IFOSFAMIDE PER1GM IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9208", "type": "HCPCS"}, {"code": "5321322", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2690.0, "discounted_cash": 2017.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IFOSFAMIDE PER1GM IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9208", "type": "HCPCS"}, {"code": "5321322", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 2690.0, "discounted_cash": 2017.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IFR CORO W/WO PHARM STRESS", "code_information": [{"code": "93799", "type": "CPT"}, {"code": "4610014", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 6231.0, "discounted_cash": 4673.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IG-E SERUM", "code_information": [{"code": "82785", "type": "CPT"}, {"code": "7003513", "type": "CDM"}], "standard_charges": [{"gross_charge": 1187.0, "discounted_cash": 890.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IG-E SERUM/3", "code_information": [{"code": "82785", "type": "CPT"}, {"code": "7253513", "type": "CDM"}], "standard_charges": [{"gross_charge": 1187.0, "discounted_cash": 890.25, "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": 11505.0, "discounted_cash": 8628.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ILOPERIDONE 12MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305928", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 154.0, "discounted_cash": 115.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ILOPERIDONE 12MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305928", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 154.0, "discounted_cash": 115.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ILOPERIDONE 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305926", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 145.0, "discounted_cash": 108.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ILOPERIDONE 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305926", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 145.0, "discounted_cash": 108.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ILOPERIDONE 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305925", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 138.0, "discounted_cash": 103.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ILOPERIDONE 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305925", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 138.0, "discounted_cash": 103.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ILOPERIDONE 6MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305927", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 138.0, "discounted_cash": 103.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ILOPERIDONE 6MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305927", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 138.0, "discounted_cash": 103.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMATINIB 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305930", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 428.0, "discounted_cash": 321.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMATINIB 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305930", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 428.0, "discounted_cash": 321.0, "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": 5604.0, "discounted_cash": 4203.0, "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": 4833.0, "discounted_cash": 3624.75, "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": 9698.0, "discounted_cash": 7273.5, "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": 9119.0, "discounted_cash": 6839.25, "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": 9119.0, "discounted_cash": 6839.25, "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": 9119.0, "discounted_cash": 6839.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMIGLUCERASE PER 10U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1786", "type": "HCPCS"}, {"code": "5321229", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 661.0, "discounted_cash": 495.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMIGLUCERASE PER 10U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1786", "type": "HCPCS"}, {"code": "5321229", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 661.0, "discounted_cash": 495.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMIPENEM/CIL PER250MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0743", "type": "HCPCS"}, {"code": "5321324", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 323.0, "discounted_cash": 242.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMIPENEM/CIL PER250MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0743", "type": "HCPCS"}, {"code": "5321324", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 323.0, "discounted_cash": 242.25, "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": 36.0, "discounted_cash": 27.0, "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": 36.0, "discounted_cash": 27.0, "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": 39.0, "discounted_cash": 29.25, "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": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMIPRAMINE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305954", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMIPRAMINE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305954", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "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": 472.0, "discounted_cash": 354.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMM ADM EA ADDL VACCINE", "code_information": [{"code": "90472", "type": "CPT"}, {"code": "6124002", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 170.0, "discounted_cash": 127.5, "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": 401.0, "discounted_cash": 300.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMM ADMIN SNGL/COMBO VAC", "code_information": [{"code": "90471", "type": "CPT"}, {"code": "3110472", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 353.0, "discounted_cash": 264.75, "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": 512.0, "discounted_cash": 384.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMM ADMIN SNGL/COMBO VAC", "code_information": [{"code": "90471", "type": "CPT"}, {"code": "6110471", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 496.0, "discounted_cash": 372.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMM ADMIN SNGL/COMBO VAC", "code_information": [{"code": "90471", "type": "CPT"}, {"code": "6120472", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 398.0, "discounted_cash": 298.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMM ADMIN SNGL/COMBO VAC", "code_information": [{"code": "90471", "type": "CPT"}, {"code": "6290471", "type": "CDM"}], "standard_charges": [{"gross_charge": 353.0, "discounted_cash": 264.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMM ADMIN-1 VACCINE", "code_information": [{"code": "90471", "type": "CPT"}, {"code": "3910471", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 496.0, "discounted_cash": 372.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMCYT MLTIPLEX AB STAIN", "code_information": [{"code": "88344", "type": "CPT"}, {"code": "4308344", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 657.0, "discounted_cash": 492.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUN NONINFC QL/SEMI/M", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "7006636", "type": "CDM"}], "standard_charges": [{"gross_charge": 368.0, "discounted_cash": 276.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUN NONINFC QL/SEMI/M/2", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "7253516", "type": "CDM"}], "standard_charges": [{"gross_charge": 337.0, "discounted_cash": 252.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUN NONINFC QL/SEMI/SG", "code_information": [{"code": "83518", "type": "CPT"}, {"code": "7013510", "type": "CDM"}], "standard_charges": [{"gross_charge": 727.0, "discounted_cash": 545.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUN NONINFC QL/SEMI/SG", "code_information": [{"code": "83518", "type": "CPT"}, {"code": "7258379", "type": "CDM"}], "standard_charges": [{"gross_charge": 149.0, "discounted_cash": 111.75, "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": 516.0, "discounted_cash": 387.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNCYT 1ST AB PER SPEC", "code_information": [{"code": "88342", "type": "CPT"}, {"code": "7058342", "type": "CDM"}], "standard_charges": [{"gross_charge": 1575.0, "discounted_cash": 1181.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNE COMPLEX/2", "code_information": [{"code": "86332", "type": "CPT"}, {"code": "7254239", "type": "CDM"}], "standard_charges": [{"gross_charge": 1254.0, "discounted_cash": 940.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNE COMPLEX/3", "code_information": [{"code": "86332", "type": "CPT"}, {"code": "7006371", "type": "CDM"}], "standard_charges": [{"gross_charge": 1254.0, "discounted_cash": 940.5, "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": 477.0, "discounted_cash": 357.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOCYTO EA ADD AB STN", "code_information": [{"code": "88341", "type": "CPT"}, {"code": "7058376", "type": "CDM"}], "standard_charges": [{"gross_charge": 280.0, "discounted_cash": 210.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNODIFFUSION GEL QUAL", "code_information": [{"code": "86331", "type": "CPT"}, {"code": "7256331", "type": "CDM"}], "standard_charges": [{"gross_charge": 264.0, "discounted_cash": 198.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOFIX ELECTRO OTHER SR", "code_information": [{"code": "86335", "type": "CPT"}, {"code": "4106338", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 376.0, "discounted_cash": 282.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOFIX ELECTRO OTHER SR", "code_information": [{"code": "86335", "type": "CPT"}, {"code": "4126338", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 80.0, "discounted_cash": 60.0, "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": 927.0, "discounted_cash": 695.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOFIX ELECTRO OTHER SR/4", "code_information": [{"code": "86335", "type": "CPT"}, {"code": "7256344", "type": "CDM"}], "standard_charges": [{"gross_charge": 128.0, "discounted_cash": 96.0, "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": 881.0, "discounted_cash": 660.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOFIX ELECTRO SERUM", "code_information": [{"code": "86334", "type": "CPT"}, {"code": "4126334", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOFIX ELECTRO SERUM", "code_information": [{"code": "86334", "type": "CPT"}, {"code": "7252785", "type": "CDM"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOFIX ELECTRO SERUM/4", "code_information": [{"code": "86334", "type": "CPT"}, {"code": "7258634", "type": "CDM"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "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": 512.0, "discounted_cash": 384.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOFLR AB ADDL STAIN", "code_information": [{"code": "88350", "type": "CPT"}, {"code": "4308360", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 395.0, "discounted_cash": 296.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOGLOB SUBCLASS EA", "code_information": [{"code": "82787", "type": "CPT"}, {"code": "7252788", "type": "CDM"}], "standard_charges": [{"gross_charge": 303.0, "discounted_cash": 227.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOGLOB SUBCLASS EA/2", "code_information": [{"code": "82787", "type": "CPT"}, {"code": "7002788", "type": "CDM"}], "standard_charges": [{"gross_charge": 303.0, "discounted_cash": 227.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOGLOB SUBCLASS EA/2", "code_information": [{"code": "82787", "type": "CPT"}, {"code": "7252789", "type": "CDM"}], "standard_charges": [{"gross_charge": 303.0, "discounted_cash": 227.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOGLOB SUBCLASS EA/3", "code_information": [{"code": "82787", "type": "CPT"}, {"code": "7002789", "type": "CDM"}], "standard_charges": [{"gross_charge": 303.0, "discounted_cash": 227.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOGLOB SUBCLASS EA/3", "code_information": [{"code": "82787", "type": "CPT"}, {"code": "7252790", "type": "CDM"}], "standard_charges": [{"gross_charge": 303.0, "discounted_cash": 227.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOGLOB SUBCLASS EA/4", "code_information": [{"code": "82787", "type": "CPT"}, {"code": "7002790", "type": "CDM"}], "standard_charges": [{"gross_charge": 303.0, "discounted_cash": 227.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOGLOB SUBCLASS EA/4", "code_information": [{"code": "82787", "type": "CPT"}, {"code": "7252791", "type": "CDM"}], "standard_charges": [{"gross_charge": 303.0, "discounted_cash": 227.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOGLOB SUBCLASS EA/5", "code_information": [{"code": "82787", "type": "CPT"}, {"code": "7002791", "type": "CDM"}], "standard_charges": [{"gross_charge": 303.0, "discounted_cash": 227.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP ACL REPAIR TIGHTROPE W/IB", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132875", "type": "CDM"}], "standard_charges": [{"gross_charge": 4686.0, "discounted_cash": 3514.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP ACS ANTER CERV SHORELINE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132657", "type": "CDM"}], "standard_charges": [{"gross_charge": 596.0, "discounted_cash": 447.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP ADAP/EXT LD NSTM", "code_information": [{"code": "C1883", "type": "HCPCS"}, {"code": "8241350", "type": "CDM"}], "standard_charges": [{"gross_charge": 2890.0, "discounted_cash": 2167.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP ADAP/EXT LD PM NSTIM", "code_information": [{"code": "C1883", "type": "HCPCS"}, {"code": "8240180", "type": "CDM"}], "standard_charges": [{"gross_charge": 2956.0, "discounted_cash": 2217.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP ALLOGRAFT OSTEOFACTOR", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137642", "type": "CDM"}], "standard_charges": [{"gross_charge": 11516.0, "discounted_cash": 8637.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP ANCHOR LUMBAR GLOBUS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4012109", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1576.0, "discounted_cash": 1182.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP ANKLE TOTAL TALUS RESTOR3D", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8136514", "type": "CDM"}], "standard_charges": [{"gross_charge": 136541.0, "discounted_cash": 102405.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP ARTHRODESIS X-FUSE", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4022992", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10267.0, "discounted_cash": 7700.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP ASSEMBLY LORDOTIC ORTHOFIX", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136529", "type": "CDM"}], "standard_charges": [{"gross_charge": 33174.0, "discounted_cash": 24880.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BALLOON INSPACE", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8132300", "type": "CDM"}], "standard_charges": [{"gross_charge": 54595.0, "discounted_cash": 40946.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BASEPLATE ASSMBLY SKELETAL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8136727", "type": "CDM"}], "standard_charges": [{"gross_charge": 47857.0, "discounted_cash": 35892.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BDY PROXIMAL EQUINOX EXACT", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8136434", "type": "CDM"}], "standard_charges": [{"gross_charge": 51526.0, "discounted_cash": 38644.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BIOINDUCTV ARTHR W/DEL DVC", "code_information": [{"code": "C1763", "type": "HCPCS"}, {"code": "4028480", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 29482.0, "discounted_cash": 22111.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BLN PRES REG", "code_information": [{"code": "C1815", "type": "HCPCS"}, {"code": "8172500", "type": "CDM"}], "standard_charges": [{"gross_charge": 16537.0, "discounted_cash": 12402.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BN CORTICAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132904", "type": "CDM"}], "standard_charges": [{"gross_charge": 6167.0, "discounted_cash": 4625.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BN CUBES", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132901", "type": "CDM"}], "standard_charges": [{"gross_charge": 2764.0, "discounted_cash": 2073.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BN DOWEL", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8132903", "type": "CDM"}], "standard_charges": [{"gross_charge": 13200.0, "discounted_cash": 9900.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BN FEMORAL HEAD", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8132908", "type": "CDM"}], "standard_charges": [{"gross_charge": 7155.0, "discounted_cash": 5366.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BN FIBULA", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132906", "type": "CDM"}], "standard_charges": [{"gross_charge": 4320.0, "discounted_cash": 3240.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BN GRFT SUB OSTEO 5", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8247019", "type": "CDM"}], "standard_charges": [{"gross_charge": 13814.0, "discounted_cash": 10360.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BN MATRIX 1", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8132911", "type": "CDM"}], "standard_charges": [{"gross_charge": 7653.0, "discounted_cash": 5739.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BN MATRIX 2", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8132912", "type": "CDM"}], "standard_charges": [{"gross_charge": 17166.0, "discounted_cash": 12874.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BN MATRIX 3", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8132890", "type": "CDM"}], "standard_charges": [{"gross_charge": 1681.0, "discounted_cash": 1260.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BN MATRIX 6", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8132893", "type": "CDM"}], "standard_charges": [{"gross_charge": 5046.0, "discounted_cash": 3784.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BN PATELLA TENDON", "code_information": [{"code": "C1762", "type": "HCPCS"}, {"code": "8132909", "type": "CDM"}], "standard_charges": [{"gross_charge": 22553.0, "discounted_cash": 16914.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BN PUTTY EASYPACK MAGNETOS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137017", "type": "CDM"}], "standard_charges": [{"gross_charge": 7859.0, "discounted_cash": 5894.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BN PUTTY MAGNETOS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137018", "type": "CDM"}], "standard_charges": [{"gross_charge": 21454.0, "discounted_cash": 16090.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BN SPACER", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132910", "type": "CDM"}], "standard_charges": [{"gross_charge": 9299.0, "discounted_cash": 6974.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BN SPACER HEDRON", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137012", "type": "CDM"}], "standard_charges": [{"gross_charge": 48862.0, "discounted_cash": 36646.5, "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": 16601.0, "discounted_cash": 12450.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BOLT SLEEVE LEGION", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132879", "type": "CDM"}], "standard_charges": [{"gross_charge": 8124.0, "discounted_cash": 6093.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BONE SUBST FOAM A/S", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4010687", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9142.0, "discounted_cash": 6856.5, "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": 3787.0, "discounted_cash": 2840.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP CABLE SADDLE EVOS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132989", "type": "CDM"}], "standard_charges": [{"gross_charge": 3857.33, "discounted_cash": 2893.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP CAGE INTERBODY CASCADIA", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136391", "type": "CDM"}], "standard_charges": [{"gross_charge": 31594.0, "discounted_cash": 23695.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP CAGE INTERBODY SEASPINE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136390", "type": "CDM"}], "standard_charges": [{"gross_charge": 8688.0, "discounted_cash": 6516.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP CAGE INTERBODY WAVEFORM", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8136396", "type": "CDM"}], "standard_charges": [{"gross_charge": 41575.49, "discounted_cash": 31181.62, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP CAGE-X CERVICAL 4MM CAVUX", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136423", "type": "CDM"}], "standard_charges": [{"gross_charge": 17026.0, "discounted_cash": 12769.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP CARDIAC MONITOR DM5300", "code_information": [{"code": "C1764", "type": "HCPCS"}, {"code": "4000318", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 34463.0, "discounted_cash": 25847.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP CARDIAC MONITOR EL+DM5500", "code_information": [{"code": "C1764", "type": "HCPCS"}, {"code": "4000325", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 51758.0, "discounted_cash": 38818.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP CARTRIDGE UROLIFT UL2-C", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8174039", "type": "CDM"}], "standard_charges": [{"gross_charge": 43080.0, "discounted_cash": 32310.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP CARTRIDGE UROLIFT UL2-CHK", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8174038", "type": "CDM"}], "standard_charges": [{"gross_charge": 11296.0, "discounted_cash": 8472.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP CENTRALIZ DISTL VERSYS ZIM", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137763", "type": "CDM"}], "standard_charges": [{"gross_charge": 810.0, "discounted_cash": 607.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP CERV DISC ARTFCL SIMPLIFY", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "4012034", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 46917.0, "discounted_cash": 35187.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP CLIP/TUBE", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8152000", "type": "CDM"}], "standard_charges": [{"gross_charge": 1751.0, "discounted_cash": 1313.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP CMC MINI TIGHTRP SYS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4012018", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 13439.0, "discounted_cash": 10079.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP CONFIRM CARD DM4500", "code_information": [{"code": "C1764", "type": "HCPCS"}, {"code": "4008535", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5136.0, "discounted_cash": 3852.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP CONNECTOR INVICTUS REV", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137605", "type": "CDM"}], "standard_charges": [{"gross_charge": 6559.0, "discounted_cash": 4919.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP CONVENIENCE PK GRAFTLINK", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4012024", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 15836.0, "discounted_cash": 11877.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP COUPLER OFFSET", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8132951", "type": "CDM"}], "standard_charges": [{"gross_charge": 12657.0, "discounted_cash": 9492.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP CUFF URIN SPHINCTER", "code_information": [{"code": "C1815", "type": "HCPCS"}, {"code": "8151993", "type": "CDM"}], "standard_charges": [{"gross_charge": 33844.0, "discounted_cash": 25383.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP DEV JOINT", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8240187", "type": "CDM"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP DISC ARTFCL PRODISC", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "4012032", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 41822.0, "discounted_cash": 31366.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP ELBOW PIN AXIS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137620", "type": "CDM"}], "standard_charges": [{"gross_charge": 2717.0, "discounted_cash": 2037.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP EXTEN PC BN REPLMNT", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8136454", "type": "CDM"}], "standard_charges": [{"gross_charge": 20103.0, "discounted_cash": 15077.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP FBRSTITCH CRV PLY 2-0 FBWR", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4012059", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5428.0, "discounted_cash": 4071.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP FEM MIDSCT MALE FEM ELEOS", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137562", "type": "CDM"}], "standard_charges": [{"gross_charge": 51267.0, "discounted_cash": 38450.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP FEM OSS DISTL ELIP SEG ZIM", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137879", "type": "CDM"}], "standard_charges": [{"gross_charge": 87308.53, "discounted_cash": 65481.4, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP FEMORAL AUGMENT 10MM SZ3", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137737", "type": "CDM"}], "standard_charges": [{"gross_charge": 6919.0, "discounted_cash": 5189.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP FEMUR COATED PERSONA PSP", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8139909", "type": "CDM"}], "standard_charges": [{"gross_charge": 22975.93, "discounted_cash": 17231.95, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP FEMUR DISTAL ELEOS", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8132672", "type": "CDM"}], "standard_charges": [{"gross_charge": 83515.0, "discounted_cash": 62636.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP FIXTURE BAHA", "code_information": [{"code": "L8690", "type": "HCPCS"}, {"code": "4023000", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 25201.0, "discounted_cash": 18900.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP FOOT/ANKLE TENDON FHL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137402", "type": "CDM"}], "standard_charges": [{"gross_charge": 11808.0, "discounted_cash": 8856.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP FOREFOOT INTERNLBRC PEEK", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4012061", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11900.0, "discounted_cash": 8925.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP GAMMATILE DEVICE", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8172501", "type": "CDM"}], "standard_charges": [{"gross_charge": 59386.0, "discounted_cash": 44539.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP GASTRO INTERNAL CLIP", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8174866", "type": "CDM"}], "standard_charges": [{"gross_charge": 2612.0, "discounted_cash": 1959.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP GEN NSTIM EON", "code_information": [{"code": "C1820", "type": "HCPCS"}, {"code": "4023002", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 139723.0, "discounted_cash": 104792.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP GEN NSTIM N-RECHG", "code_information": [{"code": "C1767", "type": "HCPCS"}, {"code": "8240186", "type": "CDM"}], "standard_charges": [{"gross_charge": 48631.0, "discounted_cash": 36473.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP GEN NSTIM N-RECHG INTELLIS", "code_information": [{"code": "C1767", "type": "HCPCS"}, {"code": "4008467", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5055.0, "discounted_cash": 3791.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP GEN NSTIM N-RECHG1", "code_information": [{"code": "C1767", "type": "HCPCS"}, {"code": "8241454", "type": "CDM"}], "standard_charges": [{"gross_charge": 71497.0, "discounted_cash": 53622.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP GEN NSTIM N-RECHG3", "code_information": [{"code": "C1767", "type": "HCPCS"}, {"code": "8241455", "type": "CDM"}], "standard_charges": [{"gross_charge": 230981.0, "discounted_cash": 173235.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP GEN NSTIM NONRECHG", "code_information": [{"code": "L8679", "type": "HCPCS"}, {"code": "4023030", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 104226.0, "discounted_cash": 78169.5, "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": 213468.0, "discounted_cash": 160101.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP GEN NSTIM RECHARGE", "code_information": [{"code": "C1820", "type": "HCPCS"}, {"code": "8241453", "type": "CDM"}], "standard_charges": [{"gross_charge": 163085.0, "discounted_cash": 122313.75, "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": 127396.0, "discounted_cash": 95547.0, "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": 230657.0, "discounted_cash": 172992.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP GEN NSTM RESTORESNSR", "code_information": [{"code": "C1820", "type": "HCPCS"}, {"code": "8174861", "type": "CDM"}], "standard_charges": [{"gross_charge": 112475.0, "discounted_cash": 84356.25, "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": 203332.0, "discounted_cash": 152499.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP GEN PULSE ALPHA WAVEWRITER", "code_information": [{"code": "C1820", "type": "HCPCS"}, {"code": "4008532", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 213468.0, "discounted_cash": 160101.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP GLENOID CORTILOC PEGGED", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8136462", "type": "CDM"}], "standard_charges": [{"gross_charge": 9384.0, "discounted_cash": 7038.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP GLENOID UNIVERS VAULTLOCK", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137406", "type": "CDM"}], "standard_charges": [{"gross_charge": 16549.0, "discounted_cash": 12411.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP HIP ANCILLARY STRYKER CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013104", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 658.0, "discounted_cash": 493.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP HIP SPACER", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8132905", "type": "CDM"}], "standard_charges": [{"gross_charge": 469.0, "discounted_cash": 351.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP HIP STEM INSIGNIA", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137788", "type": "CDM"}], "standard_charges": [{"gross_charge": 17998.0, "discounted_cash": 13498.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP HUM SCRW TP LCK EQNX EXACT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136419", "type": "CDM"}], "standard_charges": [{"gross_charge": 5340.0, "discounted_cash": 4005.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP HUMERAL ADAPTER", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137646", "type": "CDM"}], "standard_charges": [{"gross_charge": 25640.0, "discounted_cash": 19230.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP HUMERAL TRY +3 STD ZIMMER", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012552", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10663.0, "discounted_cash": 7997.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP IFUSE-TORQ SI-BONE NTAP", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8137540", "type": "CDM"}], "standard_charges": [{"gross_charge": 31728.67, "discounted_cash": 23796.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP INS TIB BARRIER MRH STRYKR", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137714", "type": "CDM"}], "standard_charges": [{"gross_charge": 5721.0, "discounted_cash": 4290.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP INSERT POLY SULCUS", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137557", "type": "CDM"}], "standard_charges": [{"gross_charge": 16583.0, "discounted_cash": 12437.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP INSRT BUMPER TRANSTN STRYK", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8136490", "type": "CDM"}], "standard_charges": [{"gross_charge": 5608.0, "discounted_cash": 4206.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP INSRT OR3O DM XLPE", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137795", "type": "CDM"}], "standard_charges": [{"gross_charge": 5331.0, "discounted_cash": 3998.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP INSRT OR3O DM XLPE 28/42", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137752", "type": "CDM"}], "standard_charges": [{"gross_charge": 6081.0, "discounted_cash": 4560.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP INSRT TIBIAL PROXIMAL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8132673", "type": "CDM"}], "standard_charges": [{"gross_charge": 10636.0, "discounted_cash": 7977.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP KNEE DEVICE CUSTOM", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8132652", "type": "CDM"}], "standard_charges": [{"gross_charge": 178884.0, "discounted_cash": 134163.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP LD CARD/DFIB NEC/D/S", "code_information": [{"code": "C1896", "type": "HCPCS"}, {"code": "8240191", "type": "CDM"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP LD CARDV/DFIB EC DC", "code_information": [{"code": "C1895", "type": "HCPCS"}, {"code": "8240188", "type": "CDM"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP LD CARDV/DFIB EC SC", "code_information": [{"code": "C1777", "type": "HCPCS"}, {"code": "8240189", "type": "CDM"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "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": 4803.0, "discounted_cash": 3602.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP LD NSTIM", "code_information": [{"code": "C1778", "type": "HCPCS"}, {"code": "8240193", "type": "CDM"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP LD NSTIM TEST KT", "code_information": [{"code": "C1897", "type": "HCPCS"}, {"code": "8240195", "type": "CDM"}], "standard_charges": [{"gross_charge": 2022.0, "discounted_cash": 1516.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP LD PM/CARD-DFIB COMB", "code_information": [{"code": "C1899", "type": "HCPCS"}, {"code": "8240197", "type": "CDM"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP LNR ACE DUALMOBLTY G7 ZIMR", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137764", "type": "CDM"}], "standard_charges": [{"gross_charge": 14740.0, "discounted_cash": 11055.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP LOAD EYELID GOLD", "code_information": [{"code": "A4649", "type": "HCPCS"}, {"code": "8182895", "type": "CDM"}], "standard_charges": [{"gross_charge": 2654.0, "discounted_cash": 1990.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP LOOP PROCINCH ADJ TENSION", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4012106", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4104.0, "discounted_cash": 3078.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP MARKER BIO ZORB", "code_information": [{"code": "A4648", "type": "HCPCS"}, {"code": "4027987", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8927.0, "discounted_cash": 6695.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP MARKER TISSUE", "code_information": [{"code": "C1739", "type": "HCPCS"}, {"code": "8240206", "type": "CDM"}], "standard_charges": [{"gross_charge": 1106.0, "discounted_cash": 829.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP MENISCAL SYS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132919", "type": "CDM"}], "standard_charges": [{"gross_charge": 5134.0, "discounted_cash": 3850.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP MENISCUS ARROW PLA", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8247090", "type": "CDM"}], "standard_charges": [{"gross_charge": 1212.0, "discounted_cash": 909.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP MESH", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8240199", "type": "CDM"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP MESH TITANIUM", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8152019", "type": "CDM"}], "standard_charges": [{"gross_charge": 2425.0, "discounted_cash": 1818.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP MONITOR CARD CONFIRM RX", "code_information": [{"code": "C1764", "type": "HCPCS"}, {"code": "4000363", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 42450.0, "discounted_cash": 31837.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP MONITOR CARDIAC LUXDX", "code_information": [{"code": "C1764", "type": "HCPCS"}, {"code": "4000322", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 50088.0, "discounted_cash": 37566.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP MTP CARTILAG CARTIVA", "code_information": [{"code": "L8641", "type": "HCPCS"}, {"code": "4012303", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 50184.0, "discounted_cash": 37638.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP NAIL CAP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132946", "type": "CDM"}], "standard_charges": [{"gross_charge": 3369.0, "discounted_cash": 2526.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP NAIL FIBULAR", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132611", "type": "CDM"}], "standard_charges": [{"gross_charge": 25549.0, "discounted_cash": 19161.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP NAIL LOCKING LNG", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132920", "type": "CDM"}], "standard_charges": [{"gross_charge": 18543.0, "discounted_cash": 13907.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP NAIL TROCHANTER", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132927", "type": "CDM"}], "standard_charges": [{"gross_charge": 14753.0, "discounted_cash": 11064.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP NASAL LATERA ABSORB", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8174865", "type": "CDM"}], "standard_charges": [{"gross_charge": 15064.0, "discounted_cash": 11298.0, "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": 204694.0, "discounted_cash": 153520.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP NSTIM SPINAL ALGOVITA", "code_information": [{"code": "C1820", "type": "HCPCS"}, {"code": "4008508", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 185010.0, "discounted_cash": 138757.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP NSTM ELEC ARRAY", "code_information": [{"code": "4913650", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 51027.0, "discounted_cash": 38270.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP OFFSET ADAPTER", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137579", "type": "CDM"}], "standard_charges": [{"gross_charge": 6185.0, "discounted_cash": 4638.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP OR30 DUAL MOBI LINER", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137773", "type": "CDM"}], "standard_charges": [{"gross_charge": 9384.0, "discounted_cash": 7038.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP OR30 DUAL MOBI LINER 42X54", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137753", "type": "CDM"}], "standard_charges": [{"gross_charge": 10702.0, "discounted_cash": 8026.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP OSSEOTI MULTI HL ACET SHLL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137578", "type": "CDM"}], "standard_charges": [{"gross_charge": 25950.0, "discounted_cash": 19462.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PATELLA SUTUREPLATE II", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136476", "type": "CDM"}], "standard_charges": [{"gross_charge": 25549.0, "discounted_cash": 19161.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PEG SMOOTH", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8241459", "type": "CDM"}], "standard_charges": [{"gross_charge": 1892.0, "discounted_cash": 1419.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PEG THREAD/UNTHREADED", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8241458", "type": "CDM"}], "standard_charges": [{"gross_charge": 739.0, "discounted_cash": 554.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PIN HALF LONG", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132943", "type": "CDM"}], "standard_charges": [{"gross_charge": 1472.0, "discounted_cash": 1104.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PIN SNAP-OFF ALL SZS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132606", "type": "CDM"}], "standard_charges": [{"gross_charge": 4174.0, "discounted_cash": 3130.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PINS LATRL INTBDY SEASPINE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132601", "type": "CDM"}], "standard_charges": [{"gross_charge": 547.05, "discounted_cash": 410.29, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PIP STRGHT/BENT DYNANITE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136457", "type": "CDM"}], "standard_charges": [{"gross_charge": 16165.0, "discounted_cash": 12123.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PLATE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8240213", "type": "CDM"}], "standard_charges": [{"gross_charge": 2469.0, "discounted_cash": 1851.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PLATE ANTERIOR SHORELINE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137599", "type": "CDM"}], "standard_charges": [{"gross_charge": 9540.0, "discounted_cash": 7155.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PLATE LCKING COVER REGATTA", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137602", "type": "CDM"}], "standard_charges": [{"gross_charge": 1914.66, "discounted_cash": 1436.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PLATE OFFSET BOOMERANG", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132865", "type": "CDM"}], "standard_charges": [{"gross_charge": 11329.0, "discounted_cash": 8496.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PLATE STRAIGHT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132930", "type": "CDM"}], "standard_charges": [{"gross_charge": 911.0, "discounted_cash": 683.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PLT 2 HOLE LATERAL SEASPNE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132987", "type": "CDM"}], "standard_charges": [{"gross_charge": 27352.3, "discounted_cash": 20514.23, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PLT ORBITAL FLOOR", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8152015", "type": "CDM"}], "standard_charges": [{"gross_charge": 9729.0, "discounted_cash": 7296.75, "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": 7919.0, "discounted_cash": 5939.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PLUG FISTULA ENTERCT", "code_information": [{"code": "C1763", "type": "HCPCS"}, {"code": "4028498", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 28497.0, "discounted_cash": 21372.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PMP CNTRL UR SPHINE", "code_information": [{"code": "C1815", "type": "HCPCS"}, {"code": "8176120", "type": "CDM"}], "standard_charges": [{"gross_charge": 34613.0, "discounted_cash": 25959.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PMP INF PROGRAMMABLE", "code_information": [{"code": "C1772", "type": "HCPCS"}, {"code": "8240185", "type": "CDM"}], "standard_charges": [{"gross_charge": 38096.0, "discounted_cash": 28572.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PMP INF SYNCHROMED", "code_information": [{"code": "C1772", "type": "HCPCS"}, {"code": "8241468", "type": "CDM"}], "standard_charges": [{"gross_charge": 95541.0, "discounted_cash": 71655.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PMP INF SYNCHROMED P", "code_information": [{"code": "C1772", "type": "HCPCS"}, {"code": "8241474", "type": "CDM"}], "standard_charges": [{"gross_charge": 86916.0, "discounted_cash": 65187.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PMP INF TEMP N-PRGRM", "code_information": [{"code": "C2626", "type": "HCPCS"}, {"code": "8240183", "type": "CDM"}], "standard_charges": [{"gross_charge": 1600.0, "discounted_cash": 1200.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PORT INDWELLING", "code_information": [{"code": "C1788", "type": "HCPCS"}, {"code": "8240201", "type": "CDM"}], "standard_charges": [{"gross_charge": 1989.0, "discounted_cash": 1491.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PORT POWER BARD", "code_information": [{"code": "C1788", "type": "HCPCS"}, {"code": "8241475", "type": "CDM"}], "standard_charges": [{"gross_charge": 2564.0, "discounted_cash": 1923.0, "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": 7220.0, "discounted_cash": 5415.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP POUCH PMP PAIN", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "4023009", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 950.0, "discounted_cash": 712.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PROS URINARY SPHINCT", "code_information": [{"code": "C1815", "type": "HCPCS"}, {"code": "8240365", "type": "CDM"}], "standard_charges": [{"gross_charge": 10886.0, "discounted_cash": 8164.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PROSTHESIS BREAST", "code_information": [{"code": "C1789", "type": "HCPCS"}, {"code": "8240202", "type": "CDM"}], "standard_charges": [{"gross_charge": 3285.0, "discounted_cash": 2463.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP RCRD CRD LINQ II", "code_information": [{"code": "C1764", "type": "HCPCS"}, {"code": "4000319", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 39624.0, "discounted_cash": 29718.0, "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": 35156.0, "discounted_cash": 26367.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP RD STABLZTN PHALANGE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132928", "type": "CDM"}], "standard_charges": [{"gross_charge": 4719.0, "discounted_cash": 3539.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP RECRDR CARD CONFIRM", "code_information": [{"code": "C1764", "type": "HCPCS"}, {"code": "4000365", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 38050.0, "discounted_cash": 28537.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP RECRDR CARD REVEAL", "code_information": [{"code": "C1764", "type": "HCPCS"}, {"code": "8240372", "type": "CDM"}], "standard_charges": [{"gross_charge": 32996.0, "discounted_cash": 24747.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP RESER 65ML", "code_information": [{"code": "C1813", "type": "HCPCS"}, {"code": "8155030", "type": "CDM"}], "standard_charges": [{"gross_charge": 13562.0, "discounted_cash": 10171.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP ROD UNID EXP COCR", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137657", "type": "CDM"}], "standard_charges": [{"gross_charge": 17888.0, "discounted_cash": 13416.0, "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": 512.0, "discounted_cash": 384.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP SCREW SNAP-OFF ALL SZS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132663", "type": "CDM"}], "standard_charges": [{"gross_charge": 1409.0, "discounted_cash": 1056.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP SCREW SPINAL SOLERA", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136716", "type": "CDM"}], "standard_charges": [{"gross_charge": 12522.0, "discounted_cash": 9391.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP SCREW TAP GLOBUS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132664", "type": "CDM"}], "standard_charges": [{"gross_charge": 1580.0, "discounted_cash": 1185.0, "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": 5085.0, "discounted_cash": 3813.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP SCRW COVER REFLECT THRD SN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136407", "type": "CDM"}], "standard_charges": [{"gross_charge": 700.0, "discounted_cash": 525.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP SCRW WASH SI-LOK SELECT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136408", "type": "CDM"}], "standard_charges": [{"gross_charge": 22179.0, "discounted_cash": 16634.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP SECNDRY FX W/BIOCMP SW LCK", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4010683", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12703.0, "discounted_cash": 9527.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP SEPTAL OCCLUDER", "code_information": [{"code": "C1817", "type": "HCPCS"}, {"code": "8241489", "type": "CDM"}], "standard_charges": [{"gross_charge": 87211.0, "discounted_cash": 65408.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP SHEET MEDPOR ULTHIN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4028506", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2220.0, "discounted_cash": 1665.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP SHLD ADAPT VERSA COMP STND", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137758", "type": "CDM"}], "standard_charges": [{"gross_charge": 1777.0, "discounted_cash": 1332.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP SHOULDER REV LINER", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8136719", "type": "CDM"}], "standard_charges": [{"gross_charge": 4412.0, "discounted_cash": 3309.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP SINUS TARSI", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8132945", "type": "CDM"}], "standard_charges": [{"gross_charge": 9629.0, "discounted_cash": 7221.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP SLV FEMORAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132935", "type": "CDM"}], "standard_charges": [{"gross_charge": 25176.0, "discounted_cash": 18882.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP SPACER AGX COALITION RDO7D", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8137867", "type": "CDM"}], "standard_charges": [{"gross_charge": 10733.0, "discounted_cash": 8049.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP SPACER CCX ATEC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137862", "type": "CDM"}], "standard_charges": [{"gross_charge": 37518.0, "discounted_cash": 28138.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP SPACER CERVICAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137739", "type": "CDM"}], "standard_charges": [{"gross_charge": 7464.0, "discounted_cash": 5598.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP SPACER HUMERAL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137860", "type": "CDM"}], "standard_charges": [{"gross_charge": 4180.0, "discounted_cash": 3135.0, "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": 11163.0, "discounted_cash": 8372.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP SPACER RISE-L GLOBUS", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8136425", "type": "CDM"}], "standard_charges": [{"gross_charge": 42652.0, "discounted_cash": 31989.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP SPACER SPINAL SYSTEM", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137008", "type": "CDM"}], "standard_charges": [{"gross_charge": 37915.0, "discounted_cash": 28436.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP SPACER TRANSCND NANO PEEK", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8137868", "type": "CDM"}], "standard_charges": [{"gross_charge": 42582.06, "discounted_cash": 31936.55, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP SPNL SCRW REDUC RELINE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137774", "type": "CDM"}], "standard_charges": [{"gross_charge": 7701.0, "discounted_cash": 5775.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP STEM DISTAL RESTORATN STRT", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137589", "type": "CDM"}], "standard_charges": [{"gross_charge": 27224.0, "discounted_cash": 20418.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP STEM EXTENDER STRYKER", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137735", "type": "CDM"}], "standard_charges": [{"gross_charge": 27553.0, "discounted_cash": 20664.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP STEM FEM FLUTE REG STRYKER", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137742", "type": "CDM"}], "standard_charges": [{"gross_charge": 9167.0, "discounted_cash": 6875.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP STEM FEMOR MODUL SYS STRY", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137716", "type": "CDM"}], "standard_charges": [{"gross_charge": 25444.0, "discounted_cash": 19083.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP SYNTHETIC URINARY1ML", "code_information": [{"code": "L8606", "type": "HCPCS"}, {"code": "8130040", "type": "CDM"}], "standard_charges": [{"gross_charge": 1952.0, "discounted_cash": 1464.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP SYS DIALYSIS ACCESS", "code_information": [{"code": "C1881", "type": "HCPCS"}, {"code": "8240184", "type": "CDM"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP SYS FIXATION KARMA", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137804", "type": "CDM"}], "standard_charges": [{"gross_charge": 15797.0, "discounted_cash": 11847.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP SYS SPEED CAP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136451", "type": "CDM"}], "standard_charges": [{"gross_charge": 24322.0, "discounted_cash": 18241.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP TALAR DOME FLAT CUT CADENC", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137808", "type": "CDM"}], "standard_charges": [{"gross_charge": 58860.0, "discounted_cash": 44145.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP TALAR DOME SULCUS", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137707", "type": "CDM"}], "standard_charges": [{"gross_charge": 39530.0, "discounted_cash": 29647.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP TENDON ACHILLES", "code_information": [{"code": "C1762", "type": "HCPCS"}, {"code": "8132942", "type": "CDM"}], "standard_charges": [{"gross_charge": 16327.0, "discounted_cash": 12245.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP TENDON GRACILIS", "code_information": [{"code": "C1762", "type": "HCPCS"}, {"code": "8137704", "type": "CDM"}], "standard_charges": [{"gross_charge": 32572.0, "discounted_cash": 24429.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP TENDON PERONEUS", "code_information": [{"code": "C1762", "type": "HCPCS"}, {"code": "4023081", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16691.0, "discounted_cash": 12518.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP TENDON SYSTEM QUADLINK", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137778", "type": "CDM"}], "standard_charges": [{"gross_charge": 28105.03, "discounted_cash": 21078.77, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP TENDON TIBIALIS", "code_information": [{"code": "C1762", "type": "HCPCS"}, {"code": "8132948", "type": "CDM"}], "standard_charges": [{"gross_charge": 11810.0, "discounted_cash": 8857.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP TIB HINGE W/ROTATIONL STOP", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137861", "type": "CDM"}], "standard_charges": [{"gross_charge": 54631.0, "discounted_cash": 40973.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP TIB POLY SPACER THCK ELEOS", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8139904", "type": "CDM"}], "standard_charges": [{"gross_charge": 22924.0, "discounted_cash": 17193.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP TIB TRABECULR CONE CNT LRG", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137543", "type": "CDM"}], "standard_charges": [{"gross_charge": 50470.46, "discounted_cash": 37852.85, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP TIBIAL AUGMENT TRIATHLON", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137873", "type": "CDM"}], "standard_charges": [{"gross_charge": 6161.0, "discounted_cash": 4620.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP TIBIAL BASEPLATE SM STRYKR", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137715", "type": "CDM"}], "standard_charges": [{"gross_charge": 30152.0, "discounted_cash": 22614.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP TIBIAL INSERT CUSTOM", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132654", "type": "CDM"}], "standard_charges": [{"gross_charge": 8992.0, "discounted_cash": 6744.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP TIBIAL POLY SPACER ELEOS", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8132671", "type": "CDM"}], "standard_charges": [{"gross_charge": 26364.0, "discounted_cash": 19773.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP TIBIAL PROXIMAL SMALL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8132674", "type": "CDM"}], "standard_charges": [{"gross_charge": 20172.0, "discounted_cash": 15129.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP TIBIAL ROTATING STRYKER", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137711", "type": "CDM"}], "standard_charges": [{"gross_charge": 26985.0, "discounted_cash": 20238.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP TIBIAL SLEEVE HRHK STRYKER", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137712", "type": "CDM"}], "standard_charges": [{"gross_charge": 4688.0, "discounted_cash": 3516.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP TIBL BASEPLT RVS TRIATHLON", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137875", "type": "CDM"}], "standard_charges": [{"gross_charge": 24532.0, "discounted_cash": 18399.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP TIBL TRIATHLON TRITAN CONE", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137709", "type": "CDM"}], "standard_charges": [{"gross_charge": 30061.0, "discounted_cash": 22545.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP TRAY TIBAL STANDARD RT/LT", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8136711", "type": "CDM"}], "standard_charges": [{"gross_charge": 15721.0, "discounted_cash": 11790.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP TROCHANTER PROX FEMUR COMP", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137553", "type": "CDM"}], "standard_charges": [{"gross_charge": 46501.0, "discounted_cash": 34875.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP TUNLD INTRATHCL CATH", "code_information": [{"code": "4912350", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 36176.0, "discounted_cash": 27132.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP URINARY SYN 1ML", "code_information": [{"code": "L8606", "type": "HCPCS"}, {"code": "8241492", "type": "CDM"}], "standard_charges": [{"gross_charge": 2613.0, "discounted_cash": 1959.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP WEDGE", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8152025", "type": "CDM"}], "standard_charges": [{"gross_charge": 19834.0, "discounted_cash": 14875.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP WEDGE FEM DIST HING LEGION", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8132675", "type": "CDM"}], "standard_charges": [{"gross_charge": 12521.0, "discounted_cash": 9390.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP WIRE CALIBRATED", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132607", "type": "CDM"}], "standard_charges": [{"gross_charge": 2862.0, "discounted_cash": 2146.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMPL INTERN FIX SPINE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8152007", "type": "CDM"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMPL ORBITAL", "code_information": [{"code": "L8610", "type": "HCPCS"}, {"code": "8152014", "type": "CDM"}], "standard_charges": [{"gross_charge": 6090.0, "discounted_cash": 4567.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMPL ORBITAL FLOOR", "code_information": [{"code": "L8610", "type": "HCPCS"}, {"code": "8152010", "type": "CDM"}], "standard_charges": [{"gross_charge": 601.0, "discounted_cash": 450.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMPL SLEEVE TYPE", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8152032", "type": "CDM"}], "standard_charges": [{"gross_charge": 1638.0, "discounted_cash": 1228.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMPL SUTURE ANCHOR", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8152038", "type": "CDM"}], "standard_charges": [{"gross_charge": 2903.0, "discounted_cash": 2177.25, "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": 23619.0, "discounted_cash": 17714.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMPLANT/REPLCE INTRATHECAL PMP", "code_information": [{"code": "4912362", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 117147.0, "discounted_cash": 87860.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMPLT SUBQ DEFIB INTEROG", "code_information": [{"code": "93261", "type": "CPT"}, {"code": "4610327", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 1286.0, "discounted_cash": 964.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMRT COMPLEX", "code_information": [{"code": "77386", "type": "CPT"}, {"code": "5107386", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 5350.0, "discounted_cash": 4012.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMRT MLC CONST DESIGN", "code_information": [{"code": "77338", "type": "CPT"}, {"code": "5100022", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 12732.0, "discounted_cash": 9549.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMRT PLAN W DOSE VOLUME", "code_information": [{"code": "77301", "type": "CPT"}, {"code": "5107302", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 29288.0, "discounted_cash": 21966.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMRT SIMPLE", "code_information": [{"code": "77385", "type": "CPT"}, {"code": "5107385", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 5369.0, "discounted_cash": 4026.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IN SITU EA PRB PER SPEC", "code_information": [{"code": "88365", "type": "CPT"}, {"code": "4303520", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 708.0, "discounted_cash": 531.0, "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": 12682.0, "discounted_cash": 9511.5, "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": 4453.0, "discounted_cash": 3339.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INCOBOTULINUMTOXIN A PER 1U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0588", "type": "HCPCS"}, {"code": "5321293", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INCOBOTULINUMTOXIN A PER 1U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0588", "type": "HCPCS"}, {"code": "5321293", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "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": 7925.0, "discounted_cash": 5943.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IND EDUC/TRN 15MIN", "code_information": [{"code": "6402070", "type": "CDM"}], "standard_charges": [{"gross_charge": 189.0, "discounted_cash": 141.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INDAPAMIDE 1.25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305978", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INDAPAMIDE 1.25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305978", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "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": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INDIGOTINDISULFONATE PER1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9220", "type": "HCPCS"}, {"code": "5321230", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INDIGOTINDISULFONATE PER1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9220", "type": "HCPCS"}, {"code": "5321230", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "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": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INDIUM111 WBC DOSE", "code_information": [{"code": "A9570", "type": "HCPCS"}, {"code": "5199570", "type": "CDM"}, {"code": "343", "type": "RC"}], "standard_charges": [{"gross_charge": 23044.0, "discounted_cash": 17283.0, "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": 1189.0, "discounted_cash": 891.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INDOMETHACIN 100MG SUPP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338498", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1674.0, "discounted_cash": 1255.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INDOMETHACIN 100MG SUPP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338498", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1674.0, "discounted_cash": 1255.5, "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": 792.0, "discounted_cash": 594.0, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INDOMETHACIN 50MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306004", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INDOMETHACIN 50MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306004", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INDOMETHACIN 50MG SUPP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338497", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1333.0, "discounted_cash": 999.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INDOMETHACIN 50MG SUPP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338497", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1333.0, "discounted_cash": 999.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INDOMETHACIN 75MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306008", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INDOMETHACIN 75MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306008", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "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": 1065.0, "discounted_cash": 798.75, "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": 101.0, "discounted_cash": 75.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT DRUG SUSCEPT", "code_information": [{"code": "87900", "type": "CPT"}, {"code": "7257909", "type": "CDM"}], "standard_charges": [{"gross_charge": 761.0, "discounted_cash": 570.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT DRUG SUSCEPT/3", "code_information": [{"code": "87900", "type": "CPT"}, {"code": "7257910", "type": "CDM"}], "standard_charges": [{"gross_charge": 323.0, "discounted_cash": 242.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS AMP PRB/11", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "7257624", "type": "CDM"}], "standard_charges": [{"gross_charge": 990.0, "discounted_cash": 742.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS AMP PRB/12", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "7256216", "type": "CDM"}], "standard_charges": [{"gross_charge": 990.0, "discounted_cash": 742.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS AMP PRB/2", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "7256223", "type": "CDM"}], "standard_charges": [{"gross_charge": 990.0, "discounted_cash": 742.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS AMP PRB/20", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "7006313", "type": "CDM"}], "standard_charges": [{"gross_charge": 990.0, "discounted_cash": 742.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS AMP PRB/26", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "7257797", "type": "CDM"}], "standard_charges": [{"gross_charge": 365.0, "discounted_cash": 273.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS AMP PRB/30", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "7257782", "type": "CDM"}], "standard_charges": [{"gross_charge": 225.0, "discounted_cash": 168.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS AMP PRB/33", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "7257799", "type": "CDM"}], "standard_charges": [{"gross_charge": 646.0, "discounted_cash": 484.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS AMP PRB/37", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "7257794", "type": "CDM"}], "standard_charges": [{"gross_charge": 990.0, "discounted_cash": 742.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS AMP PRB/39", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "7258783", "type": "CDM"}], "standard_charges": [{"gross_charge": 779.0, "discounted_cash": 584.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS AMP PRB/40", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "7258732", "type": "CDM"}], "standard_charges": [{"gross_charge": 1498.0, "discounted_cash": 1123.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS AMP PRB/43", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "7257802", "type": "CDM"}], "standard_charges": [{"gross_charge": 990.0, "discounted_cash": 742.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS AMP PRB/48", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "7257796", "type": "CDM"}], "standard_charges": [{"gross_charge": 990.0, "discounted_cash": 742.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS AMP PRB/5", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "7258782", "type": "CDM"}], "standard_charges": [{"gross_charge": 432.0, "discounted_cash": 324.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS AMP PRB/7", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "7257780", "type": "CDM"}], "standard_charges": [{"gross_charge": 1736.0, "discounted_cash": 1302.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS AMP PRB/8", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "7257810", "type": "CDM"}], "standard_charges": [{"gross_charge": 495.0, "discounted_cash": 371.25, "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": 197.0, "discounted_cash": 147.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS DIR OPT/13", "code_information": [{"code": "87899", "type": "CPT"}, {"code": "7257893", "type": "CDM"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS DIR OPT/15", "code_information": [{"code": "87899", "type": "CPT"}, {"code": "4107908", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 269.0, "discounted_cash": 201.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS DIR OPT/2", "code_information": [{"code": "87899", "type": "CPT"}, {"code": "4127895", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS DIR OPT/3", "code_information": [{"code": "87899", "type": "CPT"}, {"code": "4127909", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS DIR OPT/8", "code_information": [{"code": "87899", "type": "CPT"}, {"code": "4107911", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 300.0, "discounted_cash": 225.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS QUANT/2", "code_information": [{"code": "87799", "type": "CPT"}, {"code": "7257800", "type": "CDM"}], "standard_charges": [{"gross_charge": 1049.0, "discounted_cash": 786.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS QUANT/4", "code_information": [{"code": "87799", "type": "CPT"}, {"code": "7016234", "type": "CDM"}], "standard_charges": [{"gross_charge": 1161.0, "discounted_cash": 870.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS QUANT/4", "code_information": [{"code": "87799", "type": "CPT"}, {"code": "7257623", "type": "CDM"}], "standard_charges": [{"gross_charge": 1161.0, "discounted_cash": 870.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECTIOUS AGNT NOS IA", "code_information": [{"code": "87449", "type": "CPT"}, {"code": "7257449", "type": "CDM"}], "standard_charges": [{"gross_charge": 481.0, "discounted_cash": 360.75, "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": 197.0, "discounted_cash": 147.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECTIOUS AGNT NOS IA/12", "code_information": [{"code": "87449", "type": "CPT"}, {"code": "4108643", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 208.0, "discounted_cash": 156.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECTIOUS AGNT NOS IA/2", "code_information": [{"code": "87449", "type": "CPT"}, {"code": "4107447", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 204.0, "discounted_cash": 153.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECTIOUS AGNT NOS IA/2", "code_information": [{"code": "87449", "type": "CPT"}, {"code": "4127453", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 143.0, "discounted_cash": 107.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECTIOUS AGNT NOS IA/2", "code_information": [{"code": "87449", "type": "CPT"}, {"code": "7257450", "type": "CDM"}], "standard_charges": [{"gross_charge": 751.0, "discounted_cash": 563.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECTIOUS AGNT NOS IA/4", "code_information": [{"code": "87449", "type": "CPT"}, {"code": "7017454", "type": "CDM"}], "standard_charges": [{"gross_charge": 481.0, "discounted_cash": 360.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECTIOUS AGNT NOS IA/4", "code_information": [{"code": "87449", "type": "CPT"}, {"code": "7258744", "type": "CDM"}], "standard_charges": [{"gross_charge": 871.0, "discounted_cash": 653.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECTIOUS AGNT NOS IA/5", "code_information": [{"code": "87449", "type": "CPT"}, {"code": "7257912", "type": "CDM"}], "standard_charges": [{"gross_charge": 162.0, "discounted_cash": 121.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECTIOUS AGNT NOS IA/9", "code_information": [{"code": "87449", "type": "CPT"}, {"code": "4127448", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFERIOR VENACAVAGRAM", "code_information": [{"code": "75825", "type": "CPT"}, {"code": "4615826", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 10775.0, "discounted_cash": 8081.25, "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": 9680.0, "discounted_cash": 7260.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLIXIMAB PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1745", "type": "HCPCS"}, {"code": "5321356", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 759.0, "discounted_cash": 569.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLIXIMAB PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1745", "type": "HCPCS"}, {"code": "5321356", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 759.0, "discounted_cash": 569.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLIXIMAB-ABDA PER 10MG IJ", "code_information": [{"code": "Q5104", "type": "HCPCS"}, {"code": "5321288", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 428.0, "discounted_cash": 321.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLIXIMAB-ABDA PER 10MG IJ", "code_information": [{"code": "Q5104", "type": "HCPCS"}, {"code": "5321288", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 428.0, "discounted_cash": 321.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLIXIMAB-DYYB PER 10MG IJ", "code_information": [{"code": "Q5103", "type": "HCPCS"}, {"code": "5321298", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 766.0, "discounted_cash": 574.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLIXIMAB-DYYB PER 10MG IJ", "code_information": [{"code": "Q5103", "type": "HCPCS"}, {"code": "5321298", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 766.0, "discounted_cash": 574.5, "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": 829.0, "discounted_cash": 621.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA A/B IA", "code_information": [{"code": "87400", "type": "CPT"}, {"code": "4123517", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "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": 829.0, "discounted_cash": 621.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA A/B IA/2", "code_information": [{"code": "87400", "type": "CPT"}, {"code": "4127400", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA VACC ADMIN", "code_information": [{"code": "G0008", "type": "HCPCS"}, {"code": "3914110", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 194.0, "discounted_cash": 145.5, "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": 154.0, "discounted_cash": 115.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA VACC ADMIN", "code_information": [{"code": "G0008", "type": "HCPCS"}, {"code": "6110008", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 194.0, "discounted_cash": 145.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA VACC ADMIN", "code_information": [{"code": "G0008", "type": "HCPCS"}, {"code": "6120008", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 282.0, "discounted_cash": 211.5, "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": 258.0, "discounted_cash": 193.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA VACC ADMIN", "code_information": [{"code": "G0008", "type": "HCPCS"}, {"code": "6290008", "type": "CDM"}], "standard_charges": [{"gross_charge": 230.0, "discounted_cash": 172.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA VIRUS AB/2", "code_information": [{"code": "86710", "type": "CPT"}, {"code": "7006207", "type": "CDM"}], "standard_charges": [{"gross_charge": 352.0, "discounted_cash": 264.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA VIRUS AB/2", "code_information": [{"code": "86710", "type": "CPT"}, {"code": "7256207", "type": "CDM"}], "standard_charges": [{"gross_charge": 352.0, "discounted_cash": 264.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA VIRUS AB/3", "code_information": [{"code": "86710", "type": "CPT"}, {"code": "7006208", "type": "CDM"}], "standard_charges": [{"gross_charge": 352.0, "discounted_cash": 264.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA VIRUS AB/3", "code_information": [{"code": "86710", "type": "CPT"}, {"code": "7256208", "type": "CDM"}], "standard_charges": [{"gross_charge": 352.0, "discounted_cash": 264.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUX PROTEIOS GROWTH FACTOR", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132655", "type": "CDM"}], "standard_charges": [{"gross_charge": 31989.0, "discounted_cash": 23991.75, "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": 83.0, "discounted_cash": 62.25, "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": 83.0, "discounted_cash": 62.25, "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": 82.0, "discounted_cash": 61.5, "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": 82.0, "discounted_cash": 61.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INHIBIN A", "code_information": [{"code": "86336", "type": "CPT"}, {"code": "7256354", "type": "CDM"}], "standard_charges": [{"gross_charge": 339.0, "discounted_cash": 254.25, "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": 2446.0, "discounted_cash": 1834.5, "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": 2197.0, "discounted_cash": 1647.75, "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": 2446.0, "discounted_cash": 1834.5, "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": 652.0, "discounted_cash": 489.0, "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": 605.0, "discounted_cash": 453.75, "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": 823.0, "discounted_cash": 617.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ ADD SEQUENTL IVP", "code_information": [{"code": "96375", "type": "CPT"}, {"code": "6110775", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 823.0, "discounted_cash": 617.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ ADD SEQUENTL IVP", "code_information": [{"code": "96375", "type": "CPT"}, {"code": "6120775", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 255.0, "discounted_cash": 191.25, "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": 823.0, "discounted_cash": 617.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ ADD SEQUENTL IVP", "code_information": [{"code": "96375", "type": "CPT"}, {"code": "6290775", "type": "CDM"}], "standard_charges": [{"gross_charge": 668.0, "discounted_cash": 501.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ ADD SEQUENTL IVP", "code_information": [{"code": "96375", "type": "CPT"}, {"code": "6920775", "type": "CDM"}], "standard_charges": [{"gross_charge": 725.0, "discounted_cash": 543.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ AIR/CM PERITNL CAV", "code_information": [{"code": "4917690", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2458.0, "discounted_cash": 1843.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ ANESTH LUMB/CAUD SGL", "code_information": [{"code": "4912315", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4979.0, "discounted_cash": 3734.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ ANESTH OCCIPTL NERVE", "code_information": [{"code": "4914405", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1797.0, "discounted_cash": 1347.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ BLADDER RETRO UR", "code_information": [{"code": "4907620", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2476.0, "discounted_cash": 1857.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ CELIAC PLEXUS NRV", "code_information": [{"code": "5057605", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6552.0, "discounted_cash": 4914.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ CHEMO ADD DRUG IVP", "code_information": [{"code": "96411", "type": "CPT"}, {"code": "6926411", "type": "CDM"}], "standard_charges": [{"gross_charge": 784.0, "discounted_cash": 588.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ CHEMO INIT DRUG IVP", "code_information": [{"code": "96409", "type": "CPT"}, {"code": "6926409", "type": "CDM"}], "standard_charges": [{"gross_charge": 784.0, "discounted_cash": 588.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ CM EVAL GJTUBE", "code_information": [{"code": "4909468", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2087.0, "discounted_cash": 1565.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ CM EVAL GJTUBE", "code_information": [{"code": "4919468", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2324.0, "discounted_cash": 1743.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ CM EVAL GTUBE", "code_information": [{"code": "4909465", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2019.0, "discounted_cash": 1514.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ CM EVAL GTUBE", "code_information": [{"code": "4919465", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2441.0, "discounted_cash": 1830.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ ELBOW ARTHROGRAM", "code_information": [{"code": "5117099", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 487.0, "discounted_cash": 365.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ EPID BLD PATCH", "code_information": [{"code": "62273", "type": "CPT"}, {"code": "6132273", "type": "CDM"}, {"code": "983", "type": "RC"}], "standard_charges": [{"gross_charge": 4106.0, "discounted_cash": 3079.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ EPID CERV/THORC", "code_information": [{"code": "4912298", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4253.0, "discounted_cash": 3189.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ EPID LUMB/CAUD", "code_information": [{"code": "4900403", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6028.0, "discounted_cash": 4521.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ EPID LUMB/CAUD", "code_information": [{"code": "4910404", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4012.0, "discounted_cash": 3009.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ EVAL PREV PV SHUNT", "code_information": [{"code": "4919427", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2040.0, "discounted_cash": 1530.0, "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": 921.0, "discounted_cash": 690.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ F/CYSTO OR VCUG", "code_information": [{"code": "5011600", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 792.0, "discounted_cash": 594.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ F/CYSTO OR VCUG", "code_information": [{"code": "5051600", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 801.0, "discounted_cash": 600.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ FOR SIALOGRAPHY", "code_information": [{"code": "4907695", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1230.0, "discounted_cash": 922.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ GALACTO/DUCTO PROC", "code_information": [{"code": "3071001", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 239.0, "discounted_cash": 179.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ HIP ARTHRO W/O ANES", "code_information": [{"code": "4907650", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1644.0, "discounted_cash": 1233.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ HIP ARTHRO W/O ANES", "code_information": [{"code": "5017650", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1701.0, "discounted_cash": 1275.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ HIP ARTHRO W/O ANES", "code_information": [{"code": "5117095", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1644.0, "discounted_cash": 1233.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ HIP ARTHROGRM W/ANES", "code_information": [{"code": "4907655", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1644.0, "discounted_cash": 1233.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ LUMB/CAUD EA ADD LVL", "code_information": [{"code": "4912316", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3045.0, "discounted_cash": 2283.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ LYMPHANGIOGRAPHY", "code_information": [{"code": "4917680", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1764.0, "discounted_cash": 1323.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ MYELOGRAM LUMBAR", "code_information": [{"code": "4907685", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2616.0, "discounted_cash": 1962.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ MYELOGRAM LUMBAR", "code_information": [{"code": "4917685", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2616.0, "discounted_cash": 1962.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ NEPHROGRM EXIS ACC", "code_information": [{"code": "4917665", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 937.0, "discounted_cash": 702.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ NEPHROSTOGRAM", "code_information": [{"code": "4910430", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6692.0, "discounted_cash": 5019.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ PERC EXT PSEUDANYSM", "code_information": [{"code": "4616002", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2165.0, "discounted_cash": 1623.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ PERC EXT PSEUDANYSM", "code_information": [{"code": "4916002", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1879.0, "discounted_cash": 1409.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ PERC EXT PSEUDANYSM", "code_information": [{"code": "5066002", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2165.0, "discounted_cash": 1623.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ PROC KNEE ARTHROGRM", "code_information": [{"code": "4907670", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 601.0, "discounted_cash": 450.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ PROC KNEE ARTHROGRM", "code_information": [{"code": "5017670", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 646.0, "discounted_cash": 484.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ PROC KNEE ARTHROGRM", "code_information": [{"code": "5117094", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 686.0, "discounted_cash": 514.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ SHOULDER ARTHROGRAM", "code_information": [{"code": "4907700", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 670.0, "discounted_cash": 502.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ SHOULDER ARTHROGRAM", "code_information": [{"code": "5017700", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1016.0, "discounted_cash": 762.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ SHOULDER ARTHROGRAM", "code_information": [{"code": "5117093", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 849.0, "discounted_cash": 636.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ SINUS TRACT DIAGNSTC", "code_information": [{"code": "4907705", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 433.0, "discounted_cash": 324.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ SINUS TRACT DIAGNSTC", "code_information": [{"code": "4917705", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 497.0, "discounted_cash": 372.75, "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": 633.0, "discounted_cash": 474.75, "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": 633.0, "discounted_cash": 474.75, "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": 724.0, "discounted_cash": 543.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ T/P/D IVP SAME SUBST", "code_information": [{"code": "96376", "type": "CPT"}, {"code": "6110776", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 798.0, "discounted_cash": 598.5, "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": 760.0, "discounted_cash": 570.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ T/P/D IVP SAME SUBST", "code_information": [{"code": "96376", "type": "CPT"}, {"code": "6290776", "type": "CDM"}], "standard_charges": [{"gross_charge": 668.0, "discounted_cash": 501.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ T/P/D IVP SAME SUBST", "code_information": [{"code": "96376", "type": "CPT"}, {"code": "6920776", "type": "CDM"}], "standard_charges": [{"gross_charge": 725.0, "discounted_cash": 543.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ TX PRPH/DX IVP INT", "code_information": [{"code": "96374", "type": "CPT"}, {"code": "6120774", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 397.0, "discounted_cash": 297.75, "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": 386.0, "discounted_cash": 289.5, "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": 283.0, "discounted_cash": 212.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ TX/PROPH/DX SQ/IM", "code_information": [{"code": "96372", "type": "CPT"}, {"code": "3910782", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 330.0, "discounted_cash": 247.5, "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": 374.0, "discounted_cash": 280.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ TX/PROPH/DX SQ/IM", "code_information": [{"code": "96372", "type": "CPT"}, {"code": "6110782", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 374.0, "discounted_cash": 280.5, "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": 399.0, "discounted_cash": 299.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ TX/PROPH/DX SQ/IM", "code_information": [{"code": "96372", "type": "CPT"}, {"code": "6290782", "type": "CDM"}], "standard_charges": [{"gross_charge": 330.0, "discounted_cash": 247.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ TX/PROPH/DX SQ/IM", "code_information": [{"code": "96372", "type": "CPT"}, {"code": "6920782", "type": "CDM"}], "standard_charges": [{"gross_charge": 330.0, "discounted_cash": 247.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ TX/PROPH/DX/SQ/IM", "code_information": [{"code": "96372", "type": "CPT"}, {"code": "6120772", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 374.0, "discounted_cash": 280.5, "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": 633.0, "discounted_cash": 474.75, "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": 690.0, "discounted_cash": 517.5, "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": 823.0, "discounted_cash": 617.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ TX/PRPH/DX IVP INT", "code_information": [{"code": "96374", "type": "CPT"}, {"code": "6110774", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 823.0, "discounted_cash": 617.25, "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": 823.0, "discounted_cash": 617.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ TX/PRPH/DX IVP INT", "code_information": [{"code": "96374", "type": "CPT"}, {"code": "6290774", "type": "CDM"}], "standard_charges": [{"gross_charge": 725.0, "discounted_cash": 543.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ TX/PRPH/DX IVP INT", "code_information": [{"code": "96374", "type": "CPT"}, {"code": "6920774", "type": "CDM"}], "standard_charges": [{"gross_charge": 725.0, "discounted_cash": 543.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ URETER/ILEAL CONDUIT", "code_information": [{"code": "4907735", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2527.0, "discounted_cash": 1895.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ VENOGRPHY EXTRMTY", "code_information": [{"code": "4617690", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1335.0, "discounted_cash": 1001.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ VENOGRPHY EXTRMTY", "code_information": [{"code": "4906004", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1488.0, "discounted_cash": 1116.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ VENOGRPHY EXTRMTY", "code_information": [{"code": "4916005", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1172.0, "discounted_cash": 879.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ WRIST ARTHROGRAM", "code_information": [{"code": "4907745", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 807.0, "discounted_cash": 605.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ WRIST ARTHROGRAM", "code_information": [{"code": "5017745", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 856.0, "discounted_cash": 642.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ WRIST ARTHROGRAM", "code_information": [{"code": "5117091", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 856.0, "discounted_cash": 642.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ&CATH HYSTER/SONOHYST", "code_information": [{"code": "4907740", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2974.0, "discounted_cash": 2230.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ&CATH HYSTER/SONOHYST", "code_information": [{"code": "5067740", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2969.0, "discounted_cash": 2226.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ+INDWL CATH LUM/SAC", "code_information": [{"code": "4912327", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6645.0, "discounted_cash": 4983.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJECT PROC SACRO JNT", "code_information": [{"code": "4917096", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2339.0, "discounted_cash": 1754.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJECT SPINE DISK LMBR", "code_information": [{"code": "4907715", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1850.0, "discounted_cash": 1387.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJECT SPINE DISK LMBR", "code_information": [{"code": "4917715", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1703.0, "discounted_cash": 1277.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJECTABLE BULK AGENT", "code_information": [{"code": "L8606", "type": "HCPCS"}, {"code": "8182614", "type": "CDM"}], "standard_charges": [{"gross_charge": 1989.0, "discounted_cash": 1491.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INNOVAMATRIX ECM 2CMX2CM PSC", "code_information": [{"code": "A2001", "type": "HCPCS"}, {"code": "4028523", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 691.0, "discounted_cash": 518.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INNOVAMATRIX ECM 2CMX2CM PSC", "code_information": [{"code": "A2001", "type": "HCPCS"}, {"code": "4028523", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 691.0, "discounted_cash": 518.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INNOVAMATRIX ECM 4CMX4CM PSC", "code_information": [{"code": "A2001", "type": "HCPCS"}, {"code": "4028524", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 380.0, "discounted_cash": 285.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INNOVAMATRIX ECM 4CMX4CM PSC", "code_information": [{"code": "A2001", "type": "HCPCS"}, {"code": "4028524", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 380.0, "discounted_cash": 285.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INNOVAMATRIX ECM 5CM X 5CM PSC", "code_information": [{"code": "A2001", "type": "HCPCS"}, {"code": "4028521", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 313.0, "discounted_cash": 234.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INNOVAMATRIX ECM 5CM X 5CM PSC", "code_information": [{"code": "A2001", "type": "HCPCS"}, {"code": "4028521", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 313.0, "discounted_cash": 234.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INNOVAMATRIX PD 50SQCM PSC", "code_information": [{"code": "A2001", "type": "HCPCS"}, {"code": "4028522", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INNOVAMATRIX PD 50SQCM PSC", "code_information": [{"code": "A2001", "type": "HCPCS"}, {"code": "4028522", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INS ANALG ASPR70/30 10ML", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321443", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 921.0, "discounted_cash": 690.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INS ANALG ASPR70/30 10ML", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321443", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 921.0, "discounted_cash": 690.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INS ANALG LISP50/50 DOSE", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1815", "type": "HCPCS"}, {"code": "5321273", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INS ANALG LISP50/50 DOSE", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1815", "type": "HCPCS"}, {"code": "5321273", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "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": 2206.0, "discounted_cash": 1654.5, "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": 2206.0, "discounted_cash": 1654.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INS ANALOG ASP 70/30DOSE", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321441", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS ANALOG ASP 70/30DOSE", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321441", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS ANALOG ASPAR 10ML", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321446", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1515.0, "discounted_cash": 1136.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INS ANALOG ASPAR 10ML", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321446", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1515.0, "discounted_cash": 1136.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INS ANALOG ASPAR 3ML", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321448", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 379.0, "discounted_cash": 284.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INS ANALOG ASPAR 3ML", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321448", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 379.0, "discounted_cash": 284.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INS ANALOG ASPAR DOSE", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321445", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 107.0, "discounted_cash": 80.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INS ANALOG ASPAR DOSE", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321445", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 107.0, "discounted_cash": 80.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INS ANALOG ASPR70/30 3ML", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321444", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 327.0, "discounted_cash": 245.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INS ANALOG ASPR70/30 3ML", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321444", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 327.0, "discounted_cash": 245.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INS ANALOG LISPRO 10ML", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321453", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 848.0, "discounted_cash": 636.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS ANALOG LISPRO 10ML", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321453", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 848.0, "discounted_cash": 636.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS ANALOG LISPRO 3ML", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321399", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 327.0, "discounted_cash": 245.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INS ANALOG LISPRO 3ML", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321399", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 327.0, "discounted_cash": 245.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INS ANALOG LISPRO DOSE", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321454", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 284.0, "discounted_cash": 213.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS ANALOG LISPRO DOSE", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321454", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 284.0, "discounted_cash": 213.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INS ASPART PER 5U PFS IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1815", "type": "HCPCS"}, {"code": "5321257", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INS ASPART PER 5U PFS IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1815", "type": "HCPCS"}, {"code": "5321257", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INS ASPR 70/30 5U PFS IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1815", "type": "HCPCS"}, {"code": "5321268", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INS ASPR 70/30 5U PFS IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1815", "type": "HCPCS"}, {"code": "5321268", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "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": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INS BEAR DL CMPRT CONFORMIS CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013320", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2648.0, "discounted_cash": 1986.0, "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": 31526.0, "discounted_cash": 23644.5, "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": 18428.0, "discounted_cash": 13821.0, "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": 31526.0, "discounted_cash": 23644.5, "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": 13691.0, "discounted_cash": 10268.25, "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": 16188.0, "discounted_cash": 12141.0, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INS DETEMIR 10ML", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321440", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 995.0, "discounted_cash": 746.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INS DETEMIR 10ML", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321440", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 995.0, "discounted_cash": 746.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INS DETEMIR PEN 3ML", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321438", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 467.0, "discounted_cash": 350.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INS DETEMIR PEN 3ML", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321438", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 467.0, "discounted_cash": 350.25, "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": 13.0, "discounted_cash": 9.75, "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": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INS DETEMR PER 5U PFS IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1815", "type": "HCPCS"}, {"code": "5321259", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INS DETEMR PER 5U PFS IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1815", "type": "HCPCS"}, {"code": "5321259", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INS ENDOVA VENACAVA FILT", "code_information": [{"code": "4617191", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 32078.0, "discounted_cash": 24058.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INS ENDOVA VENACAVA FILT", "code_information": [{"code": "4917191", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 31705.0, "discounted_cash": 23778.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "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": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INS GLARGINE 10ML", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321407", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1242.0, "discounted_cash": 931.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INS GLARGINE 10ML", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321407", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1242.0, "discounted_cash": 931.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INS GLARGINE DOSE", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321408", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INS GLARGINE DOSE", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321408", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "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": 3.0, "discounted_cash": 2.25, "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": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INS H REG 500U 20ML", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321384", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3332.0, "discounted_cash": 2499.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS H REG 500U 20ML", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321384", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 3332.0, "discounted_cash": 2499.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS HUM 50/50 10ML", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321385", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 665.0, "discounted_cash": 498.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INS HUM 50/50 10ML", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321385", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 665.0, "discounted_cash": 498.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INS HUM 70/30 10ML", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321456", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 665.0, "discounted_cash": 498.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INS HUM 70/30 10ML", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321456", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 665.0, "discounted_cash": 498.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INS HUM 70/30 3ML VL IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1815", "type": "HCPCS"}, {"code": "5321499", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 348.0, "discounted_cash": 261.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS HUM 70/30 3ML VL IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1815", "type": "HCPCS"}, {"code": "5321499", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 348.0, "discounted_cash": 261.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS HUM 70/30 DOSE", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321457", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS HUM 70/30 DOSE", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321457", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS HUM LENTE 10ML", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321458", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 665.0, "discounted_cash": 498.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INS HUM LENTE 10ML", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321458", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 665.0, "discounted_cash": 498.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INS HUM NPH 10ML", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321461", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 665.0, "discounted_cash": 498.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INS HUM NPH 10ML", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321461", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 665.0, "discounted_cash": 498.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INS HUM NPH DOSE", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321462", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS HUM NPH DOSE", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321462", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS HUM REG 10ML", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321450", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 665.0, "discounted_cash": 498.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INS HUM REG 10ML", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321450", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 665.0, "discounted_cash": 498.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INS HUM REG DOSE", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321451", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS HUM REG DOSE", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321451", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS HUM ULTRALENTE 10ML", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321463", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 665.0, "discounted_cash": 498.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INS HUM ULTRALENTE 10ML", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321463", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 665.0, "discounted_cash": 498.75, "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": 13.0, "discounted_cash": 9.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "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": 14.0, "discounted_cash": 10.5, "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": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INS LNR BEAR HUM VITA E ZIM CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012972", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16953.0, "discounted_cash": 12714.75, "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": 19533.0, "discounted_cash": 14649.75, "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": 3.0, "discounted_cash": 2.25, "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": 3.0, "discounted_cash": 2.25, "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": 3.0, "discounted_cash": 2.25, "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": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INS POLY INFNTY EVRLST CRSSLK", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012683", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 23340.0, "discounted_cash": 17505.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS REDO SPINE NRST GEN", "code_information": [{"code": "4913685", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 294876.0, "discounted_cash": 221157.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS REG BF/PK DOSE", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321426", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS REG BF/PK DOSE", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321426", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "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": 4.0, "discounted_cash": 3.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INS TEMP BLAD CTH COMPLX", "code_information": [{"code": "4911703", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1004.0, "discounted_cash": 753.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS TIB PLY INFNTY BIOFM 3DSZ3", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012681", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 67130.0, "discounted_cash": 50347.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INS TUNN INTRAPER CATH", "code_information": [{"code": "4919418", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 44145.0, "discounted_cash": 33108.75, "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": 19386.0, "discounted_cash": 14539.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INS/BEAR TIB MRHK STRYKR 20MM", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012062", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10427.0, "discounted_cash": 7820.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INS/BR PLY HGH CRSLK CRIN CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013217", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9203.0, "discounted_cash": 6902.25, "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": 20835.0, "discounted_cash": 15626.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INS/PMGEN W/EXISDUALLDS", "code_information": [{"code": "4612505", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 17041.0, "discounted_cash": 12780.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INS/RPL PM W/TRNSV LD AT", "code_information": [{"code": "4613206", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 18900.0, "discounted_cash": 14175.0, "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": 18081.0, "discounted_cash": 13560.75, "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": 20882.0, "discounted_cash": 15661.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INSERT HUM LNR BEAR EXACT CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012841", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9354.0, "discounted_cash": 7015.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INSERT HUM LNR BEAR ZIMMER CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012937", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8476.0, "discounted_cash": 6357.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INSERT KNEE REVISION SN CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012883", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 17082.0, "discounted_cash": 12811.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INSERT KNEE TS REV STRYKR CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013109", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 17940.0, "discounted_cash": 13455.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INSERT POLY EVERLAST ALL SZS", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137744", "type": "CDM"}], "standard_charges": [{"gross_charge": 23340.0, "discounted_cash": 17505.0, "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": 1445.0, "discounted_cash": 1083.75, "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": 1445.0, "discounted_cash": 1083.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INSERT THORACOSTMY TUBE", "code_information": [{"code": "4917772", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3270.0, "discounted_cash": 2452.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INSERT THORACOSTMY TUBE", "code_information": [{"code": "5057576", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7101.0, "discounted_cash": 5325.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INSERT TIBIAL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137720", "type": "CDM"}], "standard_charges": [{"gross_charge": 19904.0, "discounted_cash": 14928.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INSIT E ADD PRB CMP ASST", "code_information": [{"code": "88373", "type": "CPT"}, {"code": "4308373", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 1682.0, "discounted_cash": 1261.5, "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": 1682.0, "discounted_cash": 1261.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INSITU ADD PROBE MANUAL", "code_information": [{"code": "88369", "type": "CPT"}, {"code": "4308391", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 1320.0, "discounted_cash": 990.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INSITU EA ADD SNGL PROBE", "code_information": [{"code": "88364", "type": "CPT"}, {"code": "4308389", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 708.0, "discounted_cash": 531.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INSITU EA ADD SNGL PROBE", "code_information": [{"code": "88364", "type": "CPT"}, {"code": "7058364", "type": "CDM"}], "standard_charges": [{"gross_charge": 730.0, "discounted_cash": 547.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INSITU EA MULTIPLEX STN", "code_information": [{"code": "88366", "type": "CPT"}, {"code": "4308370", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 858.0, "discounted_cash": 643.5, "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": 21042.0, "discounted_cash": 15781.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT BEAR PLY CNVNT HGH SN CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012909", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8540.0, "discounted_cash": 6405.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT BEAR TOTAL CONFORMIS CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013321", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4299.0, "discounted_cash": 3224.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT BILI DRAIN EXT", "code_information": [{"code": "4917760", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2950.0, "discounted_cash": 2212.5, "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": 30113.0, "discounted_cash": 22584.75, "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": 33812.0, "discounted_cash": 25359.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT HUM LINR BEAR STRYK CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013025", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 14352.0, "discounted_cash": 10764.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT HUM LNR BEARN TORNIER CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013507", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11135.0, "discounted_cash": 8351.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT HUM SPACR/TRY TORNIER CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013509", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 17914.0, "discounted_cash": 13435.5, "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": 16548.0, "discounted_cash": 12411.0, "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": 788.0, "discounted_cash": 591.0, "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": 6022.0, "discounted_cash": 4516.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT NONTUNNL CV CTH 5>", "code_information": [{"code": "4616556", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2920.0, "discounted_cash": 2190.0, "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": 3351.0, "discounted_cash": 2513.25, "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": 8466.0, "discounted_cash": 6349.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT PICC W/IMG 5+YR", "code_information": [{"code": "4916573", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7974.0, "discounted_cash": 5980.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT PICC W/IMG 5+YR", "code_information": [{"code": "6296573", "type": "CDM"}], "standard_charges": [{"gross_charge": 8466.0, "discounted_cash": 6349.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT PULSE GEN MULT LDS", "code_information": [{"code": "4613217", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 165878.0, "discounted_cash": 124408.5, "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": 73601.0, "discounted_cash": 55200.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT TNL CV CTH5>WO PMP", "code_information": [{"code": "4616558", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 13712.0, "discounted_cash": 10284.0, "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": 12319.0, "discounted_cash": 9239.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT TRAN ELCTRD DUAL", "code_information": [{"code": "4612507", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 33400.0, "discounted_cash": 25050.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT TRAN ELCTRD SNGL", "code_information": [{"code": "4612510", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 13336.0, "discounted_cash": 10002.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT TUNLD PLEURAL CATH", "code_information": [{"code": "4912019", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 31149.0, "discounted_cash": 23361.75, "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": 28204.0, "discounted_cash": 21153.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT UTERN TNDS/VAG OVD", "code_information": [{"code": "5107155", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 14256.0, "discounted_cash": 10692.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT/BEAR FLX CNG XLK ZIM CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012982", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9155.0, "discounted_cash": 6866.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT/BEAR HI CRSLK XLP SN CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012907", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11388.0, "discounted_cash": 8541.0, "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": 11961.0, "discounted_cash": 8970.75, "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": 7355.0, "discounted_cash": 5516.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT/BEAR VIVACIT E ZIMM CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012986", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11487.96, "discounted_cash": 8615.97, "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": 6668.0, "discounted_cash": 5001.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT/RPL SQ DEFIB W/ELE", "code_information": [{"code": "4610319", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 304748.0, "discounted_cash": 228561.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT/RPLC AICD & LDS", "code_information": [{"code": "4613249", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 18081.0, "discounted_cash": 13560.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INST DUODENOSCOPE SINGLE USE", "code_information": [{"code": "C1748", "type": "HCPCS"}, {"code": "8081201", "type": "CDM"}], "standard_charges": [{"gross_charge": 123145.0, "discounted_cash": 92358.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INSULIN ANTIBODIES", "code_information": [{"code": "86337", "type": "CPT"}, {"code": "7256042", "type": "CDM"}], "standard_charges": [{"gross_charge": 1621.0, "discounted_cash": 1215.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INSULIN ANTIBODIES/2", "code_information": [{"code": "86337", "type": "CPT"}, {"code": "7006042", "type": "CDM"}], "standard_charges": [{"gross_charge": 1615.0, "discounted_cash": 1211.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INSULIN DRIP PER 5U PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1815", "type": "HCPCS"}, {"code": "5321291", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INSULIN DRIP PER 5U PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1815", "type": "HCPCS"}, {"code": "5321291", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INSULIN GF BINDING PROTEIN/3", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7253544", "type": "CDM"}], "standard_charges": [{"gross_charge": 1056.0, "discounted_cash": 792.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INSULIN GF BINDING PROTEIN/4", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7253547", "type": "CDM"}], "standard_charges": [{"gross_charge": 520.0, "discounted_cash": 390.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INSULIN GF BINDING PROTEIN/5", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7253592", "type": "CDM"}], "standard_charges": [{"gross_charge": 1056.0, "discounted_cash": 792.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INSULIN PEN NEEDLE EACH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321361", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INSULIN PEN NEEDLE EACH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321361", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INSULIN TOTAL", "code_information": [{"code": "83525", "type": "CPT"}, {"code": "7003525", "type": "CDM"}], "standard_charges": [{"gross_charge": 918.0, "discounted_cash": 688.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INSULIN TOTAL", "code_information": [{"code": "83525", "type": "CPT"}, {"code": "7253525", "type": "CDM"}], "standard_charges": [{"gross_charge": 918.0, "discounted_cash": 688.5, "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": 215.0, "discounted_cash": 161.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INTEGRA 2LAY 10X12.5 PER SQ CM", "code_information": [{"code": "Q4104", "type": "HCPCS"}, {"code": "4023184", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 215.0, "discounted_cash": 161.25, "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": 3118.0, "discounted_cash": 2338.5, "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": 3118.0, "discounted_cash": 2338.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INTEGRA 4INX5IN 120CM PR SQ CM", "code_information": [{"code": "Q4108", "type": "HCPCS"}, {"code": "8241496", "type": "CDM"}], "standard_charges": [{"gross_charge": 1090.0, "discounted_cash": 817.5, "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": 17546.0, "discounted_cash": 13159.5, "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": 17546.0, "discounted_cash": 13159.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INTEGRA MSH 2LAY SQ CM", "code_information": [{"code": "C9363", "type": "HCPCS"}, {"code": "4023189", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 251.0, "discounted_cash": 188.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INTEGRA MSH 2LAY SQ CM", "code_information": [{"code": "C9363", "type": "HCPCS"}, {"code": "4023189", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 251.0, "discounted_cash": 188.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INTENSIVE CARE INTERMED", "code_information": [{"code": "1990062", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 8049.0, "discounted_cash": 6036.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTENSIVE CARE INTERMED", "code_information": [{"code": "2020062", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 8049.0, "discounted_cash": 6036.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTENSIVE CARE INTERMED", "code_information": [{"code": "2120062", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 8049.0, "discounted_cash": 6036.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTENSIVE CARE INTERMED", "code_information": [{"code": "2160062", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 8049.0, "discounted_cash": 6036.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTENSIVE CARE INTERMED", "code_information": [{"code": "2180062", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 8049.0, "discounted_cash": 6036.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTENSIVE CARE INTERMED", "code_information": [{"code": "2190062", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 8049.0, "discounted_cash": 6036.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTENSIVE CARE INTERMED", "code_information": [{"code": "2510062", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 8049.0, "discounted_cash": 6036.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTENSIVE CARE UNIT", "code_information": [{"code": "1990022", "type": "CDM"}, {"code": "200", "type": "RC"}], "standard_charges": [{"gross_charge": 9783.0, "discounted_cash": 7337.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INTENSIVE CARE UNIT", "code_information": [{"code": "2020022", "type": "CDM"}, {"code": "200", "type": "RC"}], "standard_charges": [{"gross_charge": 9783.0, "discounted_cash": 7337.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INTENSIVE CARE UNIT", "code_information": [{"code": "2120022", "type": "CDM"}, {"code": "200", "type": "RC"}], "standard_charges": [{"gross_charge": 9783.0, "discounted_cash": 7337.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INTERFER ALFA2B PER1MUIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9214", "type": "HCPCS"}, {"code": "5321486", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 409.0, "discounted_cash": 306.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTERFER ALFA2B PER1MUIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9214", "type": "HCPCS"}, {"code": "5321486", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 409.0, "discounted_cash": 306.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTERFER B-1A 1MCG IM IJ", "code_information": [{"code": "Q3027", "type": "HCPCS"}, {"code": "5321505", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 354.0, "discounted_cash": 265.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INTERFER B-1A 1MCG IM IJ", "code_information": [{"code": "Q3027", "type": "HCPCS"}, {"code": "5321505", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 354.0, "discounted_cash": 265.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INTERFER B-1A 1MCG SQ IJ", "code_information": [{"code": "Q3028", "type": "HCPCS"}, {"code": "5321506", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 107.0, "discounted_cash": 80.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INTERFER B-1A 1MCG SQ IJ", "code_information": [{"code": "Q3028", "type": "HCPCS"}, {"code": "5321506", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 107.0, "discounted_cash": 80.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INTERFER BETA-1B .3MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1830", "type": "HCPCS"}, {"code": "5321477", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1780.0, "discounted_cash": 1335.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INTERFER BETA-1B .3MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1830", "type": "HCPCS"}, {"code": "5321477", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1780.0, "discounted_cash": 1335.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INTERFERON/2", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7253552", "type": "CDM"}], "standard_charges": [{"gross_charge": 512.0, "discounted_cash": 384.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INTERLEUKIN/4", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7253549", "type": "CDM"}], "standard_charges": [{"gross_charge": 520.0, "discounted_cash": 390.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INTERLEUKIN/9", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7258381", "type": "CDM"}], "standard_charges": [{"gross_charge": 126.0, "discounted_cash": 94.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INTERSTIT RADELM CMPLEX", "code_information": [{"code": "77778", "type": "CPT"}, {"code": "5107778", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 12125.0, "discounted_cash": 9093.75, "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": 6027.0, "discounted_cash": 4520.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INTGRTD KERATOPROSTHES", "code_information": [{"code": "C1818", "type": "HCPCS"}, {"code": "8240233", "type": "CDM"}], "standard_charges": [{"gross_charge": 27923.0, "discounted_cash": 20942.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INTR HEMOSTASIS FASTCATH", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8247250", "type": "CDM"}], "standard_charges": [{"gross_charge": 379.0, "discounted_cash": 284.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INTR SHTH CATH AVANTI", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "4032850", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 213.0, "discounted_cash": 159.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTR SHTH CATH AVANTI 2", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8174946", "type": "CDM"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INTR SHTH PERIPH PINNACL", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8241506", "type": "CDM"}], "standard_charges": [{"gross_charge": 919.0, "discounted_cash": 689.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INTR SHTH PINNACLE R/O", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "4023190", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 419.0, "discounted_cash": 314.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INTR SHTH SUPER", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8241503", "type": "CDM"}], "standard_charges": [{"gross_charge": 1768.0, "discounted_cash": 1326.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INTR SHTH ULTIMUM", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8241507", "type": "CDM"}], "standard_charges": [{"gross_charge": 9628.0, "discounted_cash": 7221.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INTR URETERAL ACCESS", "code_information": [{"code": "C1892", "type": "HCPCS"}, {"code": "8241529", "type": "CDM"}], "standard_charges": [{"gross_charge": 525.0, "discounted_cash": 393.75, "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": 43591.0, "discounted_cash": 32693.25, "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": 28785.0, "discounted_cash": 21588.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRACAV RADELMNT CMPLEX", "code_information": [{"code": "77763", "type": "CPT"}, {"code": "5107763", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 4235.0, "discounted_cash": 3176.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRACAV RADELMNT SIMPLE", "code_information": [{"code": "77761", "type": "CPT"}, {"code": "5107761", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 1976.0, "discounted_cash": 1482.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRACRAN ADM AGNT ADDL", "code_information": [{"code": "4911651", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 24615.0, "discounted_cash": 18461.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRACRAN ADM THERA AGNT", "code_information": [{"code": "4911650", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 24615.0, "discounted_cash": 18461.25, "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": 8861.0, "discounted_cash": 6645.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRAVENTRICULAR PACING", "code_information": [{"code": "93612", "type": "CPT"}, {"code": "6111012", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 30376.0, "discounted_cash": 22782.0, "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": 29172.0, "discounted_cash": 21879.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRD ST LEAD PMKR SOLO TRAK", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8177155", "type": "CDM"}], "standard_charges": [{"gross_charge": 216.0, "discounted_cash": 162.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRINSIC FACTOR ANTIBDY", "code_information": [{"code": "86340", "type": "CPT"}, {"code": "7005536", "type": "CDM"}], "standard_charges": [{"gross_charge": 864.0, "discounted_cash": 648.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRINSIC FACTOR ANTIBDY", "code_information": [{"code": "86340", "type": "CPT"}, {"code": "7255536", "type": "CDM"}], "standard_charges": [{"gross_charge": 864.0, "discounted_cash": 648.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRO CATH SHTH STD", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8174932", "type": "CDM"}], "standard_charges": [{"gross_charge": 164.0, "discounted_cash": 123.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRO COOK CHECKFLO LG", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8241501", "type": "CDM"}], "standard_charges": [{"gross_charge": 876.0, "discounted_cash": 657.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRO EP IC LASER N-GUID", "code_information": [{"code": "C2629", "type": "HCPCS"}, {"code": "8240225", "type": "CDM"}], "standard_charges": [{"gross_charge": 1379.0, "discounted_cash": 1034.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRO EP IC N-LSR N-GD 2", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8240229", "type": "CDM"}], "standard_charges": [{"gross_charge": 725.0, "discounted_cash": 543.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRO EP IC N-LSR N-GUID", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8240223", "type": "CDM"}], "standard_charges": [{"gross_charge": 4906.0, "discounted_cash": 3679.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRO FLEXOR CHECKFLO", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8241509", "type": "CDM"}], "standard_charges": [{"gross_charge": 404.0, "discounted_cash": 303.0, "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": 7978.0, "discounted_cash": 5983.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRO PEEL AWAY", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8174943", "type": "CDM"}], "standard_charges": [{"gross_charge": 443.0, "discounted_cash": 332.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRO SAFESHEATH II CLS", "code_information": [{"code": "C1892", "type": "HCPCS"}, {"code": "8174938", "type": "CDM"}], "standard_charges": [{"gross_charge": 1218.0, "discounted_cash": 913.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRO SHTH CATH BRITE TP", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8174945", "type": "CDM"}], "standard_charges": [{"gross_charge": 226.0, "discounted_cash": 169.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRO SHTH COR PINNALCE", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8182688", "type": "CDM"}], "standard_charges": [{"gross_charge": 419.0, "discounted_cash": 314.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRO SHTH COR PINNCL GW", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8182689", "type": "CDM"}], "standard_charges": [{"gross_charge": 388.0, "discounted_cash": 291.0, "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": 591.0, "discounted_cash": 443.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRO SHTH STEERABL", "code_information": [{"code": "C1766", "type": "HCPCS"}, {"code": "8174939", "type": "CDM"}], "standard_charges": [{"gross_charge": 6870.0, "discounted_cash": 5152.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRODUCER LD NSTIM", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8241511", "type": "CDM"}], "standard_charges": [{"gross_charge": 2025.0, "discounted_cash": 1518.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTUBATION", "code_information": [{"code": "3110210", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 744.0, "discounted_cash": 558.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INTUBATION", "code_information": [{"code": "5500205", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 705.0, "discounted_cash": 528.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IODINE TINCTURE 60ML TS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335994", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 171.0, "discounted_cash": 128.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IODINE TINCTURE 60ML TS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335994", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 171.0, "discounted_cash": 128.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IODINE/K IODIDE5% 14MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315360", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 183.0, "discounted_cash": 137.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IODINE/K IODIDE5% 14MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315360", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 183.0, "discounted_cash": 137.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IOL ANTERIOR CHAMBER", "code_information": [{"code": "V2630", "type": "HCPCS"}, {"code": "8122064", "type": "CDM"}], "standard_charges": [{"gross_charge": 662.0, "discounted_cash": 496.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IOL MONOFOCAL 3PC 6.0", "code_information": [{"code": "V2631", "type": "HCPCS"}, {"code": "8122066", "type": "CDM"}], "standard_charges": [{"gross_charge": 673.75, "discounted_cash": 505.31, "setting": "both", "billing_class": "facility"}]}, {"description": "IOL POSTERIOR CHMBR", "code_information": [{"code": "V2632", "type": "HCPCS"}, {"code": "8122044", "type": "CDM"}], "standard_charges": [{"gross_charge": 1541.0, "discounted_cash": 1155.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IOL POSTERIOR UV WAVEFRONT", "code_information": [{"code": "V2632", "type": "HCPCS"}, {"code": "8122046", "type": "CDM"}], "standard_charges": [{"gross_charge": 562.0, "discounted_cash": 421.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IONM IN OR 15 MIN", "code_information": [{"code": "95940", "type": "CPT"}, {"code": "3215941", "type": "CDM"}, {"code": "740", "type": "RC"}], "standard_charges": [{"gross_charge": 512.0, "discounted_cash": 384.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IONM REMOTE PER HOUR", "code_information": [{"code": "95941", "type": "CPT"}, {"code": "3215942", "type": "CDM"}, {"code": "740", "type": "RC"}], "standard_charges": [{"gross_charge": 2257.0, "discounted_cash": 1692.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IP CAPD", "code_information": [{"code": "90945", "type": "CPT"}, {"code": "5600904", "type": "CDM"}, {"code": "803", "type": "RC"}], "standard_charges": [{"gross_charge": 2473.0, "discounted_cash": 1854.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IP CCPD", "code_information": [{"code": "90945", "type": "CPT"}, {"code": "5600910", "type": "CDM"}, {"code": "804", "type": "RC"}], "standard_charges": [{"gross_charge": 2473.0, "discounted_cash": 1854.75, "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": 1016.0, "discounted_cash": 762.0, "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": 1016.0, "discounted_cash": 762.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IPILIMUMAB PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9228", "type": "HCPCS"}, {"code": "5321503", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1062.0, "discounted_cash": 796.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IPILIMUMAB PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9228", "type": "HCPCS"}, {"code": "5321503", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1062.0, "discounted_cash": 796.5, "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": 353.0, "discounted_cash": 264.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IPPB TX DEMO AND/OR EVAL", "code_information": [{"code": "94664", "type": "CPT"}, {"code": "5500504", "type": "CDM"}, {"code": "410", "type": "RC"}], "standard_charges": [{"gross_charge": 425.0, "discounted_cash": 318.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 762.0, "discounted_cash": 571.5, "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": 762.0, "discounted_cash": 571.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IPRATROPIUM PER DOSE IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5331238", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IPRATROPIUM PER DOSE IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5331238", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "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": 1856.0, "discounted_cash": 1392.0, "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": 1856.0, "discounted_cash": 1392.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IPRATROPIUM18MCG14GM IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5331237", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 583.0, "discounted_cash": 437.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IPRATROPIUM18MCG14GM IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5331237", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 583.0, "discounted_cash": 437.25, "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": 497.0, "discounted_cash": 372.75, "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": 497.0, "discounted_cash": 372.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IPRATROPIUMNAS.06%15MLSP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331236", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 496.0, "discounted_cash": 372.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IPRATROPIUMNAS.06%15MLSP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331236", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 496.0, "discounted_cash": 372.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IRINOTECAN PER 20MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9206", "type": "HCPCS"}, {"code": "5321502", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1952.0, "discounted_cash": 1464.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IRINOTECAN PER 20MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9206", "type": "HCPCS"}, {"code": "5321502", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1952.0, "discounted_cash": 1464.0, "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": 384.0, "discounted_cash": 288.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IRON ASSAY", "code_information": [{"code": "83540", "type": "CPT"}, {"code": "4123540", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IRON ASSAY", "code_information": [{"code": "83540", "type": "CPT"}, {"code": "4153540", "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": 264.0, "discounted_cash": 198.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IRON BINDING CAPCTY", "code_information": [{"code": "83550", "type": "CPT"}, {"code": "4123550", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 23.0, "discounted_cash": 17.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IRON BINDING CAPCTY", "code_information": [{"code": "83550", "type": "CPT"}, {"code": "4153550", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IRON STAIN PERPH BLOOD", "code_information": [{"code": "85536", "type": "CPT"}, {"code": "4105537", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 343.0, "discounted_cash": 257.25, "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": 11.0, "discounted_cash": 8.25, "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": 11.0, "discounted_cash": 8.25, "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": 249.0, "discounted_cash": 186.75, "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": 249.0, "discounted_cash": 186.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IRRIGANT OPHTH 30ML OS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5331241", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 172.0, "discounted_cash": 129.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IRRIGANT OPHTH 30ML OS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5331241", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 172.0, "discounted_cash": 129.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IRRIGATE VASC ACCESS DEV", "code_information": [{"code": "96523", "type": "CPT"}, {"code": "3606523", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 443.0, "discounted_cash": 332.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IRRIGATE VASC ACCESS DEV", "code_information": [{"code": "96523", "type": "CPT"}, {"code": "3606523", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 443.0, "discounted_cash": 332.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IRRIGATE VASC ACCESS DEV", "code_information": [{"code": "96523", "type": "CPT"}, {"code": "6296523", "type": "CDM"}], "standard_charges": [{"gross_charge": 251.0, "discounted_cash": 188.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IRRIGATE VASC ACCESS DEV", "code_information": [{"code": "96523", "type": "CPT"}, {"code": "6926523", "type": "CDM"}], "standard_charges": [{"gross_charge": 443.0, "discounted_cash": 332.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ISLET CELL ANTIBODY", "code_information": [{"code": "86341", "type": "CPT"}, {"code": "7006348", "type": "CDM"}], "standard_charges": [{"gross_charge": 481.0, "discounted_cash": 360.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ISLET CELL ANTIBODY/5", "code_information": [{"code": "86341", "type": "CPT"}, {"code": "7256430", "type": "CDM"}], "standard_charges": [{"gross_charge": 289.0, "discounted_cash": 216.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ISOLYTE P D5 500ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412500", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ISOMETH/DICHLOR/APAP CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306095", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ISOMETH/DICHLOR/APAP CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306095", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ISONIAZID 100MGTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306097", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ISONIAZID 100MGTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306097", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 33.0, "discounted_cash": 24.75, "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": 33.0, "discounted_cash": 24.75, "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": 138.0, "discounted_cash": 103.5, "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": 468.0, "discounted_cash": 351.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ISOSORBID MN 120MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306187", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ISOSORBID MN 120MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306187", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ISOSORBIDE DN 30MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306183", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ISOSORBIDE DN 30MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306183", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "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": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ISOSORBIDE DN 40MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306185", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 11.0, "discounted_cash": 8.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ISOSORBIDE DN 40MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306185", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 11.0, "discounted_cash": 8.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ISOSORBIDE DN 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306173", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ISOSORBIDE DN 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306173", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ISOSORBIDE DN2.5MG SL TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306193", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ISOSORBIDE DN2.5MG SL TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306193", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ISOSORBIDE MN 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306176", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ISOSORBIDE MN 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306176", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "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": 3.0, "discounted_cash": 2.25, "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": 58.0, "discounted_cash": 43.5, "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": 58.0, "discounted_cash": 43.5, "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": 60.0, "discounted_cash": 45.0, "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": 60.0, "discounted_cash": 45.0, "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": 209.0, "discounted_cash": 156.75, "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": 209.0, "discounted_cash": 156.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ISRADIPINE 2.5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306255", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ISRADIPINE 2.5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306255", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ISRADIPINE 5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306256", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ISRADIPINE 5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306256", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ITRACONAZOLE", "code_information": [{"code": "80189", "type": "CPT"}, {"code": "7250077", "type": "CDM"}], "standard_charges": [{"gross_charge": 2659.0, "discounted_cash": 1994.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ITRACONAZOLE 100MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306257", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 145.0, "discounted_cash": 108.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ITRACONAZOLE 100MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306257", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 145.0, "discounted_cash": 108.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ITRACONAZOLE PER 50MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1835", "type": "HCPCS"}, {"code": "5321591", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 511.0, "discounted_cash": 383.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ITRACONAZOLE PER 50MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1835", "type": "HCPCS"}, {"code": "5321591", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 511.0, "discounted_cash": 383.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ITRACONAZOLE10/1 10ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315396", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 158.0, "discounted_cash": 118.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ITRACONAZOLE10/1 10ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315396", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 158.0, "discounted_cash": 118.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ITRACONAZOLE10/1 150MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315395", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 137.0, "discounted_cash": 102.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ITRACONAZOLE10/1 150MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315395", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 137.0, "discounted_cash": 102.75, "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": 288.0, "discounted_cash": 216.0, "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": 277.0, "discounted_cash": 207.75, "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": 347.0, "discounted_cash": 260.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF CONCURRENT", "code_information": [{"code": "96368", "type": "CPT"}, {"code": "6110768", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 366.0, "discounted_cash": 274.5, "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": 349.0, "discounted_cash": 261.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF CONCURRENT", "code_information": [{"code": "96368", "type": "CPT"}, {"code": "6290768", "type": "CDM"}], "standard_charges": [{"gross_charge": 332.0, "discounted_cash": 249.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF CONCURRENT", "code_information": [{"code": "96368", "type": "CPT"}, {"code": "6920768", "type": "CDM"}], "standard_charges": [{"gross_charge": 332.0, "discounted_cash": 249.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF EA ADD HR", "code_information": [{"code": "96366", "type": "CPT"}, {"code": "6120766", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 255.0, "discounted_cash": 191.25, "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": 356.0, "discounted_cash": 267.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF HYD EA ADD HR", "code_information": [{"code": "96361", "type": "CPT"}, {"code": "3600761", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 277.0, "discounted_cash": 207.75, "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": 451.0, "discounted_cash": 338.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF HYD EA ADD HR", "code_information": [{"code": "96361", "type": "CPT"}, {"code": "6110761", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 366.0, "discounted_cash": 274.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF HYD EA ADD HR", "code_information": [{"code": "96361", "type": "CPT"}, {"code": "6120761", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 255.0, "discounted_cash": 191.25, "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": 349.0, "discounted_cash": 261.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF HYD EA ADD HR", "code_information": [{"code": "96361", "type": "CPT"}, {"code": "6290761", "type": "CDM"}], "standard_charges": [{"gross_charge": 332.0, "discounted_cash": 249.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF HYD EA ADD HR", "code_information": [{"code": "96361", "type": "CPT"}, {"code": "6920761", "type": "CDM"}], "standard_charges": [{"gross_charge": 332.0, "discounted_cash": 249.0, "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": 520.0, "discounted_cash": 390.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF HYD INIT 31-60MIN", "code_information": [{"code": "96360", "type": "CPT"}, {"code": "3600760", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 407.0, "discounted_cash": 305.25, "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": 662.0, "discounted_cash": 496.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF HYD INIT 31-60MIN", "code_information": [{"code": "96360", "type": "CPT"}, {"code": "6110760", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 513.0, "discounted_cash": 384.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF HYD INIT 31-60MIN", "code_information": [{"code": "96360", "type": "CPT"}, {"code": "6120762", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 1309.0, "discounted_cash": 981.75, "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": 611.0, "discounted_cash": 458.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF HYD INIT 31-60MIN", "code_information": [{"code": "96360", "type": "CPT"}, {"code": "6290760", "type": "CDM"}], "standard_charges": [{"gross_charge": 467.0, "discounted_cash": 350.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF HYD INIT 31-60MIN", "code_information": [{"code": "96360", "type": "CPT"}, {"code": "6920760", "type": "CDM"}], "standard_charges": [{"gross_charge": 467.0, "discounted_cash": 350.25, "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": 277.0, "discounted_cash": 207.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF SEQUENTL 1 HR", "code_information": [{"code": "96367", "type": "CPT"}, {"code": "3600767", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 277.0, "discounted_cash": 207.75, "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": 347.0, "discounted_cash": 260.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF SEQUENTL 1 HR", "code_information": [{"code": "96367", "type": "CPT"}, {"code": "6110767", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 366.0, "discounted_cash": 274.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF SEQUENTL 1 HR", "code_information": [{"code": "96367", "type": "CPT"}, {"code": "6120767", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 347.0, "discounted_cash": 260.25, "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": 349.0, "discounted_cash": 261.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF SEQUENTL 1 HR", "code_information": [{"code": "96367", "type": "CPT"}, {"code": "6290767", "type": "CDM"}], "standard_charges": [{"gross_charge": 332.0, "discounted_cash": 249.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF SEQUENTL 1 HR", "code_information": [{"code": "96367", "type": "CPT"}, {"code": "6920767", "type": "CDM"}], "standard_charges": [{"gross_charge": 332.0, "discounted_cash": 249.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF TOCILIZU COV19 1ST DOSE", "code_information": [{"code": "M0249", "type": "HCPCS"}, {"code": "6290018", "type": "CDM"}], "standard_charges": [{"gross_charge": 1652.0, "discounted_cash": 1239.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF TOCILIZU COV19 2ND DOSE", "code_information": [{"code": "M0250", "type": "HCPCS"}, {"code": "6290019", "type": "CDM"}], "standard_charges": [{"gross_charge": 1961.0, "discounted_cash": 1470.75, "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": 360.0, "discounted_cash": 270.0, "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": 360.0, "discounted_cash": 270.0, "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": 427.0, "discounted_cash": 320.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF TX EA ADD HR", "code_information": [{"code": "96366", "type": "CPT"}, {"code": "6110766", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 372.0, "discounted_cash": 279.0, "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": 444.0, "discounted_cash": 333.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF TX EA ADD HR", "code_information": [{"code": "96366", "type": "CPT"}, {"code": "6290766", "type": "CDM"}], "standard_charges": [{"gross_charge": 312.0, "discounted_cash": 234.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF TX EA ADD HR", "code_information": [{"code": "96366", "type": "CPT"}, {"code": "6920766", "type": "CDM"}], "standard_charges": [{"gross_charge": 338.0, "discounted_cash": 253.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF TX INIT <= 1 HR", "code_information": [{"code": "96365", "type": "CPT"}, {"code": "6120765", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 1309.0, "discounted_cash": 981.75, "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": 407.0, "discounted_cash": 305.25, "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": 498.0, "discounted_cash": 373.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF TX INIT <=1 HR", "code_information": [{"code": "96365", "type": "CPT"}, {"code": "4610780", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 417.0, "discounted_cash": 312.75, "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": 611.0, "discounted_cash": 458.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF TX INIT <=1 HR", "code_information": [{"code": "96365", "type": "CPT"}, {"code": "6110765", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 513.0, "discounted_cash": 384.75, "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": 504.0, "discounted_cash": 378.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF TX INIT <=1 HR", "code_information": [{"code": "96365", "type": "CPT"}, {"code": "6290765", "type": "CDM"}], "standard_charges": [{"gross_charge": 429.0, "discounted_cash": 321.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF TX INIT <=1 HR", "code_information": [{"code": "96365", "type": "CPT"}, {"code": "6920765", "type": "CDM"}], "standard_charges": [{"gross_charge": 467.0, "discounted_cash": 350.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IV RADIOPH LOCALZTN ONLY", "code_information": [{"code": "78808", "type": "CPT"}, {"code": "5208808", "type": "CDM"}, {"code": "342", "type": "RC"}], "standard_charges": [{"gross_charge": 2902.0, "discounted_cash": 2176.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IVABRADINE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306258", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 82.0, "discounted_cash": 61.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IVABRADINE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306258", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 82.0, "discounted_cash": 61.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 27.0, "discounted_cash": 20.25, "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": 27.0, "discounted_cash": 20.25, "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": 429.0, "discounted_cash": 321.75, "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": 429.0, "discounted_cash": 321.75, "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": 526.0, "discounted_cash": 394.5, "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": 526.0, "discounted_cash": 394.5, "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": 476.0, "discounted_cash": 357.0, "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": 476.0, "discounted_cash": 357.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IVIG PRIVIGEN PER500MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1459", "type": "HCPCS"}, {"code": "5321599", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 157.0, "discounted_cash": 117.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IVIG PRIVIGEN PER500MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1459", "type": "HCPCS"}, {"code": "5321599", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 157.0, "discounted_cash": 117.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IVP WITH RENAL TOMOS", "code_information": [{"code": "74415", "type": "CPT"}, {"code": "4904415", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 3793.0, "discounted_cash": 2844.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IVP WITH RENAL TOMOS", "code_information": [{"code": "74415", "type": "CPT"}, {"code": "5014415", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 4544.0, "discounted_cash": 3408.0, "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": 2459.0, "discounted_cash": 1844.25, "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": 3689.0, "discounted_cash": 2766.75, "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": 1443.0, "discounted_cash": 1082.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IVUS NON CORON ADDL VESL", "code_information": [{"code": "4917251", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 9339.0, "discounted_cash": 7004.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IVUS NON CORONARY INITL", "code_information": [{"code": "4615944", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1398.0, "discounted_cash": 1048.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IVUS NON CORONARY INITL", "code_information": [{"code": "4915944", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1331.0, "discounted_cash": 998.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IXABEPILONE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9207", "type": "HCPCS"}, {"code": "5327620", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 804.0, "discounted_cash": 603.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IXABEPILONE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9207", "type": "HCPCS"}, {"code": "5327620", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 804.0, "discounted_cash": 603.0, "setting": "both", "billing_class": "facility"}]}, {"description": "JAK2 VARIANT", "code_information": [{"code": "81270", "type": "CPT"}, {"code": "7050035", "type": "CDM"}], "standard_charges": [{"gross_charge": 875.0, "discounted_cash": 656.25, "setting": "both", "billing_class": "facility"}]}, {"description": "JAK2 VARIANT/2", "code_information": [{"code": "81270", "type": "CPT"}, {"code": "7259213", "type": "CDM"}], "standard_charges": [{"gross_charge": 1827.0, "discounted_cash": 1370.25, "setting": "both", "billing_class": "facility"}]}, {"description": "JOINT 2 OR MORE SNGL VW", "code_information": [{"code": "77077", "type": "CPT"}, {"code": "4904068", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 387.0, "discounted_cash": 290.25, "setting": "both", "billing_class": "facility"}]}, {"description": "JOINT 2 OR MORE SNGL VW", "code_information": [{"code": "77077", "type": "CPT"}, {"code": "5014068", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 387.0, "discounted_cash": 290.25, "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": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "K IODIDE 1GM/ML 30ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316107", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 320.0, "discounted_cash": 240.0, "setting": "both", "billing_class": "facility"}]}, {"description": "K IODIDE 1GM/ML 30ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316107", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 320.0, "discounted_cash": 240.0, "setting": "both", "billing_class": "facility"}]}, {"description": "K IODIDE 1GM/ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316105", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 15.0, "discounted_cash": 11.25, "setting": "both", "billing_class": "facility"}]}, {"description": "K IODIDE 1GM/ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316105", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 15.0, "discounted_cash": 11.25, "setting": "both", "billing_class": "facility"}]}, {"description": "K IODIDE/IODINE 480ML TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337090", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "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": 35.0, "discounted_cash": 26.25, "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": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "K WIRE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132950", "type": "CDM"}], "standard_charges": [{"gross_charge": 1356.0, "discounted_cash": 1017.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KAPPA LAMBDA LT CHN QUAN", "code_information": [{"code": "83521", "type": "CPT"}, {"code": "7253884", "type": "CDM"}], "standard_charges": [{"gross_charge": 270.0, "discounted_cash": 202.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KAPPA LAMBDA LT CHN QUAN/2", "code_information": [{"code": "83521", "type": "CPT"}, {"code": "7253888", "type": "CDM"}], "standard_charges": [{"gross_charge": 137.0, "discounted_cash": 102.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KAPPA LAMBDA LT CHN QUAN/3", "code_information": [{"code": "83521", "type": "CPT"}, {"code": "7253889", "type": "CDM"}], "standard_charges": [{"gross_charge": 137.0, "discounted_cash": 102.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KCL 10% 30ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316089", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KCL 10% 30ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316089", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KCL 20% 15ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316093", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KCL 20% 15ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316093", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KCL 20MEQ PK PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316097", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KCL 20MEQ PK PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316097", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KCL 20MEQ/15ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316103", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KCL 20MEQ/15ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316103", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KETAMINE 10MG/1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321626", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KETAMINE 10MG/ML 20ML", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321625", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KETAMINE 30MG/3ML PFS IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321628", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "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": 52.0, "discounted_cash": 39.0, "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": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KETAMINE LEVEL", "code_information": [{"code": "80357", "type": "CPT"}, {"code": "7252383", "type": "CDM"}], "standard_charges": [{"gross_charge": 520.0, "discounted_cash": 390.0, "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": 301.0, "discounted_cash": 225.75, "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": 301.0, "discounted_cash": 225.75, "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": 229.0, "discounted_cash": 171.75, "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": 229.0, "discounted_cash": 171.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "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": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KETOROLAC .4% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331352", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 355.0, "discounted_cash": 266.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KETOROLAC .4% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331352", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 355.0, "discounted_cash": 266.25, "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": 383.0, "discounted_cash": 287.25, "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": 383.0, "discounted_cash": 287.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 662.0, "discounted_cash": 496.5, "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": 662.0, "discounted_cash": 496.5, "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": 49.0, "discounted_cash": 36.75, "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": 49.0, "discounted_cash": 36.75, "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": 23.0, "discounted_cash": 17.25, "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": 23.0, "discounted_cash": 17.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KETOSTEROID 17 TOTAL", "code_information": [{"code": "83586", "type": "CPT"}, {"code": "7253586", "type": "CDM"}], "standard_charges": [{"gross_charge": 497.0, "discounted_cash": 372.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KETOTIFEN .025%5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331358", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 98.0, "discounted_cash": 73.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KETOTIFEN .025%5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331358", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 98.0, "discounted_cash": 73.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KID IMG FL/FUN SNG W RX", "code_information": [{"code": "78708", "type": "CPT"}, {"code": "5018708", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 6739.0, "discounted_cash": 5054.25, "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": 1370.0, "discounted_cash": 1027.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KID IMG FL/FUN SNG WO RX", "code_information": [{"code": "78707", "type": "CPT"}, {"code": "5018707", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 8275.0, "discounted_cash": 6206.25, "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": 1983.0, "discounted_cash": 1487.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KIT ACU-SINCH KNOTLESS W/INSRT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8081923", "type": "CDM"}], "standard_charges": [{"gross_charge": 11034.0, "discounted_cash": 8275.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KIT FIRST FRACT STABILIT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8174997", "type": "CDM"}], "standard_charges": [{"gross_charge": 21934.0, "discounted_cash": 16450.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KNE UN VI E JRN PLYTB BS SN CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012927", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12526.0, "discounted_cash": 9394.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KNE UNI PKR X3 EIU UN STRY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013076", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11961.0, "discounted_cash": 8970.75, "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": 1368.0, "discounted_cash": 1026.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KNEE 1-2 VIEWS", "code_information": [{"code": "73560", "type": "CPT"}, {"code": "5013582", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1357.0, "discounted_cash": 1017.75, "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": 1322.0, "discounted_cash": 991.5, "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": 1721.0, "discounted_cash": 1290.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KNEE 3 VIEWS", "code_information": [{"code": "73562", "type": "CPT"}, {"code": "5013562", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1357.0, "discounted_cash": 1017.75, "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": 1721.0, "discounted_cash": 1290.75, "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": 883.0, "discounted_cash": 662.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KNEE ARTHROGRAPHY", "code_information": [{"code": "73580", "type": "CPT"}, {"code": "5013580", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 952.0, "discounted_cash": 714.0, "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": 1285.0, "discounted_cash": 963.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KNEE COMP 4 VW MIN", "code_information": [{"code": "73564", "type": "CPT"}, {"code": "5013570", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1285.0, "discounted_cash": 963.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KNEE EXTENSION STEM ZIMM CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012987", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10986.0, "discounted_cash": 8239.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KNEE UNI JRN OX FEM ACC SN CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012925", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 21638.0, "discounted_cash": 16228.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KNEE UNI MCK FEMUR STRYKER CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013072", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16746.0, "discounted_cash": 12559.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KNEE UNI MCK TIBIA STRYKER CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013074", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11602.0, "discounted_cash": 8701.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KNEE ZUK UNI ACC GN JRN SN CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012923", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8257.0, "discounted_cash": 6192.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KO ADJ JNT POS RIGD SPPT", "code_information": [{"code": "L1832", "type": "HCPCS"}, {"code": "8130047", "type": "CDM"}], "standard_charges": [{"gross_charge": 6357.0, "discounted_cash": 4767.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KO IMMOBILIZER", "code_information": [{"code": "L1830", "type": "HCPCS"}, {"code": "8130006", "type": "CDM"}], "standard_charges": [{"gross_charge": 216.0, "discounted_cash": 162.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KT ARTERIAL LN", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8241567", "type": "CDM"}], "standard_charges": [{"gross_charge": 258.0, "discounted_cash": 193.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KT ASPIRATION TB CAT RX INDIGO", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8081863", "type": "CDM"}], "standard_charges": [{"gross_charge": 7552.0, "discounted_cash": 5664.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KT BN CEMT W MIXER", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132958", "type": "CDM"}], "standard_charges": [{"gross_charge": 2022.0, "discounted_cash": 1516.5, "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": 8251.0, "discounted_cash": 6188.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KT BN VOID FILLER CASO4", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4013102", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8816.0, "discounted_cash": 6612.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KT BN VOID FILLER OSTEOCRETE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132586", "type": "CDM"}], "standard_charges": [{"gross_charge": 18683.0, "discounted_cash": 14012.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KT CATH ARES ANTIBIOTIC", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8081884", "type": "CDM"}], "standard_charges": [{"gross_charge": 4609.0, "discounted_cash": 3456.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KT CATH BENCHMARK 071", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056973", "type": "CDM"}], "standard_charges": [{"gross_charge": 9965.0, "discounted_cash": 7473.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KT CATH ELITE MAHURKAR", "code_information": [{"code": "C1752", "type": "HCPCS"}, {"code": "8081017", "type": "CDM"}], "standard_charges": [{"gross_charge": 561.0, "discounted_cash": 420.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KT CATH PLEURAL", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8032569", "type": "CDM"}], "standard_charges": [{"gross_charge": 3596.0, "discounted_cash": 2697.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KT CATH REPEFUSION 5MAX JET 7", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056958", "type": "CDM"}], "standard_charges": [{"gross_charge": 33765.0, "discounted_cash": 25323.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KT CATH REPERFUS 3MAX ASP TUB", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8058335", "type": "CDM"}], "standard_charges": [{"gross_charge": 23573.0, "discounted_cash": 17679.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KT CATH REPERFUSN ACE60 ASP TB", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056957", "type": "CDM"}], "standard_charges": [{"gross_charge": 34261.0, "discounted_cash": 25695.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KT CATH REPERFUSN ACE64 ASP TB", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056953", "type": "CDM"}], "standard_charges": [{"gross_charge": 31263.0, "discounted_cash": 23447.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KT CATH REPERFUSN ACE68 ASP TB", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056954", "type": "CDM"}], "standard_charges": [{"gross_charge": 31263.0, "discounted_cash": 23447.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KT CATH THERMODILUTION", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8056967", "type": "CDM"}], "standard_charges": [{"gross_charge": 3028.0, "discounted_cash": 2271.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KT CHOLANGIOGRAPHY", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8081921", "type": "CDM"}], "standard_charges": [{"gross_charge": 463.0, "discounted_cash": 347.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KT CORE DECMPRSS W GRFT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4023395", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 45230.0, "discounted_cash": 33922.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KT DRAIN PERITONEAL ESSENTIAL", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8081984", "type": "CDM"}], "standard_charges": [{"gross_charge": 10498.0, "discounted_cash": 7873.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KT DRN BILIARY", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8081985", "type": "CDM"}], "standard_charges": [{"gross_charge": 775.0, "discounted_cash": 581.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KT DRN NRO EXT", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8175012", "type": "CDM"}], "standard_charges": [{"gross_charge": 1207.0, "discounted_cash": 905.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KT DRN PLEURAL", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8081993", "type": "CDM"}], "standard_charges": [{"gross_charge": 528.0, "discounted_cash": 396.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KT DRN SUMP", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8081995", "type": "CDM"}], "standard_charges": [{"gross_charge": 3087.0, "discounted_cash": 2315.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KT DVC CRYOABLATION CLARIFIX", "code_information": [{"code": "C2618", "type": "HCPCS"}, {"code": "8174154", "type": "CDM"}], "standard_charges": [{"gross_charge": 13320.0, "discounted_cash": 9990.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KT FASTNER SEROSAFUSE IMP", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8082062", "type": "CDM"}], "standard_charges": [{"gross_charge": 54453.0, "discounted_cash": 40839.75, "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"}], "standard_charges": [{"gross_charge": 1854.0, "discounted_cash": 1390.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KT FIBULOCK IMPLANT SYSTEM", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4013103", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6810.0, "discounted_cash": 5107.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KT FRACTURE BALLOON OMNICURVE", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8132588", "type": "CDM"}], "standard_charges": [{"gross_charge": 23491.0, "discounted_cash": 17618.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KT INSTR ACCESS INTRACEPT", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8081019", "type": "CDM"}], "standard_charges": [{"gross_charge": 18596.0, "discounted_cash": 13947.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KT INTERSPCE SHOULDR EXACT CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013191", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 52612.0, "discounted_cash": 39459.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KT INTRO HEMO SWARTZ SL", "code_information": [{"code": "C1893", "type": "HCPCS"}, {"code": "8178091", "type": "CDM"}], "standard_charges": [{"gross_charge": 642.0, "discounted_cash": 481.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KT INTRO IMPELLA 14FR", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8082622", "type": "CDM"}], "standard_charges": [{"gross_charge": 2720.0, "discounted_cash": 2040.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KT INTRO MICRO", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8082157", "type": "CDM"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 105.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KT INTRO MICRO TCAR ENROUTE", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8082219", "type": "CDM"}], "standard_charges": [{"gross_charge": 546.0, "discounted_cash": 409.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KT INTRO NSTIM LD", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "4033000", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 2475.0, "discounted_cash": 1856.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KT KNEE ANCH HYBRID FIBERTAK", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8081846", "type": "CDM"}], "standard_charges": [{"gross_charge": 4354.0, "discounted_cash": 3265.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KT KNOTLESS AC IMPLANT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011767", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 15325.0, "discounted_cash": 11493.75, "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": 57790.0, "discounted_cash": 43342.5, "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": 13678.0, "discounted_cash": 10258.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KT LD NSTIM OCTRODE 60CM", "code_information": [{"code": "C1778", "type": "HCPCS"}, {"code": "4008580", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 32932.0, "discounted_cash": 24699.0, "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": 38009.0, "discounted_cash": 28506.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KT LD TINED AXONICS NEURO", "code_information": [{"code": "C1778", "type": "HCPCS"}, {"code": "4008665", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 32499.0, "discounted_cash": 24374.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KT LD TINED INTERSTIM 28CM", "code_information": [{"code": "C1778", "type": "HCPCS"}, {"code": "8082191", "type": "CDM"}], "standard_charges": [{"gross_charge": 16047.0, "discounted_cash": 12035.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KT LD TINED W/PERCUTN EXT 2201", "code_information": [{"code": "C1778", "type": "HCPCS"}, {"code": "4008552", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 973.0, "discounted_cash": 729.75, "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": 5665.0, "discounted_cash": 4248.75, "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": 21326.0, "discounted_cash": 15994.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KT LEAD SURPASS 2005", "code_information": [{"code": "C1778", "type": "HCPCS"}, {"code": "4008666", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 21326.0, "discounted_cash": 15994.5, "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": 7075.0, "discounted_cash": 5306.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KT MICROPUNCT INTRO", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8082216", "type": "CDM"}], "standard_charges": [{"gross_charge": 566.0, "discounted_cash": 424.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KT NSTIM D LD ACCESSORY", "code_information": [{"code": "C1883", "type": "HCPCS"}, {"code": "8082271", "type": "CDM"}], "standard_charges": [{"gross_charge": 1975.0, "discounted_cash": 1481.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KT PASTA BRIDGE REPAIR", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4013148", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12451.0, "discounted_cash": 9338.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KT PERCARDIOCNT", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8082360", "type": "CDM"}], "standard_charges": [{"gross_charge": 1158.0, "discounted_cash": 868.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KT PIN PLUG DFIB/PM", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8082398", "type": "CDM"}], "standard_charges": [{"gross_charge": 1174.0, "discounted_cash": 880.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KT PRB TRILOGY LITHOCLAST", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8085625", "type": "CDM"}], "standard_charges": [{"gross_charge": 7949.0, "discounted_cash": 5961.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KT RC PRGM STIMR WAVEWRITER", "code_information": [{"code": "C1787", "type": "HCPCS"}, {"code": "8082443", "type": "CDM"}], "standard_charges": [{"gross_charge": 8931.0, "discounted_cash": 6698.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KT REPAIR MINI TIGHTROPE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132965", "type": "CDM"}], "standard_charges": [{"gross_charge": 4400.0, "discounted_cash": 3300.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KT REVISION INTRATH CATH", "code_information": [{"code": "C1755", "type": "HCPCS"}, {"code": "8082457", "type": "CDM"}], "standard_charges": [{"gross_charge": 3673.0, "discounted_cash": 2754.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KT REVISION SUTRLSS PMP", "code_information": [{"code": "E0785", "type": "HCPCS"}, {"code": "8175088", "type": "CDM"}], "standard_charges": [{"gross_charge": 1209.0, "discounted_cash": 906.75, "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": 17829.0, "discounted_cash": 13371.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KT SACRAL COLPOPEXY", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4023401", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12781.0, "discounted_cash": 9585.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KT SHTH INTRO TRANSRADL", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8178117", "type": "CDM"}], "standard_charges": [{"gross_charge": 286.0, "discounted_cash": 214.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KT SHTH INTRO W/GW/DIL", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8082516", "type": "CDM"}], "standard_charges": [{"gross_charge": 753.0, "discounted_cash": 564.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KT SNARE RETRIEV DL SHTH", "code_information": [{"code": "C1773", "type": "HCPCS"}, {"code": "8082519", "type": "CDM"}], "standard_charges": [{"gross_charge": 1860.0, "discounted_cash": 1395.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KT SPINEJACK EXPANSION", "code_information": [{"code": "C1062", "type": "HCPCS"}, {"code": "8178112", "type": "CDM"}], "standard_charges": [{"gross_charge": 14735.0, "discounted_cash": 11051.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KT STNT P SGL PIG RX PSH", "code_information": [{"code": "C2625", "type": "HCPCS"}, {"code": "8062047", "type": "CDM"}], "standard_charges": [{"gross_charge": 1755.0, "discounted_cash": 1316.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KT STNT P STR RX PUSHER", "code_information": [{"code": "C2625", "type": "HCPCS"}, {"code": "8062027", "type": "CDM"}], "standard_charges": [{"gross_charge": 1425.0, "discounted_cash": 1068.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KT TIP EXPNDR NARRW BAS", "code_information": [{"code": "C1813", "type": "HCPCS"}, {"code": "8178123", "type": "CDM"}], "standard_charges": [{"gross_charge": 4382.0, "discounted_cash": 3286.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KT TONGUE STABLIZATION", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4023400", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 14917.0, "discounted_cash": 11187.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KT Y-MSH COLPAS POS DVC", "code_information": [{"code": "C1763", "type": "HCPCS"}, {"code": "4023410", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9340.0, "discounted_cash": 7005.0, "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": 491.0, "discounted_cash": 368.25, "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": 491.0, "discounted_cash": 368.25, "setting": "both", "billing_class": "facility"}]}, {"description": "L RINGERS 250ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7120", "type": "HCPCS"}, {"code": "5412540", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 415.0, "discounted_cash": 311.25, "setting": "both", "billing_class": "facility"}]}, {"description": "L RINGERS 250ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7120", "type": "HCPCS"}, {"code": "5412540", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 415.0, "discounted_cash": 311.25, "setting": "both", "billing_class": "facility"}]}, {"description": "L RINGERS 3000ML IRR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5414080", "type": "CDM"}, {"code": "270", "type": "RC"}], "standard_charges": [{"gross_charge": 379.0, "discounted_cash": 284.25, "setting": "both", "billing_class": "facility"}]}, {"description": "L RINGERS 4000ML IRR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5414085", "type": "CDM"}, {"code": "270", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "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": 450.0, "discounted_cash": 337.5, "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": 450.0, "discounted_cash": 337.5, "setting": "both", "billing_class": "facility"}]}, {"description": "L SP FACET INJ+IMAG LV3+", "code_information": [{"code": "4914495", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2067.0, "discounted_cash": 1550.25, "setting": "both", "billing_class": "facility"}]}, {"description": "L SP FACET INJ+IMAG LVL1", "code_information": [{"code": "4914493", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5611.0, "discounted_cash": 4208.25, "setting": "both", "billing_class": "facility"}]}, {"description": "L SP FACET INJ+IMAG LVL2", "code_information": [{"code": "4914494", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2094.0, "discounted_cash": 1570.5, "setting": "both", "billing_class": "facility"}]}, {"description": "L&D EPIDURAL", "code_information": [{"code": "3702299", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 1690.0, "discounted_cash": 1267.5, "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": 1618.0, "discounted_cash": 1213.5, "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": 3247.0, "discounted_cash": 2435.25, "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": 812.0, "discounted_cash": 609.0, "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": 1719.0, "discounted_cash": 1289.25, "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": 4686.0, "discounted_cash": 3514.5, "setting": "both", "billing_class": "facility"}]}, {"description": "L&D SURG LVL I INT 30 M", "code_information": [{"code": "3101214", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 9374.0, "discounted_cash": 7030.5, "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": 4469.0, "discounted_cash": 3351.75, "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": 8938.0, "discounted_cash": 6703.5, "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": 5737.0, "discounted_cash": 4302.75, "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": 11471.0, "discounted_cash": 8603.25, "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": 5887.0, "discounted_cash": 4415.25, "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": 11777.0, "discounted_cash": 8832.75, "setting": "both", "billing_class": "facility"}]}, {"description": "L-CYSTEINE 50MG/ML10MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5319720", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 210.0, "discounted_cash": 157.5, "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": 8092.0, "discounted_cash": 6069.0, "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": 4837.0, "discounted_cash": 3627.75, "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": 47.0, "discounted_cash": 35.25, "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": 47.0, "discounted_cash": 35.25, "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": 49.0, "discounted_cash": 36.75, "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": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LABETALOL 300MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306325", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LABETALOL 300MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306325", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LABOR COMPLEX 1ST HR", "code_information": [{"code": "3101208", "type": "CDM"}, {"code": "720", "type": "RC"}], "standard_charges": [{"gross_charge": 807.0, "discounted_cash": 605.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LABOR COMPLEX ADD HR", "code_information": [{"code": "3101209", "type": "CDM"}, {"code": "720", "type": "RC"}], "standard_charges": [{"gross_charge": 585.0, "discounted_cash": 438.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LABOR INTERIM 1ST HR", "code_information": [{"code": "3101206", "type": "CDM"}, {"code": "720", "type": "RC"}], "standard_charges": [{"gross_charge": 585.0, "discounted_cash": 438.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LABOR INTERIM ADD HR", "code_information": [{"code": "3101207", "type": "CDM"}, {"code": "720", "type": "RC"}], "standard_charges": [{"gross_charge": 470.0, "discounted_cash": 352.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LABOR SIMPLE 1ST HR", "code_information": [{"code": "3101204", "type": "CDM"}, {"code": "720", "type": "RC"}], "standard_charges": [{"gross_charge": 510.0, "discounted_cash": 382.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LABOR SIMPLE ADD HR", "code_information": [{"code": "3101205", "type": "CDM"}, {"code": "720", "type": "RC"}], "standard_charges": [{"gross_charge": 412.0, "discounted_cash": 309.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LACOSAMIDE", "code_information": [{"code": "80235", "type": "CPT"}, {"code": "7252554", "type": "CDM"}], "standard_charges": [{"gross_charge": 862.0, "discounted_cash": 646.5, "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": 116.0, "discounted_cash": 87.0, "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": 116.0, "discounted_cash": 87.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LACOSAMIDE 10MG/1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315430", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LACOSAMIDE 10MG/1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315430", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LACOSAMIDE 150MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327682", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 134.0, "discounted_cash": 100.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LACOSAMIDE 150MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327682", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 134.0, "discounted_cash": 100.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LACOSAMIDE 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327675", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 122.0, "discounted_cash": 91.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LACOSAMIDE 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327675", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 122.0, "discounted_cash": 91.5, "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": 53.0, "discounted_cash": 39.75, "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": 53.0, "discounted_cash": 39.75, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LACTASE 3000U TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5306335", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LACTASE 3000U TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5306335", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LACTASE ENZYME", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5339795", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LACTASE ENZYME", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5339795", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "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": 774.0, "discounted_cash": 580.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LACTATE(LACTIC ACID)", "code_information": [{"code": "83605", "type": "CPT"}, {"code": "4123605", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 29.0, "discounted_cash": 21.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LACTOBACILLUS ACIDPHL CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306339", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LACTOBACILLUS ACIDPHL CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306339", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "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": 36.0, "discounted_cash": 27.0, "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": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LACTOFERRIN FECAL QNT", "code_information": [{"code": "83631", "type": "CPT"}, {"code": "7253631", "type": "CDM"}], "standard_charges": [{"gross_charge": 400.0, "discounted_cash": 300.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LACTOSE POWDER 100GM PW", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5306330", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 318.0, "discounted_cash": 238.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LACTOSE POWDER 100GM PW", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5306330", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 318.0, "discounted_cash": 238.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LACTULOSE 10/15 15ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315456", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LACTULOSE 10/15 15ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315456", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "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": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LACTULOSE 10GM PK", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315453", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 23.0, "discounted_cash": 17.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LACTULOSE 10GM PK", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315453", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 23.0, "discounted_cash": 17.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LACTULOSE 20GM PK", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315454", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LACTULOSE 20GM PK", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315454", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "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": 205.0, "discounted_cash": 153.75, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 205.0, "discounted_cash": 153.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LAMIVUDINE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306342", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LAMIVUDINE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306342", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "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": 101.0, "discounted_cash": 75.75, "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": 101.0, "discounted_cash": 75.75, "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": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "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": 14.0, "discounted_cash": 10.5, "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": 14.0, "discounted_cash": 10.5, "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": 68.0, "discounted_cash": 51.0, "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": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LAMOTRIGINE 150MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306348", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 62.0, "discounted_cash": 46.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LAMOTRIGINE 150MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306348", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 62.0, "discounted_cash": 46.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LAMOTRIGINE 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306349", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 59.0, "discounted_cash": 44.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LAMOTRIGINE 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306349", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 59.0, "discounted_cash": 44.25, "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": 59.0, "discounted_cash": 44.25, "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": 59.0, "discounted_cash": 44.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LAMOTRIGINE QUANT", "code_information": [{"code": "80175", "type": "CPT"}, {"code": "7250040", "type": "CDM"}], "standard_charges": [{"gross_charge": 520.0, "discounted_cash": 390.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LANOLIN 30GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336118", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LANOLIN 30GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336118", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "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": 21.0, "discounted_cash": 15.75, "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": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LANOLIN BRST FEED 2ML LT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336123", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LANOLIN BRST FEED 2ML LT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336123", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LANOLIN MINRL OIL120MLLT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336141", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 145.0, "discounted_cash": 108.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LANOLIN MINRL OIL120MLLT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336141", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 145.0, "discounted_cash": 108.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LANSOPRAZOLE 15MG DT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306354", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LANSOPRAZOLE 15MG DT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306354", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "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": 113.0, "discounted_cash": 84.75, "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": 113.0, "discounted_cash": 84.75, "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": 52.0, "discounted_cash": 39.0, "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": 52.0, "discounted_cash": 39.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 116.0, "discounted_cash": 87.0, "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": 116.0, "discounted_cash": 87.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LANTHANUM CARB 250MG CTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306360", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LANTHANUM CARB 250MG CTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306360", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LANTHANUM CARB 500MG CTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306361", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LANTHANUM CARB 500MG CTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306361", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 649.0, "discounted_cash": 486.75, "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": 649.0, "discounted_cash": 486.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LD ACUITY X4 SPRL S 4674", "code_information": [{"code": "C1900", "type": "HCPCS"}, {"code": "4008564", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 31102.0, "discounted_cash": 23326.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD ACUITYX4 QUAD LV 4671", "code_information": [{"code": "C1900", "type": "HCPCS"}, {"code": "4008572", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 43249.0, "discounted_cash": 32436.75, "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": 18437.0, "discounted_cash": 13827.75, "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": 18437.0, "discounted_cash": 13827.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LD ATTAIN BIPLR 4194", "code_information": [{"code": "C1900", "type": "HCPCS"}, {"code": "8247301", "type": "CDM"}], "standard_charges": [{"gross_charge": 12501.0, "discounted_cash": 9375.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LD ATTAIN PERFORMA 4298", "code_information": [{"code": "C1900", "type": "HCPCS"}, {"code": "4000368", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 17103.0, "discounted_cash": 12827.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LD ATTAIN PERFORMA 4598", "code_information": [{"code": "C1900", "type": "HCPCS"}, {"code": "4008568", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 20848.0, "discounted_cash": 15636.0, "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": 18437.0, "discounted_cash": 13827.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFB OPTISURE LDA220Q", "code_information": [{"code": "C1895", "type": "HCPCS"}, {"code": "4008629", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 28336.0, "discounted_cash": 21252.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFB RELIANC 4STE 0293", "code_information": [{"code": "C1777", "type": "HCPCS"}, {"code": "4008616", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 29953.0, "discounted_cash": 22464.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFB RELIANC 4STE 0295", "code_information": [{"code": "C1895", "type": "HCPCS"}, {"code": "4008618", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 32945.0, "discounted_cash": 24708.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFB RELIANC 4STE 0296", "code_information": [{"code": "C1895", "type": "HCPCS"}, {"code": "4008619", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 32945.0, "discounted_cash": 24708.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFB SPRINT SECR 6935M", "code_information": [{"code": "C1777", "type": "HCPCS"}, {"code": "4008578", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 26954.0, "discounted_cash": 20215.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFIB ACUITY 4555", "code_information": [{"code": "C1900", "type": "HCPCS"}, {"code": "4000380", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 14978.0, "discounted_cash": 11233.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFIB DUAL COIL PRELIF", "code_information": [{"code": "C1895", "type": "HCPCS"}, {"code": "8247303", "type": "CDM"}], "standard_charges": [{"gross_charge": 0.01, "discounted_cash": 0.01, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFIB DURATA 7120", "code_information": [{"code": "C1895", "type": "HCPCS"}, {"code": "4000386", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 36962.0, "discounted_cash": 27721.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFIB DURATA 7120Q SJ4", "code_information": [{"code": "C1895", "type": "HCPCS"}, {"code": "4008590", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 38815.0, "discounted_cash": 29111.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFIB DURATA 7121Q SJ4", "code_information": [{"code": "C1895", "type": "HCPCS"}, {"code": "4008592", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 38815.0, "discounted_cash": 29111.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFIB DURATA 7122", "code_information": [{"code": "C1777", "type": "HCPCS"}, {"code": "4000388", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 36962.0, "discounted_cash": 27721.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFIB DURATA 7122Q SJ4", "code_information": [{"code": "C1777", "type": "HCPCS"}, {"code": "4008591", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 38815.0, "discounted_cash": 29111.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFIB DURATA 7170", "code_information": [{"code": "C1895", "type": "HCPCS"}, {"code": "4008589", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 38815.0, "discounted_cash": 29111.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFIB DURATA 7170Q SJ4", "code_information": [{"code": "C1895", "type": "HCPCS"}, {"code": "4008595", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 38815.0, "discounted_cash": 29111.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFIB EASYTRAK 4543", "code_information": [{"code": "C1900", "type": "HCPCS"}, {"code": "8241698", "type": "CDM"}], "standard_charges": [{"gross_charge": 12968.0, "discounted_cash": 9726.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFIB EMBLEM S-ICD 3501", "code_information": [{"code": "C1896", "type": "HCPCS"}, {"code": "4008644", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 49112.0, "discounted_cash": 36834.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFIB QUICKFLEX 1258T", "code_information": [{"code": "C1900", "type": "HCPCS"}, {"code": "4008599", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 20952.0, "discounted_cash": 15714.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFIB SPRINT 6935", "code_information": [{"code": "C1777", "type": "HCPCS"}, {"code": "4008601", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 32687.0, "discounted_cash": 24515.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFIB SPRINT 6944", "code_information": [{"code": "C1895", "type": "HCPCS"}, {"code": "8241754", "type": "CDM"}], "standard_charges": [{"gross_charge": 32687.0, "discounted_cash": 24515.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFIB SPRINT 6947", "code_information": [{"code": "C1895", "type": "HCPCS"}, {"code": "8240247", "type": "CDM"}], "standard_charges": [{"gross_charge": 32996.0, "discounted_cash": 24747.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFIB SUB-Q 6996SQ", "code_information": [{"code": "C1896", "type": "HCPCS"}, {"code": "8247348", "type": "CDM"}], "standard_charges": [{"gross_charge": 19230.0, "discounted_cash": 14422.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD INGEVITY MRI 7741", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "4008651", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 7374.0, "discounted_cash": 5530.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD ISOFLEX OPTIM 1944", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "4008649", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4297.0, "discounted_cash": 3222.75, "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": 4297.0, "discounted_cash": 3222.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LD LFT VENT COR VEN SYS", "code_information": [{"code": "C1900", "type": "HCPCS"}, {"code": "8241775", "type": "CDM"}], "standard_charges": [{"gross_charge": 17964.0, "discounted_cash": 13473.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LD LFT VENT COR VEN SYS3", "code_information": [{"code": "C1900", "type": "HCPCS"}, {"code": "8241777", "type": "CDM"}], "standard_charges": [{"gross_charge": 36877.0, "discounted_cash": 27657.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LD NSTIM 1X8 SUB-CMPCT", "code_information": [{"code": "C1778", "type": "HCPCS"}, {"code": "8241799", "type": "CDM"}], "standard_charges": [{"gross_charge": 14839.0, "discounted_cash": 11129.25, "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": 26355.0, "discounted_cash": 19766.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LD NSTIM INTERSTIM 3093", "code_information": [{"code": "C1778", "type": "HCPCS"}, {"code": "8241811", "type": "CDM"}], "standard_charges": [{"gross_charge": 26737.0, "discounted_cash": 20052.75, "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": 23838.0, "discounted_cash": 17878.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD NSTIM OCTAD 3778", "code_information": [{"code": "C1778", "type": "HCPCS"}, {"code": "8241815", "type": "CDM"}], "standard_charges": [{"gross_charge": 14615.0, "discounted_cash": 10961.25, "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": 36200.0, "discounted_cash": 27150.0, "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": 63206.0, "discounted_cash": 47404.5, "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": 12543.0, "discounted_cash": 9407.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PACE/SEN DFB DUAL COIL 0675", "code_information": [{"code": "C1895", "type": "HCPCS"}, {"code": "4008753", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 27085.0, "discounted_cash": 20313.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PACE/SENS DFB SGL COIL 0672", "code_information": [{"code": "C1777", "type": "HCPCS"}, {"code": "4008749", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5116.0, "discounted_cash": 3837.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PACE/SENS DFB SGL COIL 0673", "code_information": [{"code": "C1777", "type": "HCPCS"}, {"code": "4008748", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 38676.0, "discounted_cash": 29007.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PLEXA PROMRI S DX 436910", "code_information": [{"code": "C1777", "type": "HCPCS"}, {"code": "4000417", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 37518.0, "discounted_cash": 28138.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM CAPSR Z NOVUS 5054", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "4008707", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4400.0, "discounted_cash": 3300.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM CAPSURE EPI 4968", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "8241863", "type": "CDM"}], "standard_charges": [{"gross_charge": 5406.0, "discounted_cash": 4054.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM CAPSURE SENSE 4074", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "4008704", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3880.0, "discounted_cash": 2910.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM CAPSURE SENSE 4574", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "4000398", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4400.0, "discounted_cash": 3300.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM CAPSURE SP NOV5594", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "4000399", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4400.0, "discounted_cash": 3300.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM CAPSURE Z NOV 5554", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "4008709", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5462.0, "discounted_cash": 4096.5, "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": 5866.0, "discounted_cash": 4399.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM CAPSURFX NOVUS4076", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "8241867", "type": "CDM"}], "standard_charges": [{"gross_charge": 4038.0, "discounted_cash": 3028.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM CAPSURFX NOVUS5076", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "8241865", "type": "CDM"}], "standard_charges": [{"gross_charge": 4443.0, "discounted_cash": 3332.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM DEXTRUS 4135", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "4000402", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5333.0, "discounted_cash": 3999.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM DEXTRUS 4136", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "4000400", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4313.0, "discounted_cash": 3234.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM DEXTRUS 4137", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "4000401", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4313.0, "discounted_cash": 3234.75, "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": 4764.0, "discounted_cash": 3573.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM FINELN2 EZSTER4469", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "8247410", "type": "CDM"}], "standard_charges": [{"gross_charge": 3746.0, "discounted_cash": 2809.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM FINELN2 EZSTER4470", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "8247412", "type": "CDM"}], "standard_charges": [{"gross_charge": 4788.0, "discounted_cash": 3591.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM FINELN2 STEROX4456", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "8247422", "type": "CDM"}], "standard_charges": [{"gross_charge": 4146.0, "discounted_cash": 3109.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM FINELN2 STEROX4479", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "8247428", "type": "CDM"}], "standard_charges": [{"gross_charge": 3566.0, "discounted_cash": 2674.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM FINELN2 STEROX4480", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "8247430", "type": "CDM"}], "standard_charges": [{"gross_charge": 4107.0, "discounted_cash": 3080.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM FINELNII4458STEROX", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "8240256", "type": "CDM"}], "standard_charges": [{"gross_charge": 3534.0, "discounted_cash": 2650.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM INGEVITY MRI 7732", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "4008714", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6433.0, "discounted_cash": 4824.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM INGEVITY MRI 7740", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "4008717", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 7374.0, "discounted_cash": 5530.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM INGEVITY MRI 7742", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "4008712", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 7374.0, "discounted_cash": 5530.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM INGEVITY+ 7840", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "4008722", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4507.0, "discounted_cash": 3380.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM INGEVITY+ 7841", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "4008719", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4507.0, "discounted_cash": 3380.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM INGEVITY+ 7842", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "4008721", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4507.0, "discounted_cash": 3380.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM NOT TRNSVEN VDD SP", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "8240217", "type": "CDM"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM OPTISENSE 1999", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "4008738", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4573.0, "discounted_cash": 3429.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM SELECTSECURE 3830", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "8241943", "type": "CDM"}], "standard_charges": [{"gross_charge": 3878.0, "discounted_cash": 2908.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM SOLIA S", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "4008733", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5116.0, "discounted_cash": 3837.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM TENDRIL STS 2088TC", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "4008742", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4946.0, "discounted_cash": 3709.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM TENDRL ST OP1882TC", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "8242020", "type": "CDM"}], "standard_charges": [{"gross_charge": 5027.0, "discounted_cash": 3770.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM ULTIPACE PACING LPA1231", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "4008743", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4222.0, "discounted_cash": 3166.5, "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": 25143.0, "discounted_cash": 18857.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LD SUBCUTAN Q-TRAK 3010", "code_information": [{"code": "C1896", "type": "HCPCS"}, {"code": "4008820", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 36282.0, "discounted_cash": 27211.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD TENDRIL MRI LPA1200M", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "4008821", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 7058.0, "discounted_cash": 5293.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LDH-ISOENZYMES ELCTROPHR", "code_information": [{"code": "83625", "type": "CPT"}, {"code": "7003625", "type": "CDM"}], "standard_charges": [{"gross_charge": 525.0, "discounted_cash": 393.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LDH-ISOENZYMES ELCTROPHR", "code_information": [{"code": "83625", "type": "CPT"}, {"code": "7253625", "type": "CDM"}], "standard_charges": [{"gross_charge": 525.0, "discounted_cash": 393.75, "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": 234.0, "discounted_cash": 175.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LDH-LACTIC DEHYDROGENASE", "code_information": [{"code": "83615", "type": "CPT"}, {"code": "4123615", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LDH-LACTIC DEHYDROGENASE", "code_information": [{"code": "83615", "type": "CPT"}, {"code": "4153615", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 129.0, "discounted_cash": 96.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LDH-LACTIC DEHYDROGENASE", "code_information": [{"code": "83615", "type": "CPT"}, {"code": "7253615", "type": "CDM"}], "standard_charges": [{"gross_charge": 59.0, "discounted_cash": 44.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LDH-LACTIC DEHYDROGENASE/2", "code_information": [{"code": "83615", "type": "CPT"}, {"code": "4103616", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LDH-LACTIC DEHYDROGENASE/2", "code_information": [{"code": "83615", "type": "CPT"}, {"code": "4123617", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LDH-LACTIC DEHYDROGENASE/2", "code_information": [{"code": "83615", "type": "CPT"}, {"code": "4153617", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 142.0, "discounted_cash": 106.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LDH-LACTIC DEHYDROGENASE/2", "code_information": [{"code": "83615", "type": "CPT"}, {"code": "7253616", "type": "CDM"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "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": 232.0, "discounted_cash": 174.0, "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": 2145.0, "discounted_cash": 1608.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LDL CHOLESTOROL", "code_information": [{"code": "83721", "type": "CPT"}, {"code": "4122476", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LE ART IMAGING COMP BILAT", "code_information": [{"code": "93925", "type": "CPT"}, {"code": "4636040", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 2787.0, "discounted_cash": 2090.25, "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": 2332.0, "discounted_cash": 1749.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LE ART IMAGING COMP BILAT", "code_information": [{"code": "93925", "type": "CPT"}, {"code": "5119392", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 2787.0, "discounted_cash": 2090.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LE ART IMAGING UNI/LTD", "code_information": [{"code": "93926", "type": "CPT"}, {"code": "4636046", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 2180.0, "discounted_cash": 1635.0, "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": 1615.0, "discounted_cash": 1211.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LE ART IMAGING UNI/LTD", "code_information": [{"code": "93926", "type": "CPT"}, {"code": "5117202", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 2180.0, "discounted_cash": 1635.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LE ORTHOSES UNSPECIFIED", "code_information": [{"code": "L2999", "type": "HCPCS"}, {"code": "8130052", "type": "CDM"}], "standard_charges": [{"gross_charge": 560.0, "discounted_cash": 420.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LEAD QUANTITATIVE", "code_information": [{"code": "83655", "type": "CPT"}, {"code": "7003655", "type": "CDM"}], "standard_charges": [{"gross_charge": 481.0, "discounted_cash": 360.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEAD QUANTITATIVE", "code_information": [{"code": "83655", "type": "CPT"}, {"code": "7253655", "type": "CDM"}], "standard_charges": [{"gross_charge": 481.0, "discounted_cash": 360.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEAD QUANTITATIVE/2", "code_information": [{"code": "83655", "type": "CPT"}, {"code": "7003658", "type": "CDM"}], "standard_charges": [{"gross_charge": 481.0, "discounted_cash": 360.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEAD QUANTITATIVE/4", "code_information": [{"code": "83655", "type": "CPT"}, {"code": "7253658", "type": "CDM"}], "standard_charges": [{"gross_charge": 481.0, "discounted_cash": 360.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEFLUNOMIDE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306363", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 213.0, "discounted_cash": 159.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEFLUNOMIDE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306363", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 213.0, "discounted_cash": 159.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEGIONELLA AB", "code_information": [{"code": "86713", "type": "CPT"}, {"code": "7006258", "type": "CDM"}], "standard_charges": [{"gross_charge": 1162.0, "discounted_cash": 871.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LEGIONELLA AB/2", "code_information": [{"code": "86713", "type": "CPT"}, {"code": "7256724", "type": "CDM"}], "standard_charges": [{"gross_charge": 1162.0, "discounted_cash": 871.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LEGIONELLA PNEUMOPHILA/2", "code_information": [{"code": "87278", "type": "CPT"}, {"code": "7257278", "type": "CDM"}], "standard_charges": [{"gross_charge": 520.0, "discounted_cash": 390.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LENS INTRAOCULAR", "code_information": [{"code": "C1780", "type": "HCPCS"}, {"code": "8240221", "type": "CDM"}], "standard_charges": [{"gross_charge": 491.0, "discounted_cash": 368.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LEPIRUDIN PER 50MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1945", "type": "HCPCS"}, {"code": "5321648", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2724.0, "discounted_cash": 2043.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LEPIRUDIN PER 50MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1945", "type": "HCPCS"}, {"code": "5321648", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 2724.0, "discounted_cash": 2043.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LEPTOSPIRA AB", "code_information": [{"code": "86720", "type": "CPT"}, {"code": "7006178", "type": "CDM"}], "standard_charges": [{"gross_charge": 574.0, "discounted_cash": 430.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LEPTOSPIRA AB", "code_information": [{"code": "86720", "type": "CPT"}, {"code": "7256178", "type": "CDM"}], "standard_charges": [{"gross_charge": 574.0, "discounted_cash": 430.5, "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": 123.0, "discounted_cash": 92.25, "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": 123.0, "discounted_cash": 92.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LEUCOVORIN 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8999", "type": "HCPCS"}, {"code": "5306393", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 450.0, "discounted_cash": 337.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LEUCOVORIN 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8999", "type": "HCPCS"}, {"code": "5306393", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 450.0, "discounted_cash": 337.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 82.0, "discounted_cash": 61.5, "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": 82.0, "discounted_cash": 61.5, "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": 1128.0, "discounted_cash": 846.0, "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": 1128.0, "discounted_cash": 846.0, "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": 129.0, "discounted_cash": 96.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEUKO ASSMT FECAL QL/SQN", "code_information": [{"code": "89055", "type": "CPT"}, {"code": "4125049", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEUKO ASSMT FECAL QL/SQN/2", "code_information": [{"code": "89055", "type": "CPT"}, {"code": "4155049", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 130.0, "discounted_cash": 97.5, "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": 363.0, "discounted_cash": 272.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LEUKOCYTE ALKA-PHSPHTASE", "code_information": [{"code": "85540", "type": "CPT"}, {"code": "4125540", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 23.0, "discounted_cash": 17.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 7138.0, "discounted_cash": 5353.5, "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": 7138.0, "discounted_cash": 5353.5, "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": 7771.0, "discounted_cash": 5828.25, "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": 7771.0, "discounted_cash": 5828.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVALBUTERL1.25MG/.5MLIS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331374", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVALBUTERL1.25MG/.5MLIS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331374", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "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": 59.0, "discounted_cash": 44.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 59.0, "discounted_cash": 44.25, "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": 90.0, "discounted_cash": 67.5, "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": 90.0, "discounted_cash": 67.5, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVALBUTEROL45MCG/15GMIH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331378", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 432.0, "discounted_cash": 324.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVALBUTEROL45MCG/15GMIH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331378", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 432.0, "discounted_cash": 324.0, "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": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVETIRACETAM", "code_information": [{"code": "80177", "type": "CPT"}, {"code": "7250016", "type": "CDM"}], "standard_charges": [{"gross_charge": 520.0, "discounted_cash": 390.0, "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": 52.0, "discounted_cash": 39.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "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": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVETIRACETAM 750MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306407", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVETIRACETAM 750MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306407", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVETIRACETAM/2", "code_information": [{"code": "80177", "type": "CPT"}, {"code": "7258297", "type": "CDM"}], "standard_charges": [{"gross_charge": 137.0, "discounted_cash": 102.75, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOBUNOLOL .25% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331372", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 261.0, "discounted_cash": 195.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOBUNOLOL .25% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331372", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 261.0, "discounted_cash": 195.75, "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": 244.0, "discounted_cash": 183.0, "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": 244.0, "discounted_cash": 183.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOCARNITINE 250MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302069", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOCARNITINE 250MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302069", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOCARNITINE 330MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302070", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 11.0, "discounted_cash": 8.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOCARNITINE 330MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302070", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 11.0, "discounted_cash": 8.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOCARNITINE NEO IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1955", "type": "HCPCS"}, {"code": "5321705", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 284.0, "discounted_cash": 213.0, "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": 1664.0, "discounted_cash": 1248.0, "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": 207.0, "discounted_cash": 155.25, "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": 207.0, "discounted_cash": 155.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOFLOXACIN .5% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331390", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 542.0, "discounted_cash": 406.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOFLOXACIN .5% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331390", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 542.0, "discounted_cash": 406.5, "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": 147.0, "discounted_cash": 110.25, "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": 147.0, "discounted_cash": 110.25, "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": 195.0, "discounted_cash": 146.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 195.0, "discounted_cash": 146.25, "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": 284.0, "discounted_cash": 213.0, "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": 284.0, "discounted_cash": 213.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOFLOXACIN PER250MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1956", "type": "HCPCS"}, {"code": "5321709", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 216.0, "discounted_cash": 162.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOFLOXACIN PER250MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1956", "type": "HCPCS"}, {"code": "5321709", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 216.0, "discounted_cash": 162.0, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "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": 36.0, "discounted_cash": 27.0, "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": 36.0, "discounted_cash": 27.0, "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": 39.0, "discounted_cash": 29.25, "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": 39.0, "discounted_cash": 29.25, "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": 38.0, "discounted_cash": 28.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOTHYROXIN .137MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306457", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOTHYROXIN .137MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306457", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOTHYROXIN .175MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306460", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOTHYROXIN .175MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306460", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "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": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOTHYROXIN .3MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306467", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOTHYROXIN .3MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306467", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "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": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "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": 918.0, "discounted_cash": 688.5, "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": 208.0, "discounted_cash": 156.0, "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": 261.0, "discounted_cash": 195.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDOCAINE", "code_information": [{"code": "80176", "type": "CPT"}, {"code": "4124625", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDOCAINE", "code_information": [{"code": "80176", "type": "CPT"}, {"code": "7253610", "type": "CDM"}], "standard_charges": [{"gross_charge": 133.0, "discounted_cash": 99.75, "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": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDOCAINE 2% 15ML TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336231", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDOCAINE 2% 20ML TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336194", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 194.0, "discounted_cash": 145.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDOCAINE 2% 30GM GL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336198", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 280.0, "discounted_cash": 210.0, "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": 205.0, "discounted_cash": 153.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDOCAINE 4% 4ML TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336216", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 161.0, "discounted_cash": 120.75, "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": 149.0, "discounted_cash": 111.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDOCAINE 4% 5ML TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336209", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 318.0, "discounted_cash": 238.5, "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": 366.0, "discounted_cash": 274.5, "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": 89.0, "discounted_cash": 66.75, "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": 0.11, "discounted_cash": 0.08, "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": 0.11, "discounted_cash": 0.08, "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": 0.11, "discounted_cash": 0.08, "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": 0.11, "discounted_cash": 0.08, "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": 0.38, "discounted_cash": 0.29, "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": 0.38, "discounted_cash": 0.29, "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": 0.22, "discounted_cash": 0.17, "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": 0.22, "discounted_cash": 0.17, "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": 111.0, "discounted_cash": 83.25, "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": 111.0, "discounted_cash": 83.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "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": 60.0, "discounted_cash": 45.0, "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": 60.0, "discounted_cash": 45.0, "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": 262.0, "discounted_cash": 196.5, "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": 101.0, "discounted_cash": 75.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LINACLOTIDE 145MCG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306480", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 106.0, "discounted_cash": 79.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LINACLOTIDE 145MCG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306480", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 106.0, "discounted_cash": 79.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LINACLOTIDE 290MCG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306481", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 94.0, "discounted_cash": 70.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LINACLOTIDE 290MCG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306481", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 94.0, "discounted_cash": 70.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LINAGLIPTIN 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306495", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 133.0, "discounted_cash": 99.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LINAGLIPTIN 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306495", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 133.0, "discounted_cash": 99.75, "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": 8971.0, "discounted_cash": 6728.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LINER ACETABULAR CSTRND SN CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012878", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10702.0, "discounted_cash": 8026.5, "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": 13156.0, "discounted_cash": 9867.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LINER HIP REVISION SN CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012876", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 25591.0, "discounted_cash": 19193.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1033.0, "discounted_cash": 774.75, "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": 1033.0, "discounted_cash": 774.75, "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": 544.0, "discounted_cash": 408.0, "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": 544.0, "discounted_cash": 408.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LINEZOLID100/5 150MLPWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315520", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3002.0, "discounted_cash": 2251.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LINEZOLID100/5 150MLPWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315520", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 3002.0, "discounted_cash": 2251.5, "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": 39.0, "discounted_cash": 29.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LIOTHYRONINE 50MCG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306519", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LIOTHYRONINE 50MCG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306519", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LIOTHYRONINE 5MCG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306513", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LIOTHYRONINE 5MCG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306513", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LIOTRIX 30MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306540", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LIOTRIX 30MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306540", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LIP PROTECTANT 7.5GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334736", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 75.0, "discounted_cash": 56.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LIP PROTECTANT 7.5GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334736", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 75.0, "discounted_cash": 56.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LIP PROTECTANT STICK EA", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334748", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LIP PROTECTANT STICK EA", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334748", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "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": 713.0, "discounted_cash": 534.75, "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": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LIPASE", "code_information": [{"code": "83690", "type": "CPT"}, {"code": "4153690", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 303.0, "discounted_cash": 227.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LIPASE/2", "code_information": [{"code": "83690", "type": "CPT"}, {"code": "7253691", "type": "CDM"}], "standard_charges": [{"gross_charge": 168.0, "discounted_cash": 126.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LIPASE/3", "code_information": [{"code": "83690", "type": "CPT"}, {"code": "7254994", "type": "CDM"}], "standard_charges": [{"gross_charge": 487.0, "discounted_cash": 365.25, "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": 1178.0, "discounted_cash": 883.5, "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": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LIPID PANEL", "code_information": [{"code": "80061", "type": "CPT"}, {"code": "4150062", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 348.0, "discounted_cash": 261.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LIPOPROTEIN (A)", "code_information": [{"code": "83695", "type": "CPT"}, {"code": "7253716", "type": "CDM"}], "standard_charges": [{"gross_charge": 337.0, "discounted_cash": 252.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LISDEXAMFETAMINE 20MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327608", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 59.0, "discounted_cash": 44.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LISDEXAMFETAMINE 20MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327608", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 59.0, "discounted_cash": 44.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LISDEXAMFETAMINE 30MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327611", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 59.0, "discounted_cash": 44.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LISDEXAMFETAMINE 30MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327611", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 59.0, "discounted_cash": 44.25, "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": 4.0, "discounted_cash": 3.0, "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": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LISINOPRIL 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306634", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LISINOPRIL 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306634", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "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": 13.0, "discounted_cash": 9.75, "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": 13.0, "discounted_cash": 9.75, "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": 13.0, "discounted_cash": 9.75, "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": 13.0, "discounted_cash": 9.75, "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": 12.0, "discounted_cash": 9.0, "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": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LISTERIA MONOCYTOGENES AB", "code_information": [{"code": "86723", "type": "CPT"}, {"code": "7256723", "type": "CDM"}], "standard_charges": [{"gross_charge": 571.0, "discounted_cash": 428.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LISTERIA MONOCYTOGENES AB/2", "code_information": [{"code": "86723", "type": "CPT"}, {"code": "7256725", "type": "CDM"}], "standard_charges": [{"gross_charge": 571.0, "discounted_cash": 428.25, "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": 756.0, "discounted_cash": 567.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LITHIUM", "code_information": [{"code": "80178", "type": "CPT"}, {"code": "4123725", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LITHIUM", "code_information": [{"code": "80178", "type": "CPT"}, {"code": "4153725", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 240.0, "discounted_cash": 180.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LITHIUM 150MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306674", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LITHIUM 150MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306674", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LITHIUM 300MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306675", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 23.0, "discounted_cash": 17.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LITHIUM 300MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306675", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 23.0, "discounted_cash": 17.25, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "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": 3.0, "discounted_cash": 2.25, "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": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LITHIUM300MG/5ML 10ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315486", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LITHIUM300MG/5ML 10ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315486", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LITHIUM300MG/5ML 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315485", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 11.0, "discounted_cash": 8.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LITHIUM300MG/5ML 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315485", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 11.0, "discounted_cash": 8.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LITHOTRIPSY", "code_information": [{"code": "3080590", "type": "CDM"}, {"code": "790", "type": "RC"}], "standard_charges": [{"gross_charge": 46046.0, "discounted_cash": 34534.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LIVER BX W/OTHER PROC", "code_information": [{"code": "4918220", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 10123.0, "discounted_cash": 7592.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LIVER/SPLEEN IMAG STATIC", "code_information": [{"code": "78215", "type": "CPT"}, {"code": "5018215", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 10798.0, "discounted_cash": 8098.5, "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": 1586.0, "discounted_cash": 1189.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LIVER/SPLEEN VASC FLOW", "code_information": [{"code": "78216", "type": "CPT"}, {"code": "5018216", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 1198.0, "discounted_cash": 898.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LIVER/SPLEEN VASC FLOW", "code_information": [{"code": "78216", "type": "CPT"}, {"code": "5208216", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 1171.0, "discounted_cash": 878.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LNR ACE MTL CR BIO BHRR3 SN CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012879", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 7118.0, "discounted_cash": 5338.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LNR ACE OXIN OR3O DL MOB SN CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4018023", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10702.0, "discounted_cash": 8026.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LNR ACE PLY HG CRSLK AESCLP CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013331", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8405.0, "discounted_cash": 6303.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LNR ACE POLY OR3O DL MOB SN CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4018022", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6081.0, "discounted_cash": 4560.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LNR ACET HI CRSLNK INS ZIM CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012951", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9155.0, "discounted_cash": 6866.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LNR ACET MDM MTL LNR STRY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013040", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10763.0, "discounted_cash": 8072.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LNR ACET VIVACT E POLY ZIM CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012956", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12268.0, "discounted_cash": 9201.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LNR ACET X3 MBL BEAR STRYK CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013045", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8971.0, "discounted_cash": 6728.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LOCALZ TUM SPECT SGL 2+DAYS", "code_information": [{"code": "78831", "type": "CPT"}, {"code": "5208831", "type": "CDM"}, {"code": "340", "type": "RC"}], "standard_charges": [{"gross_charge": 9250.0, "discounted_cash": 6937.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LOCALZ TUM SPECT W/CT SGL 1DAY", "code_information": [{"code": "78830", "type": "CPT"}, {"code": "5208829", "type": "CDM"}, {"code": "340", "type": "RC"}], "standard_charges": [{"gross_charge": 5865.0, "discounted_cash": 4398.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LOCM 100-199MG/ML ID 1ML", "code_information": [{"code": "Q9965", "type": "HCPCS"}, {"code": "5358212", "type": "CDM"}, {"code": "255", "type": "RC"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LOCM 100-199MG/ML ID 1ML", "code_information": [{"code": "Q9965", "type": "HCPCS"}, {"code": "5358212", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "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": 13.0, "discounted_cash": 9.75, "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": 13.0, "discounted_cash": 9.75, "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": 12.0, "discounted_cash": 9.0, "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": 12.0, "discounted_cash": 9.0, "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": 48.0, "discounted_cash": 36.0, "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": 48.0, "discounted_cash": 36.0, "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": 39.0, "discounted_cash": 29.25, "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": 39.0, "discounted_cash": 29.25, "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": 19.0, "discounted_cash": 14.25, "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": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LOPINAV/RITONA 133/33 CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306730", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LOPINAV/RITONA 133/33 CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306730", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "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": 76.0, "discounted_cash": 57.0, "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": 83.0, "discounted_cash": 62.25, "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": 83.0, "discounted_cash": 62.25, "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": 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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "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": 49.0, "discounted_cash": 36.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LORAZEPAM 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306756", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LORAZEPAM 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306756", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "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": 403.0, "discounted_cash": 302.25, "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": 403.0, "discounted_cash": 302.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LORAZEPAM2MG/1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315538", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LORAZEPAM2MG/1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315538", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LOSARTAN 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306754", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LOSARTAN 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306754", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "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": 49.0, "discounted_cash": 36.75, "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": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LOXAPINE 50MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306786", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LOXAPINE 50MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306786", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LOXAPINE 5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306774", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LOXAPINE 5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306774", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LTA KIT IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321910", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 531.0, "discounted_cash": 398.25, "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": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "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": 47.0, "discounted_cash": 35.25, "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": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LUBRICANT SURG 3GM GL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337368", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LUBRICANT SURGICAL 60GM", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336299", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 365.0, "discounted_cash": 273.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LUBRICANT SURGICAL 60GM", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336299", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 365.0, "discounted_cash": 273.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LUMBAR VENOGRAM DX", "code_information": [{"code": "76496", "type": "CPT"}, {"code": "4916497", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1663.0, "discounted_cash": 1247.25, "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": 4373.0, "discounted_cash": 3279.75, "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": 10141.0, "discounted_cash": 7605.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LUNG PERFUSION DIFFER", "code_information": [{"code": "78597", "type": "CPT"}, {"code": "5208598", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 10141.0, "discounted_cash": 7605.75, "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": 11661.0, "discounted_cash": 8745.75, "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": 6670.0, "discounted_cash": 5002.5, "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": 1021.0, "discounted_cash": 765.75, "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": 175.0, "discounted_cash": 131.25, "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": 175.0, "discounted_cash": 131.25, "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": 157.0, "discounted_cash": 117.75, "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": 157.0, "discounted_cash": 117.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LURASIDONE 80MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306799", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 157.0, "discounted_cash": 117.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LURASIDONE 80MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306799", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 157.0, "discounted_cash": 117.75, "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": 549.0, "discounted_cash": 411.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LUTEINING HORMONE", "code_information": [{"code": "83002", "type": "CPT"}, {"code": "4153002", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 187.0, "discounted_cash": 140.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LUTEINING HORMONE", "code_information": [{"code": "83002", "type": "CPT"}, {"code": "7253002", "type": "CDM"}], "standard_charges": [{"gross_charge": 226.0, "discounted_cash": 169.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LYME AMP PROBE/2", "code_information": [{"code": "87476", "type": "CPT"}, {"code": "7257136", "type": "CDM"}], "standard_charges": [{"gross_charge": 620.0, "discounted_cash": 465.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LYME DISEASE AB", "code_information": [{"code": "86618", "type": "CPT"}, {"code": "7006259", "type": "CDM"}], "standard_charges": [{"gross_charge": 965.0, "discounted_cash": 723.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LYME DISEASE AB", "code_information": [{"code": "86618", "type": "CPT"}, {"code": "7256257", "type": "CDM"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LYME DISEASE AB TEST", "code_information": [{"code": "86617", "type": "CPT"}, {"code": "7250225", "type": "CDM"}], "standard_charges": [{"gross_charge": 238.0, "discounted_cash": 178.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LYME DISEASE AB TEST/2", "code_information": [{"code": "86617", "type": "CPT"}, {"code": "7006257", "type": "CDM"}], "standard_charges": [{"gross_charge": 1406.0, "discounted_cash": 1054.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LYME DISEASE AB TEST/2", "code_information": [{"code": "86617", "type": "CPT"}, {"code": "7256308", "type": "CDM"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LYME DISEASE AB TEST/4", "code_information": [{"code": "86617", "type": "CPT"}, {"code": "7256618", "type": "CDM"}], "standard_charges": [{"gross_charge": 238.0, "discounted_cash": 178.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LYME DISEASE AB TEST/6", "code_information": [{"code": "86617", "type": "CPT"}, {"code": "7258617", "type": "CDM"}], "standard_charges": [{"gross_charge": 703.0, "discounted_cash": 527.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LYME DISEASE AB/2", "code_information": [{"code": "86618", "type": "CPT"}, {"code": "7256312", "type": "CDM"}], "standard_charges": [{"gross_charge": 965.0, "discounted_cash": 723.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LYME DISEASE AB/5", "code_information": [{"code": "86618", "type": "CPT"}, {"code": "7256621", "type": "CDM"}], "standard_charges": [{"gross_charge": 336.0, "discounted_cash": 252.0, "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": 1850.0, "discounted_cash": 1387.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LYMPHNGIO BI PELVIC/ABD", "code_information": [{"code": "75807", "type": "CPT"}, {"code": "4915808", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 19330.0, "discounted_cash": 14497.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LYMPHNGIO UN PELVIC/ABD", "code_information": [{"code": "75805", "type": "CPT"}, {"code": "4915806", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2867.0, "discounted_cash": 2150.25, "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": 4.0, "discounted_cash": 3.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "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": 4.0, "discounted_cash": 3.0, "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": 26.0, "discounted_cash": 19.5, "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": 26.0, "discounted_cash": 19.5, "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": 245.0, "discounted_cash": 183.75, "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": 245.0, "discounted_cash": 183.75, "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": 383.0, "discounted_cash": 287.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MAGNESIUM", "code_information": [{"code": "83735", "type": "CPT"}, {"code": "4123735", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MAGNESIUM", "code_information": [{"code": "83735", "type": "CPT"}, {"code": "4153735", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MAGNESIUM OXIDE 200MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5306834", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MAGNESIUM OXIDE 200MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5306834", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MAGNESIUM/2", "code_information": [{"code": "83735", "type": "CPT"}, {"code": "4123755", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MAGNESIUM/2", "code_information": [{"code": "83735", "type": "CPT"}, {"code": "7253737", "type": "CDM"}], "standard_charges": [{"gross_charge": 165.0, "discounted_cash": 123.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MAGNESIUM/3", "code_information": [{"code": "83735", "type": "CPT"}, {"code": "7253739", "type": "CDM"}], "standard_charges": [{"gross_charge": 165.0, "discounted_cash": 123.75, "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": 98.0, "discounted_cash": 73.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MAGNESIUM/5", "code_information": [{"code": "83735", "type": "CPT"}, {"code": "4103756", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MAMMARY DUCT/GALACT MULT", "code_information": [{"code": "77054", "type": "CPT"}, {"code": "3070035", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 919.0, "discounted_cash": 689.25, "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": 695.0, "discounted_cash": 521.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MAMMARY IMP", "code_information": [{"code": "L8600", "type": "HCPCS"}, {"code": "8153500", "type": "CDM"}], "standard_charges": [{"gross_charge": 6559.0, "discounted_cash": 4919.25, "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": 1927.0, "discounted_cash": 1445.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MANDIBLE 4VW MIN", "code_information": [{"code": "70110", "type": "CPT"}, {"code": "5010110", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1974.0, "discounted_cash": 1480.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MANDIBLE 4VW MIN", "code_information": [{"code": "70110", "type": "CPT"}, {"code": "5110110", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2253.0, "discounted_cash": 1689.75, "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": 1521.0, "discounted_cash": 1140.75, "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": 1777.0, "discounted_cash": 1332.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MANGANESE", "code_information": [{"code": "83785", "type": "CPT"}, {"code": "7003785", "type": "CDM"}], "standard_charges": [{"gross_charge": 349.0, "discounted_cash": 261.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MANGANESE/2", "code_information": [{"code": "83785", "type": "CPT"}, {"code": "7253786", "type": "CDM"}], "standard_charges": [{"gross_charge": 349.0, "discounted_cash": 261.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MANNITOL 20% 250ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412580", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 178.0, "discounted_cash": 133.5, "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": 1403.0, "discounted_cash": 1052.25, "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": 0.74, "discounted_cash": 0.56, "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": 0.74, "discounted_cash": 0.56, "setting": "both", "billing_class": "facility"}]}, {"description": "MANUAL BLOOD COUNT", "code_information": [{"code": "85032", "type": "CPT"}, {"code": "4105012", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MANUAL BLOOD COUNT", "code_information": [{"code": "85032", "type": "CPT"}, {"code": "4125010", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MANUAL BLOOD COUNT/2", "code_information": [{"code": "85032", "type": "CPT"}, {"code": "4155041", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 116.0, "discounted_cash": 87.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MANUAL BLOOD COUNT/3", "code_information": [{"code": "85032", "type": "CPT"}, {"code": "4105041", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 227.0, "discounted_cash": 170.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MARIJUANA METABOLITE", "code_information": [{"code": "80349", "type": "CPT"}, {"code": "7252542", "type": "CDM"}], "standard_charges": [{"gross_charge": 106.0, "discounted_cash": 79.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MARKER FIDUCIAL DISP", "code_information": [{"code": "A4648", "type": "HCPCS"}, {"code": "8182907", "type": "CDM"}], "standard_charges": [{"gross_charge": 1006.0, "discounted_cash": 754.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MATRISTM MCRMTRX 500MG PER 1MG", "code_information": [{"code": "Q4118", "type": "HCPCS"}, {"code": "4023927", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 4191.0, "discounted_cash": 3143.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MATRISTM MCRMTRX 500MG PER 1MG", "code_information": [{"code": "Q4118", "type": "HCPCS"}, {"code": "4023927", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 4191.0, "discounted_cash": 3143.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MATRIX BONE IMP ALL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132979", "type": "CDM"}], "standard_charges": [{"gross_charge": 4147.0, "discounted_cash": 3110.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MATRIX FLEX MAGNETOS FLEX", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132982", "type": "CDM"}], "standard_charges": [{"gross_charge": 32879.0, "discounted_cash": 24659.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MATRX AMNION", "code_information": [{"code": "C1762", "type": "HCPCS"}, {"code": "4023897", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 18980.0, "discounted_cash": 14235.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MATRX BIOCARTILAGE MICRONIZED", "code_information": [{"code": "C1762", "type": "HCPCS"}, {"code": "4013647", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 7741.0, "discounted_cash": 5805.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MATRX BN ALLOSYNC DBM GEL/PUTT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4013648", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12010.0, "discounted_cash": 9007.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MATRX BN ALLOSYNC PURE", "code_information": [{"code": "C1762", "type": "HCPCS"}, {"code": "4013649", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9397.0, "discounted_cash": 7047.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MATRX BN OSTEOCELPLUS 5CC", "code_information": [{"code": "C1762", "type": "HCPCS"}, {"code": "4013652", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3949.0, "discounted_cash": 2961.75, "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": 62965.0, "discounted_cash": 47223.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MATRX DURAL GRFT DURAGEN", "code_information": [{"code": "C1763", "type": "HCPCS"}, {"code": "4023890", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6330.0, "discounted_cash": 4747.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MATRX TISS XENFORM", "code_information": [{"code": "C1763", "type": "HCPCS"}, {"code": "8247702", "type": "CDM"}], "standard_charges": [{"gross_charge": 19502.0, "discounted_cash": 14626.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MATRX TISSUE CONNEC INTERFYL", "code_information": [{"code": "Q4171", "type": "HCPCS"}, {"code": "4023926", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 7518.0, "discounted_cash": 5638.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MATRX TISSUE CONNEC INTERFYL", "code_information": [{"code": "Q4171", "type": "HCPCS"}, {"code": "4023926", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 7518.0, "discounted_cash": 5638.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MATRX TISSUE REINFRC OVITEX 1S", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4023939", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 57507.0, "discounted_cash": 43130.25, "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": 14277.0, "discounted_cash": 10707.75, "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": 9088.0, "discounted_cash": 6816.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MCATH CORDIS TRANSIT", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8247712", "type": "CDM"}], "standard_charges": [{"gross_charge": 3582.0, "discounted_cash": 2686.5, "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": 5033.0, "discounted_cash": 3774.75, "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": 10742.0, "discounted_cash": 8056.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MCATH DELIVERY VIA", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "4033054", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12458.0, "discounted_cash": 9343.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MCATH ECHELON GUIDING", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "4033044", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8675.0, "discounted_cash": 6506.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MCATH EXCELSIOR PRESHAPE", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "4033042", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11850.0, "discounted_cash": 8887.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MCATH EXCELSIOR STRT", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "4033043", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11724.0, "discounted_cash": 8793.0, "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": 3483.0, "discounted_cash": 2612.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MCATH HEADWAY PRESHAPE", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8057013", "type": "CDM"}], "standard_charges": [{"gross_charge": 9427.0, "discounted_cash": 7070.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MCATH MARATHON", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8240147", "type": "CDM"}], "standard_charges": [{"gross_charge": 10651.0, "discounted_cash": 7988.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MCATH MARKSMAN DELIVERY", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "4033084", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12768.0, "discounted_cash": 9576.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MCATH NEURO APOLLO", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "4033049", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 22203.0, "discounted_cash": 16652.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MCATH PHENOM 027", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "4033087", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 13563.0, "discounted_cash": 10172.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MCATH REBAR REINFORCED", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "4033092", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3353.0, "discounted_cash": 2514.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MCATH RENEGADE STC-18", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "4033091", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3263.0, "discounted_cash": 2447.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MCATH STEER SWIFTNINJA", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "4033094", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 25217.0, "discounted_cash": 18912.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MCATH SUPERCROSS OTW", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "4033096", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5724.0, "discounted_cash": 4293.0, "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": 810.0, "discounted_cash": 607.5, "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": 810.0, "discounted_cash": 607.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MECH REMVL OBSTRTN GTUBE", "code_information": [{"code": "4919460", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6625.0, "discounted_cash": 4968.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MECH THRMBCTMY VN RPEAT", "code_information": [{"code": "4617188", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 32008.0, "discounted_cash": 24006.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MECH THRMBCTMY VN RPEAT", "code_information": [{"code": "4914106", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 32008.0, "discounted_cash": 24006.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MECHLORETHAMIN PER10MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9230", "type": "HCPCS"}, {"code": "5322003", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 370.0, "discounted_cash": 277.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MECHLORETHAMIN PER10MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9230", "type": "HCPCS"}, {"code": "5322003", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 370.0, "discounted_cash": 277.5, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MECLIZINE TAB 25MG CTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306975", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.53, "discounted_cash": 0.4, "setting": "both", "billing_class": "facility"}]}, {"description": "MECLIZINE TAB 25MG CTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306975", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 0.53, "discounted_cash": 0.4, "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": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MED/SURG WITH TELEMETRY", "code_information": [{"code": "1990008", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 8049.0, "discounted_cash": 6036.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MED/SURG WITH TELEMETRY", "code_information": [{"code": "2120008", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 8049.0, "discounted_cash": 6036.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MED/SURG WITH TELEMETRY", "code_information": [{"code": "2150008", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 8049.0, "discounted_cash": 6036.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MED/SURG WITH TELEMETRY", "code_information": [{"code": "2160008", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 8049.0, "discounted_cash": 6036.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MED/SURG WITH TELEMETRY", "code_information": [{"code": "2170008", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 8049.0, "discounted_cash": 6036.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MED/SURG WITH TELEMETRY", "code_information": [{"code": "2180008", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 8049.0, "discounted_cash": 6036.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MED/SURG WITH TELEMETRY", "code_information": [{"code": "2190008", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 8049.0, "discounted_cash": 6036.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MED/SURG WITH TELEMETRY", "code_information": [{"code": "2360008", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 8049.0, "discounted_cash": 6036.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MED/SURG WITH TELEMETRY", "code_information": [{"code": "2800008", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 8049.0, "discounted_cash": 6036.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MED/SURG WITH TELEMETRY", "code_information": [{"code": "2810008", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 8049.0, "discounted_cash": 6036.75, "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": 47.0, "discounted_cash": 35.25, "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": 47.0, "discounted_cash": 35.25, "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": 36.0, "discounted_cash": 27.0, "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": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MEDROXYPROGEST 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307023", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MEDROXYPROGEST 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307023", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "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": 2.0, "discounted_cash": 1.5, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MEGESTROL 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307072", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MEGESTROL 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307072", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "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": 48.0, "discounted_cash": 36.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 101.0, "discounted_cash": 75.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 101.0, "discounted_cash": 75.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MEGESTROL40MG/ML 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8999", "type": "HCPCS"}, {"code": "5315569", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MEGESTROL40MG/ML 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8999", "type": "HCPCS"}, {"code": "5315569", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MELATONIN 3MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307080", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MELATONIN 3MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307080", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MELOXICAM 15MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307096", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MELOXICAM 15MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307096", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "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": 26.0, "discounted_cash": 19.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MELPHALAN 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8600", "type": "HCPCS"}, {"code": "5307099", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MELPHALAN 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8600", "type": "HCPCS"}, {"code": "5307099", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MEMANTINE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307111", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MEMANTINE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307111", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MEMANTINE 28MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307114", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 129.0, "discounted_cash": 96.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MEMANTINE 28MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307114", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 129.0, "discounted_cash": 96.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MEMANTINE 2MG/ML 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315581", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MEMANTINE 2MG/ML 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315581", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "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": 32.0, "discounted_cash": 24.0, "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": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MEMANTINE 7MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307112", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 137.0, "discounted_cash": 102.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MEMANTINE 7MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307112", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 137.0, "discounted_cash": 102.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MEMODERM PER SQ CM", "code_information": [{"code": "Q4126", "type": "HCPCS"}, {"code": "4023991", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 845.0, "discounted_cash": 633.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MEMODERM PER SQ CM", "code_information": [{"code": "Q4126", "type": "HCPCS"}, {"code": "4023991", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 845.0, "discounted_cash": 633.75, "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": 1006.0, "discounted_cash": 754.5, "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": 1006.0, "discounted_cash": 754.5, "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": 1236.0, "discounted_cash": 927.0, "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": 1236.0, "discounted_cash": 927.0, "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": 845.0, "discounted_cash": 633.75, "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": 845.0, "discounted_cash": 633.75, "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": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MEPERIDINE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327645", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MEPERIDINE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327645", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "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": 33.0, "discounted_cash": 24.75, "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": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MEPERIDINE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327641", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MEPERIDINE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327641", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MEPERIDINE 50MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5325575", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MEPERIDINE 50MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5325575", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "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": 204.0, "discounted_cash": 153.0, "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": 204.0, "discounted_cash": 153.0, "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": 322.0, "discounted_cash": 241.5, "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": 322.0, "discounted_cash": 241.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "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": 86.0, "discounted_cash": 64.5, "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": 147.0, "discounted_cash": 110.25, "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": 147.0, "discounted_cash": 110.25, "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": 19.0, "discounted_cash": 14.25, "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": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MEPROBAMATE 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307241", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MEPROBAMATE 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307241", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MERCAPTOPURINE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8999", "type": "HCPCS"}, {"code": "5307276", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MERCAPTOPURINE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8999", "type": "HCPCS"}, {"code": "5307276", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MERCURY QUANTITATIVE", "code_information": [{"code": "83825", "type": "CPT"}, {"code": "7003825", "type": "CDM"}], "standard_charges": [{"gross_charge": 665.0, "discounted_cash": 498.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MERCURY QUANTITATIVE", "code_information": [{"code": "83825", "type": "CPT"}, {"code": "7253825", "type": "CDM"}], "standard_charges": [{"gross_charge": 665.0, "discounted_cash": 498.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MERCURY QUANTITATIVE/6", "code_information": [{"code": "83825", "type": "CPT"}, {"code": "7253830", "type": "CDM"}], "standard_charges": [{"gross_charge": 654.0, "discounted_cash": 490.5, "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": 17.0, "discounted_cash": 12.75, "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": 17.0, "discounted_cash": 12.75, "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": 90.0, "discounted_cash": 67.5, "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": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MEROPENEM PER100MG PMXIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2185", "type": "HCPCS"}, {"code": "5322123", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MEROPENEM PER100MG PMXIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2185", "type": "HCPCS"}, {"code": "5322123", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MEROPENEM PER100MGIVPBIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2185", "type": "HCPCS"}, {"code": "5322119", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MEROPENEM PER100MGIVPBIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2185", "type": "HCPCS"}, {"code": "5322119", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "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": 157.0, "discounted_cash": 117.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 157.0, "discounted_cash": 117.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MESALAMINE 250MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307281", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MESALAMINE 250MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307281", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MESALAMINE 375MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307283", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 29.0, "discounted_cash": 21.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MESALAMINE 375MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307283", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 29.0, "discounted_cash": 21.75, "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": 50.0, "discounted_cash": 37.5, "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": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MESALAMINE 4G/60ML RE", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338510", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MESALAMINE 4G/60ML RE", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338510", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MESALAMINE 500MG SU", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338511", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MESALAMINE 500MG SU", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338511", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "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": 2564.0, "discounted_cash": 1923.0, "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": 3992.0, "discounted_cash": 2994.0, "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": 4712.0, "discounted_cash": 3534.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH SOFT 15X15CM", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4024216", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 545.0, "discounted_cash": 408.75, "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": 13477.0, "discounted_cash": 10107.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH VICRYL", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8142108", "type": "CDM"}], "standard_charges": [{"gross_charge": 9371.0, "discounted_cash": 7028.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MESNA PER 200MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9209", "type": "HCPCS"}, {"code": "5322120", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 808.0, "discounted_cash": 606.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MESNA PER 200MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9209", "type": "HCPCS"}, {"code": "5322120", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 808.0, "discounted_cash": 606.0, "setting": "both", "billing_class": "facility"}]}, {"description": "METANEPHRINES", "code_information": [{"code": "83835", "type": "CPT"}, {"code": "7003835", "type": "CDM"}], "standard_charges": [{"gross_charge": 1012.0, "discounted_cash": 759.0, "setting": "both", "billing_class": "facility"}]}, {"description": "METANEPHRINES", "code_information": [{"code": "83835", "type": "CPT"}, {"code": "7253836", "type": "CDM"}], "standard_charges": [{"gross_charge": 1012.0, "discounted_cash": 759.0, "setting": "both", "billing_class": "facility"}]}, {"description": "METANEPHRINES/2", "code_information": [{"code": "83835", "type": "CPT"}, {"code": "7253837", "type": "CDM"}], "standard_charges": [{"gross_charge": 1012.0, "discounted_cash": 759.0, "setting": "both", "billing_class": "facility"}]}, {"description": "METANEPHRINES/3", "code_information": [{"code": "83835", "type": "CPT"}, {"code": "7253838", "type": "CDM"}], "standard_charges": [{"gross_charge": 1012.0, "discounted_cash": 759.0, "setting": "both", "billing_class": "facility"}]}, {"description": "METAPROTERENL14GM/10MLIH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5331443", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 409.0, "discounted_cash": 306.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METAPROTERENL14GM/10MLIH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5331443", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 409.0, "discounted_cash": 306.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METAPROTERENOL 5%10ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331451", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 279.0, "discounted_cash": 209.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METAPROTERENOL10MG/5MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315594", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METAPROTERENOL10MG/5MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315594", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METATARSAL HEAD", "code_information": [{"code": "L8641", "type": "HCPCS"}, {"code": "4013700", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6911.0, "discounted_cash": 5183.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METATARSAL STEM", "code_information": [{"code": "L8641", "type": "HCPCS"}, {"code": "4013710", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10711.0, "discounted_cash": 8033.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METFORMIN 1000MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307363", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METFORMIN 1000MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307363", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "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": 47.0, "discounted_cash": 35.25, "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": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "METFORMIN 750MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307364", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "METFORMIN 750MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307364", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METHACHOLINE PER 1MG IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7674", "type": "HCPCS"}, {"code": "5331464", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METHACHOLINE PER 1MG IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7674", "type": "HCPCS"}, {"code": "5331464", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "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": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METHADONE 10MG/1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327667", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METHADONE 10MG/1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327667", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METHADONE 5MG TB", "code_information": [{"code": "S0109", "type": "HCPCS"}, {"code": "5327674", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METHADONE 5MG TB", "code_information": [{"code": "S0109", "type": "HCPCS"}, {"code": "5327674", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METHADONE 5MG/5ML LQ", "code_information": [{"code": "S0109", "type": "HCPCS"}, {"code": "5327661", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METHADONE 5MG/5ML LQ", "code_information": [{"code": "S0109", "type": "HCPCS"}, {"code": "5327661", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METHADONE QUANT/2", "code_information": [{"code": "80358", "type": "CPT"}, {"code": "7253840", "type": "CDM"}], "standard_charges": [{"gross_charge": 283.0, "discounted_cash": 212.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METHAZOLAMIDE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307398", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "METHAZOLAMIDE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307398", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "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": 47.0, "discounted_cash": 35.25, "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": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METHIMAZOLE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307507", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METHIMAZOLE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307507", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "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": 3.0, "discounted_cash": 2.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METHNAM/HYOSCY.03MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307484", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "METHNAM/HYOSCY.03MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307484", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "METHNAM/HYOSCY.12MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307481", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METHNAM/HYOSCY.12MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307481", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "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": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "METHOCARBAMOL 750MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307534", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "METHOCARBAMOL 750MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307534", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "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": 142.0, "discounted_cash": 106.5, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 142.0, "discounted_cash": 106.5, "setting": "both", "billing_class": "facility"}]}, {"description": "METHOHEXITAL 500MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5327680", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 498.0, "discounted_cash": 373.5, "setting": "both", "billing_class": "facility"}]}, {"description": "METHOTREXATE", "code_information": [{"code": "80204", "type": "CPT"}, {"code": "7003860", "type": "CDM"}], "standard_charges": [{"gross_charge": 1147.0, "discounted_cash": 860.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METHOTREXATE", "code_information": [{"code": "80204", "type": "CPT"}, {"code": "7023860", "type": "CDM"}], "standard_charges": [{"gross_charge": 436.0, "discounted_cash": 327.0, "setting": "both", "billing_class": "facility"}]}, {"description": "METHOTREXATE", "code_information": [{"code": "80204", "type": "CPT"}, {"code": "7073860", "type": "CDM"}], "standard_charges": [{"gross_charge": 308.0, "discounted_cash": 231.0, "setting": "both", "billing_class": "facility"}]}, {"description": "METHOTREXATE", "code_information": [{"code": "80204", "type": "CPT"}, {"code": "7253860", "type": "CDM"}], "standard_charges": [{"gross_charge": 1147.0, "discounted_cash": 860.25, "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": 94.0, "discounted_cash": 70.5, "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": 94.0, "discounted_cash": 70.5, "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": 50.0, "discounted_cash": 37.5, "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": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYL SAL MENTH 30GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336470", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYL SAL MENTH 30GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336470", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYL SALICY 60ML TS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336960", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYL SALICY 60ML TS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336960", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLDOPA 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307592", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLDOPA 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307592", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLDOPATE UPTO250MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0210", "type": "HCPCS"}, {"code": "5322235", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 149.0, "discounted_cash": 111.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLDOPATE UPTO250MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0210", "type": "HCPCS"}, {"code": "5322235", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 149.0, "discounted_cash": 111.75, "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": 11.0, "discounted_cash": 8.25, "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": 11.0, "discounted_cash": 8.25, "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": 259.0, "discounted_cash": 194.25, "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": 259.0, "discounted_cash": 194.25, "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": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "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": 3.0, "discounted_cash": 2.25, "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": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLPHENIDAT 18MGXRTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327702", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLPHENIDAT 18MGXRTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327702", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLPHENIDAT 20MGXRTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327701", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 59.0, "discounted_cash": 44.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLPHENIDAT 20MGXRTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327701", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 59.0, "discounted_cash": 44.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLPHENIDAT 27MGXRTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327705", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLPHENIDAT 27MGXRTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327705", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLPHENIDAT 30MGXRCP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327706", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLPHENIDAT 30MGXRCP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327706", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLPHENIDAT 36MGXRTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327703", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLPHENIDAT 36MGXRTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327703", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLPHENIDATE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327699", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLPHENIDATE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327699", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLPHENIDATE 10MGXRTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327609", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLPHENIDATE 10MGXRTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327609", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLPHENIDATE 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327700", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLPHENIDATE 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327700", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLPRED 16MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307654", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLPRED 16MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307654", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLPRED 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307647", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLPRED 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307647", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "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": 295.0, "discounted_cash": 221.25, "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": 295.0, "discounted_cash": 221.25, "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": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLPRED 8MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307651", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLPRED 8MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307651", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METIPRANOLOL .3% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331486", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 288.0, "discounted_cash": 216.0, "setting": "both", "billing_class": "facility"}]}, {"description": "METIPRANOLOL .3% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331486", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 288.0, "discounted_cash": 216.0, "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": 206.0, "discounted_cash": 154.5, "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": 206.0, "discounted_cash": 154.5, "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": 52.0, "discounted_cash": 39.0, "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": 52.0, "discounted_cash": 39.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "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": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METOCLOPRAMIDE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307730", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "METOCLOPRAMIDE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307730", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "METOLAZONE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307754", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METOLAZONE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307754", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "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": 39.0, "discounted_cash": 29.25, "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": 39.0, "discounted_cash": 29.25, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "METOPROLOL 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307789", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METOPROLOL 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307789", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "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": 19.0, "discounted_cash": 14.25, "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": 19.0, "discounted_cash": 14.25, "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": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METOPROLOL 12.5MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307793", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METOPROLOL 12.5MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307793", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METOPROLOL 200MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307790", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 29.0, "discounted_cash": 21.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METOPROLOL 200MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307790", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 29.0, "discounted_cash": 21.75, "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": 48.0, "discounted_cash": 36.0, "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": 48.0, "discounted_cash": 36.0, "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": 13.0, "discounted_cash": 9.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "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": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "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": 13.0, "discounted_cash": 9.75, "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": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "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": 52.0, "discounted_cash": 39.0, "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": 52.0, "discounted_cash": 39.0, "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": 0.32, "discounted_cash": 0.24, "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": 0.32, "discounted_cash": 0.24, "setting": "both", "billing_class": "facility"}]}, {"description": "METRONIDAZOLE.75%28GM GL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336559", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 403.0, "discounted_cash": 302.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METRONIDAZOLE.75%28GM GL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336559", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 403.0, "discounted_cash": 302.25, "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": 2505.0, "discounted_cash": 1878.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2505.0, "discounted_cash": 1878.75, "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": 510.0, "discounted_cash": 382.5, "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": 510.0, "discounted_cash": 382.5, "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": 49.0, "discounted_cash": 36.75, "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": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MEXILETINE 200MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307837", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MEXILETINE 200MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307837", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MEXILETINE 250MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307838", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MEXILETINE 250MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307838", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "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": 47.0, "discounted_cash": 35.25, "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": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MG SULFATE 480GM PW", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336355", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MG SULFATE 480GM PW", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336355", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "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": 31.0, "discounted_cash": 23.25, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "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": 338.0, "discounted_cash": 253.5, "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": 338.0, "discounted_cash": 253.5, "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": 11.0, "discounted_cash": 8.25, "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": 11.0, "discounted_cash": 8.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MICONAZOLE 2% 30GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336594", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 129.0, "discounted_cash": 96.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MICONAZOLE 2% 30GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336594", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 129.0, "discounted_cash": 96.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MICONAZOLE 2% 45GM PW", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336587", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 144.0, "discounted_cash": 108.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MICONAZOLE 2% 45GM PW", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336587", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 144.0, "discounted_cash": 108.0, "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": 179.0, "discounted_cash": 134.25, "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": 179.0, "discounted_cash": 134.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MICONAZOLE 2% 90GM PW", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336598", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 44.0, "discounted_cash": 33.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MICONAZOLE 2% 90GM PW", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336598", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 44.0, "discounted_cash": 33.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MICRO ALBUMIN URINE QNT", "code_information": [{"code": "82043", "type": "CPT"}, {"code": "7002043", "type": "CDM"}], "standard_charges": [{"gross_charge": 528.0, "discounted_cash": 396.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MICRO ALBUMIN URINE QNT", "code_information": [{"code": "82043", "type": "CPT"}, {"code": "7252043", "type": "CDM"}], "standard_charges": [{"gross_charge": 516.0, "discounted_cash": 387.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MICRO ALBUMIN URINE QNT/3", "code_information": [{"code": "82043", "type": "CPT"}, {"code": "7252047", "type": "CDM"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MICRODISSECTION MANUAL", "code_information": [{"code": "88381", "type": "CPT"}, {"code": "7018410", "type": "CDM"}], "standard_charges": [{"gross_charge": 3572.0, "discounted_cash": 2679.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MICRODISSECTION MANUAL", "code_information": [{"code": "88381", "type": "CPT"}, {"code": "7058381", "type": "CDM"}], "standard_charges": [{"gross_charge": 3572.0, "discounted_cash": 2679.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MICROHEMATOCRIT SPUN", "code_information": [{"code": "85013", "type": "CPT"}, {"code": "4105054", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MICROSAT INSTABILITY ANL", "code_information": [{"code": "81301", "type": "CPT"}, {"code": "7051301", "type": "CDM"}], "standard_charges": [{"gross_charge": 2653.0, "discounted_cash": 1989.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MICROSOMAL ANTIBODY EA", "code_information": [{"code": "86376", "type": "CPT"}, {"code": "7255559", "type": "CDM"}], "standard_charges": [{"gross_charge": 388.0, "discounted_cash": 291.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MICROSOMAL ANTIBODY EA/2", "code_information": [{"code": "86376", "type": "CPT"}, {"code": "7256374", "type": "CDM"}], "standard_charges": [{"gross_charge": 388.0, "discounted_cash": 291.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MICROSOMAL ANTIBODY EA/3", "code_information": [{"code": "86376", "type": "CPT"}, {"code": "7006377", "type": "CDM"}], "standard_charges": [{"gross_charge": 388.0, "discounted_cash": 291.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MICROSOMAL ANTIBODY EA/4", "code_information": [{"code": "86376", "type": "CPT"}, {"code": "7256376", "type": "CDM"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "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": 65.0, "discounted_cash": 48.75, "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": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MIDAZOLAM 2MG/1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327727", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MIDAZOLAM 2MG/1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327727", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "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": 55.0, "discounted_cash": 41.25, "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": 55.0, "discounted_cash": 41.25, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MIDLINE INSERTION 3+YRS", "code_information": [{"code": "6296410", "type": "CDM"}], "standard_charges": [{"gross_charge": 1908.0, "discounted_cash": 1431.0, "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": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "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": 60.0, "discounted_cash": 45.0, "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": 60.0, "discounted_cash": 45.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 820.0, "discounted_cash": 615.0, "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": 820.0, "discounted_cash": 615.0, "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": 31.0, "discounted_cash": 23.25, "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": 31.0, "discounted_cash": 23.25, "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": 60.0, "discounted_cash": 45.0, "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": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MINERAL OIL 180 ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315717", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MINERAL OIL 180 ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315717", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "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": 36.0, "discounted_cash": 27.0, "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": 36.0, "discounted_cash": 27.0, "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": 68.0, "discounted_cash": 51.0, "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": 68.0, "discounted_cash": 51.0, "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": "MINERAL OIL STER 30ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336646", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MINIMATRIX RESTRATA PER 5MG", "code_information": [{"code": "A2026", "type": "HCPCS"}, {"code": "4023965", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 216.0, "discounted_cash": 162.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MINIMATRIX RESTRATA PER 5MG", "code_information": [{"code": "A2026", "type": "HCPCS"}, {"code": "4023965", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 216.0, "discounted_cash": 162.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "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": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MINOCYCLINE 50MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307858", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 75.0, "discounted_cash": 56.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MINOCYCLINE 50MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307858", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 75.0, "discounted_cash": 56.25, "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": 36.0, "discounted_cash": 27.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MIRABEGRON 50MG XR24 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307871", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 112.0, "discounted_cash": 84.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MIRABEGRON 50MG XR24 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307871", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 112.0, "discounted_cash": 84.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MIRTAZAPINE 15MG DT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307877", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MIRTAZAPINE 15MG DT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307877", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "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": 85.0, "discounted_cash": 63.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MIRTAZAPINE 30MG DT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307876", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MIRTAZAPINE 30MG DT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307876", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "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": 86.0, "discounted_cash": 64.5, "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": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MIRTAZAPINE 45MG DT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307874", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MIRTAZAPINE 45MG DT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307874", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MIRTAZAPINE 7.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307872", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MIRTAZAPINE 7.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307872", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MISCELLANEOUS TOPICAL", "code_information": [{"code": "5334000", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 30.15, "discounted_cash": 22.61, "setting": "both", "billing_class": "facility"}]}, {"description": "MISCELLANEOUS TOPICAL", "code_information": [{"code": "5334000", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 30.15, "discounted_cash": 22.61, "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": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "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": 50.0, "discounted_cash": 37.5, "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": 4.0, "discounted_cash": 3.0, "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": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MITCHONDRIAL ANTIBODY", "code_information": [{"code": "86381", "type": "CPT"}, {"code": "7253533", "type": "CDM"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MITCHONDRIAL ANTIBODY/2", "code_information": [{"code": "86381", "type": "CPT"}, {"code": "7253522", "type": "CDM"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "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": 2535.0, "discounted_cash": 1901.25, "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": 2535.0, "discounted_cash": 1901.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MITOXANTRONE PER 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9293", "type": "HCPCS"}, {"code": "5322499", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3099.0, "discounted_cash": 2324.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MITOXANTRONE PER 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9293", "type": "HCPCS"}, {"code": "5322499", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 3099.0, "discounted_cash": 2324.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED OTH EA ADD15", "code_information": [{"code": "99157", "type": "CPT"}, {"code": "3609157", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 1061.0, "discounted_cash": 795.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED OTH EA ADD15", "code_information": [{"code": "99157", "type": "CPT"}, {"code": "3709157", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 1061.0, "discounted_cash": 795.75, "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": 1061.0, "discounted_cash": 795.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED OTH EA ADD15", "code_information": [{"code": "99157", "type": "CPT"}, {"code": "5079157", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 1061.0, "discounted_cash": 795.75, "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": 1061.0, "discounted_cash": 795.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED OTH<5YRS INIT15", "code_information": [{"code": "99155", "type": "CPT"}, {"code": "3609155", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 1134.0, "discounted_cash": 850.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED OTH<5YRS INIT15", "code_information": [{"code": "99155", "type": "CPT"}, {"code": "3709155", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 1134.0, "discounted_cash": 850.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED OTH<5YRS INIT15", "code_information": [{"code": "99155", "type": "CPT"}, {"code": "4919155", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 1134.0, "discounted_cash": 850.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED OTH<5YRS INIT15", "code_information": [{"code": "99155", "type": "CPT"}, {"code": "5079155", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 1134.0, "discounted_cash": 850.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED OTH<5YRS INIT15", "code_information": [{"code": "99155", "type": "CPT"}, {"code": "6109155", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 1134.0, "discounted_cash": 850.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED OTH>5YRS INIT15", "code_information": [{"code": "99156", "type": "CPT"}, {"code": "3609156", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 1134.0, "discounted_cash": 850.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED OTH>5YRS INIT15", "code_information": [{"code": "99156", "type": "CPT"}, {"code": "3709156", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 1134.0, "discounted_cash": 850.5, "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": 1134.0, "discounted_cash": 850.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED OTH>5YRS INIT15", "code_information": [{"code": "99156", "type": "CPT"}, {"code": "5079156", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 1134.0, "discounted_cash": 850.5, "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": 1134.0, "discounted_cash": 850.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED SAME EA ADD15", "code_information": [{"code": "99153", "type": "CPT"}, {"code": "3609153", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 751.0, "discounted_cash": 563.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED SAME EA ADD15", "code_information": [{"code": "99153", "type": "CPT"}, {"code": "3709153", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 744.0, "discounted_cash": 558.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED SAME EA ADD15", "code_information": [{"code": "99153", "type": "CPT"}, {"code": "4609153", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 744.0, "discounted_cash": 558.0, "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": 94.0, "discounted_cash": 70.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED SAME EA ADD15", "code_information": [{"code": "99153", "type": "CPT"}, {"code": "4919153", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 751.0, "discounted_cash": 563.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED SAME EA ADD15", "code_information": [{"code": "99153", "type": "CPT"}, {"code": "5059153", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 409.0, "discounted_cash": 306.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED SAME EA ADD15", "code_information": [{"code": "99153", "type": "CPT"}, {"code": "5079153", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 751.0, "discounted_cash": 563.25, "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": 751.0, "discounted_cash": 563.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED SAME<5YRS INIT15", "code_information": [{"code": "99151", "type": "CPT"}, {"code": "3609151", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 1863.0, "discounted_cash": 1397.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED SAME<5YRS INIT15", "code_information": [{"code": "99151", "type": "CPT"}, {"code": "3709151", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 1863.0, "discounted_cash": 1397.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED SAME<5YRS INIT15", "code_information": [{"code": "99151", "type": "CPT"}, {"code": "4919151", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 1863.0, "discounted_cash": 1397.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED SAME<5YRS INIT15", "code_information": [{"code": "99151", "type": "CPT"}, {"code": "5079151", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 1863.0, "discounted_cash": 1397.25, "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": 1863.0, "discounted_cash": 1397.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED SAME>5YRS INIT15", "code_information": [{"code": "99152", "type": "CPT"}, {"code": "3609152", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 1031.0, "discounted_cash": 773.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED SAME>5YRS INIT15", "code_information": [{"code": "99152", "type": "CPT"}, {"code": "3709152", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 1090.0, "discounted_cash": 817.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED SAME>5YRS INIT15", "code_information": [{"code": "99152", "type": "CPT"}, {"code": "4609152", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 1090.0, "discounted_cash": 817.5, "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": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED SAME>5YRS INIT15", "code_information": [{"code": "99152", "type": "CPT"}, {"code": "4919152", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 1031.0, "discounted_cash": 773.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED SAME>5YRS INIT15", "code_information": [{"code": "99152", "type": "CPT"}, {"code": "5059152", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 1119.0, "discounted_cash": 839.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED SAME>5YRS INIT15", "code_information": [{"code": "99152", "type": "CPT"}, {"code": "5079152", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 1031.0, "discounted_cash": 773.25, "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": 1031.0, "discounted_cash": 773.25, "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": 117.0, "discounted_cash": 87.75, "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": 117.0, "discounted_cash": 87.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MODAFINIL 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307884", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MODAFINIL 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307884", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MOLEC CYTOGEN INTPHS 100-300", "code_information": [{"code": "88275", "type": "CPT"}, {"code": "7058827", "type": "CDM"}], "standard_charges": [{"gross_charge": 436.0, "discounted_cash": 327.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MOLEC CYTOGEN INTPHS 100-300/2", "code_information": [{"code": "88275", "type": "CPT"}, {"code": "7038827", "type": "CDM"}], "standard_charges": [{"gross_charge": 470.0, "discounted_cash": 352.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MOLEC CYTOGEN INTPHS 25-99", "code_information": [{"code": "88274", "type": "CPT"}, {"code": "7058274", "type": "CDM"}], "standard_charges": [{"gross_charge": 808.0, "discounted_cash": 606.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MOLECULAR PATH LEVEL 1", "code_information": [{"code": "81400", "type": "CPT"}, {"code": "7071400", "type": "CDM"}], "standard_charges": [{"gross_charge": 1845.0, "discounted_cash": 1383.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MOLECULAR PATH LEVEL 1/2", "code_information": [{"code": "81400", "type": "CPT"}, {"code": "7251410", "type": "CDM"}], "standard_charges": [{"gross_charge": 1274.0, "discounted_cash": 955.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MOLECULAR PATH LEVEL 5/3", "code_information": [{"code": "81404", "type": "CPT"}, {"code": "7251414", "type": "CDM"}], "standard_charges": [{"gross_charge": 4149.0, "discounted_cash": 3111.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MOLECULR CYTO DNA PRB EA", "code_information": [{"code": "88271", "type": "CPT"}, {"code": "7058279", "type": "CDM"}], "standard_charges": [{"gross_charge": 1039.0, "discounted_cash": 779.25, "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": 303.0, "discounted_cash": 227.25, "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": 303.0, "discounted_cash": 227.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MOMETASONE NASAL 17GM SP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5331489", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 809.0, "discounted_cash": 606.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MOMETASONE NASAL 17GM SP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5331489", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 809.0, "discounted_cash": 606.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MOMETASONE220MCG.24GM IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5331494", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 976.0, "discounted_cash": 732.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MOMETASONE220MCG.24GM IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5331494", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 976.0, "discounted_cash": 732.0, "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": 82.0, "discounted_cash": 61.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 82.0, "discounted_cash": 61.5, "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": 53.0, "discounted_cash": 39.75, "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": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MORCELLATOR", "code_information": [{"code": "C1782", "type": "HCPCS"}, {"code": "8240264", "type": "CDM"}], "standard_charges": [{"gross_charge": 3280.0, "discounted_cash": 2460.0, "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": 85.0, "discounted_cash": 63.75, "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": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MORPHIN 20MG/ML .25ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327833", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MORPHIN 20MG/ML .25ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327833", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MORPHINE 0.4MG/1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327818", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MORPHINE 0.4MG/1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327818", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MORPHINE 100MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327779", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 172.0, "discounted_cash": 129.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MORPHINE 100MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327779", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 172.0, "discounted_cash": 129.0, "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": 82.0, "discounted_cash": 61.5, "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": 82.0, "discounted_cash": 61.5, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "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": 48.0, "discounted_cash": 36.0, "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": 48.0, "discounted_cash": 36.0, "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": 11.0, "discounted_cash": 8.25, "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": 11.0, "discounted_cash": 8.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MORPHINE 20MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327753", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MORPHINE 20MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327753", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MORPHINE 30MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327781", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MORPHINE 30MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327781", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "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": 69.0, "discounted_cash": 51.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 69.0, "discounted_cash": 51.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 367.0, "discounted_cash": 275.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 367.0, "discounted_cash": 275.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MORPHINE 60MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327778", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 107.0, "discounted_cash": 80.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MORPHINE 60MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327778", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 107.0, "discounted_cash": 80.25, "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": 23.0, "discounted_cash": 17.25, "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": 4.0, "discounted_cash": 3.0, "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": 4.0, "discounted_cash": 3.0, "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": 16.0, "discounted_cash": 12.0, "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": 16.0, "discounted_cash": 12.0, "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": 17.0, "discounted_cash": 12.75, "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": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MORRHUATE 50MG/ML 30MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5322518", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "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": 761.0, "discounted_cash": 570.75, "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": 761.0, "discounted_cash": 570.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MPL GENE VARIANTS", "code_information": [{"code": "81338", "type": "CPT"}, {"code": "7050037", "type": "CDM"}], "standard_charges": [{"gross_charge": 1036.0, "discounted_cash": 777.0, "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": 109.0, "discounted_cash": 81.75, "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": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MR CONTRAST ORAL 100ML", "code_information": [{"code": "Q9954", "type": "HCPCS"}, {"code": "5358243", "type": "CDM"}, {"code": "255", "type": "RC"}], "standard_charges": [{"gross_charge": 299.0, "discounted_cash": 224.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MR CONTRAST ORAL 100ML", "code_information": [{"code": "Q9954", "type": "HCPCS"}, {"code": "5358243", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 299.0, "discounted_cash": 224.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRA ABDOMEN W/ CM", "code_information": [{"code": "74185", "type": "CPT"}, {"code": "5018900", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 9506.0, "discounted_cash": 7129.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRA ABDOMEN W/ CM", "code_information": [{"code": "74185", "type": "CPT"}, {"code": "5114185", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 11392.0, "discounted_cash": 8544.0, "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": 10849.0, "discounted_cash": 8136.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRA ABDOMEN W/O CM", "code_information": [{"code": "74185", "type": "CPT"}, {"code": "5118901", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 9769.0, "discounted_cash": 7326.75, "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": 9769.0, "discounted_cash": 7326.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRA CHEST W/CONTRAST", "code_information": [{"code": "71555", "type": "CPT"}, {"code": "5018909", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 6622.0, "discounted_cash": 4966.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRA CHEST W/CONTRAST", "code_information": [{"code": "71555", "type": "CPT"}, {"code": "5110605", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 5949.0, "discounted_cash": 4461.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRA CHEST W/CONTRAST", "code_information": [{"code": "71555", "type": "CPT"}, {"code": "5258909", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 6622.0, "discounted_cash": 4966.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRA CHEST W/O CONTRAST", "code_information": [{"code": "71555", "type": "CPT"}, {"code": "5110604", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 6021.0, "discounted_cash": 4515.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRA CHEST W/O CONTRAST", "code_information": [{"code": "71555", "type": "CPT"}, {"code": "5258910", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 6021.0, "discounted_cash": 4515.75, "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": 7511.0, "discounted_cash": 5633.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRA HEAD W/O CONTRAST", "code_information": [{"code": "70544", "type": "CPT"}, {"code": "5010601", "type": "CDM"}, {"code": "615", "type": "RC"}], "standard_charges": [{"gross_charge": 4813.0, "discounted_cash": 3609.75, "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": 4813.0, "discounted_cash": 3609.75, "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": 5652.0, "discounted_cash": 4239.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRA HEAD WO/W CONTRAST", "code_information": [{"code": "70546", "type": "CPT"}, {"code": "5110603", "type": "CDM"}, {"code": "615", "type": "RC"}], "standard_charges": [{"gross_charge": 9011.0, "discounted_cash": 6758.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRA LOWR EXTRMTY W/ CM", "code_information": [{"code": "73725", "type": "CPT"}, {"code": "5118912", "type": "CDM"}, {"code": "616", "type": "RC"}], "standard_charges": [{"gross_charge": 11513.0, "discounted_cash": 8634.75, "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": 11513.0, "discounted_cash": 8634.75, "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": 10208.0, "discounted_cash": 7656.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRA NECK W CONTRAST", "code_information": [{"code": "70548", "type": "CPT"}, {"code": "5010607", "type": "CDM"}, {"code": "615", "type": "RC"}], "standard_charges": [{"gross_charge": 7475.0, "discounted_cash": 5606.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRA NECK W CONTRAST", "code_information": [{"code": "70548", "type": "CPT"}, {"code": "5110548", "type": "CDM"}, {"code": "615", "type": "RC"}], "standard_charges": [{"gross_charge": 7511.0, "discounted_cash": 5633.25, "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": 6428.0, "discounted_cash": 4821.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRA NECK W/O CONTRAST", "code_information": [{"code": "70547", "type": "CPT"}, {"code": "5010606", "type": "CDM"}, {"code": "615", "type": "RC"}], "standard_charges": [{"gross_charge": 4813.0, "discounted_cash": 3609.75, "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": 4813.0, "discounted_cash": 3609.75, "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": 4813.0, "discounted_cash": 3609.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRA NECK WO/W CONTRAST", "code_information": [{"code": "70549", "type": "CPT"}, {"code": "5010608", "type": "CDM"}, {"code": "615", "type": "RC"}], "standard_charges": [{"gross_charge": 8583.0, "discounted_cash": 6437.25, "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": 8294.0, "discounted_cash": 6220.5, "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": 7824.0, "discounted_cash": 5868.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI ABDOMEN W/ CM", "code_information": [{"code": "74182", "type": "CPT"}, {"code": "5010974", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 9761.0, "discounted_cash": 7320.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI ABDOMEN W/ CM", "code_information": [{"code": "74182", "type": "CPT"}, {"code": "5114182", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 9297.0, "discounted_cash": 6972.75, "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": 9297.0, "discounted_cash": 6972.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI ABDOMEN W/O CM", "code_information": [{"code": "74181", "type": "CPT"}, {"code": "5011075", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 7658.0, "discounted_cash": 5743.5, "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": 7338.0, "discounted_cash": 5503.5, "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": 7658.0, "discounted_cash": 5743.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI ABDOMEN WO/W CM", "code_information": [{"code": "74183", "type": "CPT"}, {"code": "5011000", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 9413.0, "discounted_cash": 7059.75, "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": 10077.0, "discounted_cash": 7557.75, "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": 10077.0, "discounted_cash": 7557.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI BRAIN W/O CONTRAST", "code_information": [{"code": "70551", "type": "CPT"}, {"code": "5010101", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 8385.0, "discounted_cash": 6288.75, "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": 8185.0, "discounted_cash": 6138.75, "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": 7925.0, "discounted_cash": 5943.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI BRAIN WITH CONTRAST", "code_information": [{"code": "70552", "type": "CPT"}, {"code": "5010810", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 8789.0, "discounted_cash": 6591.75, "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": 10030.0, "discounted_cash": 7522.5, "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": 9229.0, "discounted_cash": 6921.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI BRAIN WO/W CONTRAST", "code_information": [{"code": "70553", "type": "CPT"}, {"code": "5010816", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 14856.0, "discounted_cash": 11142.0, "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": 14586.0, "discounted_cash": 10939.5, "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": 14856.0, "discounted_cash": 11142.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI CHEST W/CONTRAST", "code_information": [{"code": "71551", "type": "CPT"}, {"code": "5111551", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 4443.0, "discounted_cash": 3332.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI CHEST W/CONTRAST", "code_information": [{"code": "71551", "type": "CPT"}, {"code": "5250971", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 4443.0, "discounted_cash": 3332.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI CHEST W/O CONTRAST", "code_information": [{"code": "71550", "type": "CPT"}, {"code": "5010181", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 3839.0, "discounted_cash": 2879.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI CHEST W/O CONTRAST", "code_information": [{"code": "71550", "type": "CPT"}, {"code": "5111550", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 3746.0, "discounted_cash": 2809.5, "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": 3782.0, "discounted_cash": 2836.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI CHEST WO/W CONTRAST", "code_information": [{"code": "71552", "type": "CPT"}, {"code": "5010972", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 4799.0, "discounted_cash": 3599.25, "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": 4592.0, "discounted_cash": 3444.0, "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": 4165.0, "discounted_cash": 3123.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI LE JNT WO/W CM", "code_information": [{"code": "73723", "type": "CPT"}, {"code": "5011007", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 9885.0, "discounted_cash": 7413.75, "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": 9413.0, "discounted_cash": 7059.75, "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": 9413.0, "discounted_cash": 7059.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI LE NONJNT W/CM", "code_information": [{"code": "73719", "type": "CPT"}, {"code": "5011005", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 9358.0, "discounted_cash": 7018.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI LE NONJNT W/CM", "code_information": [{"code": "73719", "type": "CPT"}, {"code": "5113719", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 9358.0, "discounted_cash": 7018.5, "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": 8283.0, "discounted_cash": 6212.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI LE NONJNT W/O CM", "code_information": [{"code": "73718", "type": "CPT"}, {"code": "5011004", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 6640.0, "discounted_cash": 4980.0, "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": 7378.0, "discounted_cash": 5533.5, "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": 7378.0, "discounted_cash": 5533.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI LE NONJNT WO/W CM", "code_information": [{"code": "73720", "type": "CPT"}, {"code": "5010200", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 9413.0, "discounted_cash": 7059.75, "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": 10077.0, "discounted_cash": 7557.75, "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": 10077.0, "discounted_cash": 7557.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI LOWR EXT JNT W/ CM", "code_information": [{"code": "73722", "type": "CPT"}, {"code": "5011006", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 7815.0, "discounted_cash": 5861.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI LOWR EXT JNT W/ CM", "code_information": [{"code": "73722", "type": "CPT"}, {"code": "5111006", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 9358.0, "discounted_cash": 7018.5, "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": 8488.0, "discounted_cash": 6366.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI LOWR EXT JNT W/O CM", "code_information": [{"code": "73721", "type": "CPT"}, {"code": "5010420", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 7094.0, "discounted_cash": 5320.5, "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": 6640.0, "discounted_cash": 4980.0, "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": 7561.0, "discounted_cash": 5670.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI ORB/FACE/NECK W/CM", "code_information": [{"code": "70542", "type": "CPT"}, {"code": "5010820", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 8996.0, "discounted_cash": 6747.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI ORB/FACE/NECK W/CM", "code_information": [{"code": "70542", "type": "CPT"}, {"code": "5110542", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 10013.0, "discounted_cash": 7509.75, "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": 10013.0, "discounted_cash": 7509.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI ORB/FACE/NECK WO CM", "code_information": [{"code": "70540", "type": "CPT"}, {"code": "5011023", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 5791.0, "discounted_cash": 4343.25, "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": 5791.0, "discounted_cash": 4343.25, "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": 5791.0, "discounted_cash": 4343.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI ORB/FACE/NECK WO/W C", "code_information": [{"code": "70543", "type": "CPT"}, {"code": "5010822", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 7885.0, "discounted_cash": 5913.75, "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": 7885.0, "discounted_cash": 5913.75, "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": 7885.0, "discounted_cash": 5913.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI PELVIS RAD PLAN", "code_information": [{"code": "76498", "type": "CPT"}, {"code": "5116498", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 2504.0, "discounted_cash": 1878.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI PELVIS RAD PLAN", "code_information": [{"code": "76498", "type": "CPT"}, {"code": "5256498", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 3353.0, "discounted_cash": 2514.75, "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": 5445.0, "discounted_cash": 4083.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI PELVIS W/O CONTRAST", "code_information": [{"code": "72195", "type": "CPT"}, {"code": "5010850", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 6640.0, "discounted_cash": 4980.0, "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": 6640.0, "discounted_cash": 4980.0, "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": 6640.0, "discounted_cash": 4980.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI PELVIS WO/W CONTRAST", "code_information": [{"code": "72197", "type": "CPT"}, {"code": "5010852", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 9087.0, "discounted_cash": 6815.25, "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": 9087.0, "discounted_cash": 6815.25, "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": 12021.0, "discounted_cash": 9015.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SAFETY DETER PHYS/QHP", "code_information": [{"code": "76016", "type": "CPT"}, {"code": "5010011", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 411.0, "discounted_cash": 308.25, "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": 411.0, "discounted_cash": 308.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SAFETY IMPLANT ELEC PREPJ", "code_information": [{"code": "76018", "type": "CPT"}, {"code": "5010013", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 651.0, "discounted_cash": 488.25, "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": 651.0, "discounted_cash": 488.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SAFETY IMPLT POS&/IMMOBLJ", "code_information": [{"code": "76019", "type": "CPT"}, {"code": "5010014", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 853.0, "discounted_cash": 639.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SFTY IMPLT&FB 1ST 15MIN", "code_information": [{"code": "76014", "type": "CPT"}, {"code": "5010009", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "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": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SFTY MED PHYSICS XM CSTMZ", "code_information": [{"code": "76017", "type": "CPT"}, {"code": "5010012", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 1287.0, "discounted_cash": 965.25, "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": 1287.0, "discounted_cash": 965.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SFTY MPLT&FB ADD 30MIN", "code_information": [{"code": "76015", "type": "CPT"}, {"code": "5010010", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 302.0, "discounted_cash": 226.5, "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": 302.0, "discounted_cash": 226.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SPINE CERV WO/W CM", "code_information": [{"code": "72156", "type": "CPT"}, {"code": "5010230", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 10407.0, "discounted_cash": 7805.25, "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": 10407.0, "discounted_cash": 7805.25, "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": 10407.0, "discounted_cash": 7805.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SPINE CERVICAL W/CM", "code_information": [{"code": "72142", "type": "CPT"}, {"code": "5012142", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 11994.0, "discounted_cash": 8995.5, "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": 9917.0, "discounted_cash": 7437.75, "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": 9797.0, "discounted_cash": 7347.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SPINE CERVICL W/O CM", "code_information": [{"code": "72141", "type": "CPT"}, {"code": "5010215", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 9475.0, "discounted_cash": 7106.25, "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": 8470.0, "discounted_cash": 6352.5, "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": 8470.0, "discounted_cash": 6352.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SPINE LUMBAR W/CM", "code_information": [{"code": "72149", "type": "CPT"}, {"code": "5012149", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 9797.0, "discounted_cash": 7347.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SPINE LUMBAR W/CM", "code_information": [{"code": "72149", "type": "CPT"}, {"code": "5112149", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 9797.0, "discounted_cash": 7347.75, "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": 9797.0, "discounted_cash": 7347.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SPINE LUMBAR W/O CM", "code_information": [{"code": "72148", "type": "CPT"}, {"code": "5010221", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 9475.0, "discounted_cash": 7106.25, "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": 9475.0, "discounted_cash": 7106.25, "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": 9475.0, "discounted_cash": 7106.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SPINE LUMBAR WO/W CM", "code_information": [{"code": "72158", "type": "CPT"}, {"code": "5010238", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 11565.0, "discounted_cash": 8673.75, "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": 12313.0, "discounted_cash": 9234.75, "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": 10855.0, "discounted_cash": 8141.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SPINE THOR WO/W CM", "code_information": [{"code": "72157", "type": "CPT"}, {"code": "5010234", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 10031.0, "discounted_cash": 7523.25, "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": 10031.0, "discounted_cash": 7523.25, "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": 11286.0, "discounted_cash": 8464.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SPINE THORAC W/O CM", "code_information": [{"code": "72146", "type": "CPT"}, {"code": "5010217", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 8470.0, "discounted_cash": 6352.5, "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": 8470.0, "discounted_cash": 6352.5, "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": 8470.0, "discounted_cash": 6352.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SPINE THORACIC W/CM", "code_information": [{"code": "72147", "type": "CPT"}, {"code": "5012147", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 10777.0, "discounted_cash": 8082.75, "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": 10929.0, "discounted_cash": 8196.75, "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": 10647.0, "discounted_cash": 7985.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI TMJ", "code_information": [{"code": "70336", "type": "CPT"}, {"code": "5011035", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 6018.0, "discounted_cash": 4513.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI TMJ", "code_information": [{"code": "70336", "type": "CPT"}, {"code": "5111035", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 5404.0, "discounted_cash": 4053.0, "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": 5730.0, "discounted_cash": 4297.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI UP EXT JNT W/ CM", "code_information": [{"code": "73222", "type": "CPT"}, {"code": "5010844", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 11336.0, "discounted_cash": 8502.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI UP EXT JNT W/ CM", "code_information": [{"code": "73222", "type": "CPT"}, {"code": "5110844", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 9358.0, "discounted_cash": 7018.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI UP EXT JNT W/ CM", "code_information": [{"code": "73222", "type": "CPT"}, {"code": "5250844", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 7815.0, "discounted_cash": 5861.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI UP EXT JNT W/O CM", "code_information": [{"code": "73221", "type": "CPT"}, {"code": "5010450", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 6640.0, "discounted_cash": 4980.0, "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": 7561.0, "discounted_cash": 5670.75, "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": 6640.0, "discounted_cash": 4980.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI UP EXT JNT WO/W CM", "code_information": [{"code": "73223", "type": "CPT"}, {"code": "5010846", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 10998.0, "discounted_cash": 8248.5, "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": 9413.0, "discounted_cash": 7059.75, "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": 9413.0, "discounted_cash": 7059.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI UP EXT NONJNT W/ CM", "code_information": [{"code": "73219", "type": "CPT"}, {"code": "5010842", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 9358.0, "discounted_cash": 7018.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI UP EXT NONJNT W/ CM", "code_information": [{"code": "73219", "type": "CPT"}, {"code": "5110842", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 9358.0, "discounted_cash": 7018.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI UP EXT NONJNT W/ CM", "code_information": [{"code": "73219", "type": "CPT"}, {"code": "5250842", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 9358.0, "discounted_cash": 7018.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI UP EXT NONJNT W/O CM", "code_information": [{"code": "73218", "type": "CPT"}, {"code": "5010840", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 6640.0, "discounted_cash": 4980.0, "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": 6640.0, "discounted_cash": 4980.0, "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": 6640.0, "discounted_cash": 4980.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI UP EXT NONJNT WO/WCM", "code_information": [{"code": "73220", "type": "CPT"}, {"code": "5010211", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 8595.0, "discounted_cash": 6446.25, "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": 8595.0, "discounted_cash": 6446.25, "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": 8595.0, "discounted_cash": 6446.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MSH H COMPOSITE FLEXIBL", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4024069", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6161.0, "discounted_cash": 4620.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MSH OVITEX PERMANENT POLYMER", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4020749", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 15034.0, "discounted_cash": 11275.5, "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": 12770.0, "discounted_cash": 9577.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MSH RESTORELLE Y", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4024244", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6458.0, "discounted_cash": 4843.5, "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": 3641.0, "discounted_cash": 2730.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MTB AMP PROBE", "code_information": [{"code": "87556", "type": "CPT"}, {"code": "7007556", "type": "CDM"}], "standard_charges": [{"gross_charge": 638.0, "discounted_cash": 478.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MTB AMP PROBE", "code_information": [{"code": "87556", "type": "CPT"}, {"code": "7257556", "type": "CDM"}], "standard_charges": [{"gross_charge": 638.0, "discounted_cash": 478.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MTHFR COMMON VARIANTS", "code_information": [{"code": "81291", "type": "CPT"}, {"code": "7259210", "type": "CDM"}], "standard_charges": [{"gross_charge": 807.0, "discounted_cash": 605.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MULT SLEEP LATENCY TEST", "code_information": [{"code": "95805", "type": "CPT"}, {"code": "6912115", "type": "CDM"}], "standard_charges": [{"gross_charge": 5778.0, "discounted_cash": 4333.5, "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": 173.0, "discounted_cash": 129.75, "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": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MUMPS AB", "code_information": [{"code": "86735", "type": "CPT"}, {"code": "7256712", "type": "CDM"}], "standard_charges": [{"gross_charge": 366.0, "discounted_cash": 274.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MUMPS AB/2", "code_information": [{"code": "86735", "type": "CPT"}, {"code": "7006712", "type": "CDM"}], "standard_charges": [{"gross_charge": 366.0, "discounted_cash": 274.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MUMPS AB/3", "code_information": [{"code": "86735", "type": "CPT"}, {"code": "7006735", "type": "CDM"}], "standard_charges": [{"gross_charge": 366.0, "discounted_cash": 274.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MUMPS AB/3", "code_information": [{"code": "86735", "type": "CPT"}, {"code": "7256735", "type": "CDM"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MUMPS ANTIGEN .1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5322633", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1054.0, "discounted_cash": 790.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 340.0, "discounted_cash": 255.0, "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": 340.0, "discounted_cash": 255.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 171.0, "discounted_cash": 128.25, "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": 171.0, "discounted_cash": 128.25, "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": 349.0, "discounted_cash": 261.75, "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": 349.0, "discounted_cash": 261.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MURAMIDASE", "code_information": [{"code": "85549", "type": "CPT"}, {"code": "7005549", "type": "CDM"}], "standard_charges": [{"gross_charge": 820.0, "discounted_cash": 615.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MURAMIDASE", "code_information": [{"code": "85549", "type": "CPT"}, {"code": "7255546", "type": "CDM"}], "standard_charges": [{"gross_charge": 820.0, "discounted_cash": 615.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MUSK ANTIBODY", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "7250019", "type": "CDM"}], "standard_charges": [{"gross_charge": 1056.0, "discounted_cash": 792.0, "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": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI 15ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315811", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI 15ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315811", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "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": 89.0, "discounted_cash": 66.75, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5307918", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5307918", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI DROPS 1ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316646", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI DROPS 1ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316646", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": 295.0, "discounted_cash": 221.25, "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": 295.0, "discounted_cash": 221.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI FE CTB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5307926", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.36, "discounted_cash": 0.27, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI FE CTB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5307926", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 0.36, "discounted_cash": 0.27, "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": 339.0, "discounted_cash": 254.25, "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": 339.0, "discounted_cash": 254.25, "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": 0.35, "discounted_cash": 0.26, "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": 0.35, "discounted_cash": 0.26, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI MIN 10ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315812", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI MIN 10ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315812", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "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": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "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": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI MIN THERAP TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5307916", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI MIN THERAP TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5307916", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "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": 227.0, "discounted_cash": 170.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI PRENAT W/FA 0.8MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5307928", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI PRENAT W/FA 0.8MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5307928", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI PRENAT W/FA 1MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301910", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI PRENAT W/FA 1MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301910", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI PRENATAL FA DOCUS TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312433", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI PRENATAL FA DOCUS TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312433", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "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": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "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": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI THERAP 5ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5307913", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI THERAP 5ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5307913", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "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": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "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": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI VIT B&C FA CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5307924", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI VIT B&C FA CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5307924", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI W/FE DROPS 1ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315814", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI W/FE DROPS 1ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315814", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MYCOPHENOL ACID 180MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7518", "type": "HCPCS"}, {"code": "5307959", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MYCOPHENOL ACID 180MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7518", "type": "HCPCS"}, {"code": "5307959", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MYCOPHENOL ACID 360MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7518", "type": "HCPCS"}, {"code": "5307962", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MYCOPHENOL ACID 360MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7518", "type": "HCPCS"}, {"code": "5307962", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "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": 52.0, "discounted_cash": 39.0, "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": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MYCOPHENOLATE 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7517", "type": "HCPCS"}, {"code": "5307963", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MYCOPHENOLATE 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7517", "type": "HCPCS"}, {"code": "5307963", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MYCOPHENOLATE PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7519", "type": "HCPCS"}, {"code": "5322649", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 10.0, "discounted_cash": 7.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MYCOPHENOLATE PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7519", "type": "HCPCS"}, {"code": "5322649", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 10.0, "discounted_cash": 7.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MYCOPHENOLATE200MG/ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315824", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MYCOPHENOLATE200MG/ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315824", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MYCOPHENOLIC ACID", "code_information": [{"code": "80180", "type": "CPT"}, {"code": "7254055", "type": "CDM"}], "standard_charges": [{"gross_charge": 719.0, "discounted_cash": 539.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MYCOPLASMA AB", "code_information": [{"code": "86738", "type": "CPT"}, {"code": "7006181", "type": "CDM"}], "standard_charges": [{"gross_charge": 788.0, "discounted_cash": 591.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MYCOPLASMA AB/3", "code_information": [{"code": "86738", "type": "CPT"}, {"code": "7256739", "type": "CDM"}], "standard_charges": [{"gross_charge": 788.0, "discounted_cash": 591.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MYCOPLASMA AB/4", "code_information": [{"code": "86738", "type": "CPT"}, {"code": "7256740", "type": "CDM"}], "standard_charges": [{"gross_charge": 788.0, "discounted_cash": 591.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MYCOPLASMA AMP PROBE/3", "code_information": [{"code": "87581", "type": "CPT"}, {"code": "7253876", "type": "CDM"}], "standard_charges": [{"gross_charge": 933.0, "discounted_cash": 699.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MYELIN AB/2", "code_information": [{"code": "86362", "type": "CPT"}, {"code": "7256265", "type": "CDM"}], "standard_charges": [{"gross_charge": 1300.0, "discounted_cash": 975.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MYELIN BASIC PROTEIN CSF", "code_information": [{"code": "83873", "type": "CPT"}, {"code": "7003874", "type": "CDM"}], "standard_charges": [{"gross_charge": 1460.0, "discounted_cash": 1095.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MYELIN BASIC PROTEIN CSF", "code_information": [{"code": "83873", "type": "CPT"}, {"code": "7253874", "type": "CDM"}], "standard_charges": [{"gross_charge": 1460.0, "discounted_cash": 1095.0, "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": 9928.0, "discounted_cash": 7446.0, "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": 11226.0, "discounted_cash": 8419.5, "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": 11226.0, "discounted_cash": 8419.5, "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": 5438.0, "discounted_cash": 4078.5, "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": 5484.0, "discounted_cash": 4113.0, "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": 5896.0, "discounted_cash": 4422.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MYELOPEROXIDASE (MPO) AB", "code_information": [{"code": "83876", "type": "CPT"}, {"code": "7258352", "type": "CDM"}], "standard_charges": [{"gross_charge": 368.0, "discounted_cash": 276.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MYOCARD INFARCT 1ST PASS", "code_information": [{"code": "78468", "type": "CPT"}, {"code": "5208468", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 8739.0, "discounted_cash": 6554.25, "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": 1752.0, "discounted_cash": 1314.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MYOGLOBIN", "code_information": [{"code": "83874", "type": "CPT"}, {"code": "4123873", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MYOGLOBIN", "code_information": [{"code": "83874", "type": "CPT"}, {"code": "7003873", "type": "CDM"}], "standard_charges": [{"gross_charge": 1299.0, "discounted_cash": 974.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MYOGLOBIN", "code_information": [{"code": "83874", "type": "CPT"}, {"code": "7253873", "type": "CDM"}], "standard_charges": [{"gross_charge": 1299.0, "discounted_cash": 974.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MYOGLOBIN/2", "code_information": [{"code": "83874", "type": "CPT"}, {"code": "7003875", "type": "CDM"}], "standard_charges": [{"gross_charge": 471.0, "discounted_cash": 353.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MYOGLOBIN/2", "code_information": [{"code": "83874", "type": "CPT"}, {"code": "7253875", "type": "CDM"}], "standard_charges": [{"gross_charge": 471.0, "discounted_cash": 353.25, "setting": "both", "billing_class": "facility"}]}, {"description": "N-ACETYL-PROCAINAMIDE", "code_information": [{"code": "80192", "type": "CPT"}, {"code": "4104143", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 700.0, "discounted_cash": 525.0, "setting": "both", "billing_class": "facility"}]}, {"description": "N-ACETYL-PROCAINAMIDE", "code_information": [{"code": "80192", "type": "CPT"}, {"code": "4124143", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "N-ACETYL-PROCAINAMIDE", "code_information": [{"code": "80192", "type": "CPT"}, {"code": "4154143", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 268.0, "discounted_cash": 201.0, "setting": "both", "billing_class": "facility"}]}, {"description": "N-ACETYL-PROCAINAMIDE", "code_information": [{"code": "80192", "type": "CPT"}, {"code": "7254143", "type": "CDM"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "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": 35.0, "discounted_cash": 26.25, "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": 145.0, "discounted_cash": 108.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NA BICARB 4.2% IPPB IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332293", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 251.0, "discounted_cash": 188.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NA BICARB 4.2% IPPB IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332293", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 251.0, "discounted_cash": 188.25, "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": 216.0, "discounted_cash": 162.0, "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": 13.0, "discounted_cash": 9.75, "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": 28.0, "discounted_cash": 21.0, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NA BIPHOPH/NA PHOS45MLLQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316364", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NA BIPHOPH/NA PHOS45MLLQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316364", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NA BIPHOPH/NA PHOS90MLLQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316365", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 82.0, "discounted_cash": 61.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NA BIPHOPH/NA PHOS90MLLQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316365", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 82.0, "discounted_cash": 61.5, "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": 58.0, "discounted_cash": 43.5, "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": 58.0, "discounted_cash": 43.5, "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": 58.0, "discounted_cash": 43.5, "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": 58.0, "discounted_cash": 43.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NA CITRA/CITRC AC15ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316353", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NA CITRA/CITRC AC15ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316353", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "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": 47.0, "discounted_cash": 35.25, "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": 47.0, "discounted_cash": 35.25, "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": 36.0, "discounted_cash": 27.0, "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": 36.0, "discounted_cash": 27.0, "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": 145.0, "discounted_cash": 108.75, "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": 145.0, "discounted_cash": 108.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NA GLYCEROPHOSPH 20MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5322671", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 133.0, "discounted_cash": 99.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NA HYALURONATE GL PK", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305306", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NA HYALURONATE GL PK", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305306", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "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": 116.0, "discounted_cash": 87.0, "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": 124.0, "discounted_cash": 93.0, "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": 112.0, "discounted_cash": 84.0, "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": 89.0, "discounted_cash": 66.75, "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": 35.0, "discounted_cash": 26.25, "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": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "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": 3.0, "discounted_cash": 2.25, "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": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NABUMETONE 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307960", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NABUMETONE 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307960", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NABUMETONE 750MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307961", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NABUMETONE 750MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307961", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL .65% 30ML NASAL SP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5332378", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 23.0, "discounted_cash": 17.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL .65% 30ML NASAL SP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5332378", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 23.0, "discounted_cash": 17.25, "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": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "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": 98.0, "discounted_cash": 73.5, "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": 98.0, "discounted_cash": 73.5, "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": 17.0, "discounted_cash": 12.75, "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": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL .9% 2.5ML PFS IJ", "code_information": [{"code": "A4216", "type": "HCPCS"}, {"code": "5324192", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "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": 146.0, "discounted_cash": 109.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL .9% 2ML IJ", "code_information": [{"code": "A4216", "type": "HCPCS"}, {"code": "5324191", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 177.0, "discounted_cash": 132.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL .9% 30ML IJ", "code_information": [{"code": "A4216", "type": "HCPCS"}, {"code": "5324196", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 178.0, "discounted_cash": 133.5, "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": 4.0, "discounted_cash": 3.0, "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": 593.0, "discounted_cash": 444.75, "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": 435.0, "discounted_cash": 326.25, "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": 392.0, "discounted_cash": 294.0, "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": 339.0, "discounted_cash": 254.25, "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": 460.0, "discounted_cash": 345.0, "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": 460.0, "discounted_cash": 345.0, "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": 177.0, "discounted_cash": 132.75, "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": 177.0, "discounted_cash": 132.75, "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": 387.0, "discounted_cash": 290.25, "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": 387.0, "discounted_cash": 290.25, "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": 396.0, "discounted_cash": 297.0, "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": 396.0, "discounted_cash": 297.0, "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": 191.0, "discounted_cash": 143.25, "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": 191.0, "discounted_cash": 143.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 387.0, "discounted_cash": 290.25, "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": 387.0, "discounted_cash": 290.25, "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": 144.0, "discounted_cash": 108.0, "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": 144.0, "discounted_cash": 108.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 44.0, "discounted_cash": 33.0, "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": 44.0, "discounted_cash": 33.0, "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": 47.0, "discounted_cash": 35.25, "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": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL 10% 15ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5324181", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "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": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL 3% 15ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332400", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "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": 414.0, "discounted_cash": 310.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL 7% 4ML IS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5332402", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL 7% 4ML IS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5332402", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "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": 0.36, "discounted_cash": 0.27, "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": 0.36, "discounted_cash": 0.27, "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": 156.0, "discounted_cash": 117.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL HYPERTONIC2%15ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332386", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 328.0, "discounted_cash": 246.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL HYPERTONIC2%15ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332386", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 328.0, "discounted_cash": 246.0, "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": 206.0, "discounted_cash": 154.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL HYPERTONIC5%3.5MLOO", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332404", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 206.0, "discounted_cash": 154.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL HYPERTONIC5%3.5MLOO", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332404", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 206.0, "discounted_cash": 154.5, "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": 44.0, "discounted_cash": 33.0, "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": 408.0, "discounted_cash": 306.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL.9 SLUSH BAG 1L IRR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5414025", "type": "CDM"}, {"code": "270", "type": "RC"}], "standard_charges": [{"gross_charge": 615.0, "discounted_cash": 461.25, "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": 50.0, "discounted_cash": 37.5, "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": 50.0, "discounted_cash": 37.5, "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": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NADOLOL 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307973", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NADOLOL 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307973", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "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": 23.0, "discounted_cash": 17.25, "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": 23.0, "discounted_cash": 17.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NADOLOL 80MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307978", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NADOLOL 80MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307978", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NAIL ANKLE ARTHRODESIS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132999", "type": "CDM"}], "standard_charges": [{"gross_charge": 73550.0, "discounted_cash": 55162.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NAIL INTRAMEDULLARY TYP1", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133001", "type": "CDM"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NAIL INTRAMEDULLARY TYP2", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133002", "type": "CDM"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NAIL INTRAMEDULLARY TYP3", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133003", "type": "CDM"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NAIL TIBIA", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133075", "type": "CDM"}], "standard_charges": [{"gross_charge": 9611.0, "discounted_cash": 7208.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NALBUPHINE PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2300", "type": "HCPCS"}, {"code": "5322685", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 157.0, "discounted_cash": 117.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NALBUPHINE PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2300", "type": "HCPCS"}, {"code": "5322685", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 157.0, "discounted_cash": 117.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NALMEFENE 1MG/ML 2ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5322703", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 158.0, "discounted_cash": 118.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NALOXEGOL 12.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308061", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NALOXEGOL 12.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308061", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NALOXEGOL 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308060", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NALOXEGOL 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308060", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NALOXONE NASAL 4MG SP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331502", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 195.0, "discounted_cash": 146.25, "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": 3.0, "discounted_cash": 2.25, "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": 3.0, "discounted_cash": 2.25, "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": 118.0, "discounted_cash": 88.5, "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": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NAPHAZOLINE .1% 15ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331500", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 291.0, "discounted_cash": 218.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NAPHAZOLINE .1% 15ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331500", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 291.0, "discounted_cash": 218.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NAPHAZOLINE-PHENIR15MLOS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331527", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 221.0, "discounted_cash": 165.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NAPHAZOLINE-PHENIR15MLOS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331527", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 221.0, "discounted_cash": 165.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "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": 55.0, "discounted_cash": 41.25, "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": 55.0, "discounted_cash": 41.25, "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": 484.0, "discounted_cash": 363.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NASAL BONES 3VW MIN", "code_information": [{"code": "70160", "type": "CPT"}, {"code": "5010160", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 511.0, "discounted_cash": 383.25, "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": 511.0, "discounted_cash": 383.25, "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": 165.0, "discounted_cash": 123.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NASAL SMEAR EOSINOPHILES", "code_information": [{"code": "89190", "type": "CPT"}, {"code": "4129190", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NASAL SMEAR EOSINOPHILES", "code_information": [{"code": "89190", "type": "CPT"}, {"code": "4159190", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NASOPHRYNGSCPY W/ENDOSCP", "code_information": [{"code": "92511", "type": "CPT"}, {"code": "5102511", "type": "CDM"}, {"code": "471", "type": "RC"}], "standard_charges": [{"gross_charge": 282.0, "discounted_cash": 211.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NATAMYCIN 5% 15ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331532", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2050.0, "discounted_cash": 1537.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NATAMYCIN 5% 15ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331532", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2050.0, "discounted_cash": 1537.5, "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": 48.0, "discounted_cash": 36.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NATEGLINIDE120MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308093", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NATEGLINIDE120MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308093", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "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 BRACHYTHERAPY", "code_information": [{"code": "C1715", "type": "HCPCS"}, {"code": "8240268", "type": "CDM"}], "standard_charges": [{"gross_charge": 187.0, "discounted_cash": 140.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NEBIVOLOL 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308102", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 23.0, "discounted_cash": 17.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NEBIVOLOL 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308102", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 23.0, "discounted_cash": 17.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NEBIVOLOL 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308103", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NEBIVOLOL 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308103", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NEBIVOLOL 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308104", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NEBIVOLOL 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308104", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "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": 481.0, "discounted_cash": 360.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NECK FOR SOFT TISSUES", "code_information": [{"code": "70360", "type": "CPT"}, {"code": "5010360", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 460.0, "discounted_cash": 345.0, "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": 460.0, "discounted_cash": 345.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NEEDLE ASPIRATION BIOPSY", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8056983", "type": "CDM"}], "standard_charges": [{"gross_charge": 2735.23, "discounted_cash": 2051.42, "setting": "both", "billing_class": "facility"}]}, {"description": "NEEDLE ELCTRMYGPH NONEXT", "code_information": [{"code": "95887", "type": "CPT"}, {"code": "3215887", "type": "CDM"}, {"code": "922", "type": "RC"}], "standard_charges": [{"gross_charge": 5560.0, "discounted_cash": 4170.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NEEDLE ELCTROMEYGPHY CMP", "code_information": [{"code": "95886", "type": "CPT"}, {"code": "3215852", "type": "CDM"}, {"code": "922", "type": "RC"}], "standard_charges": [{"gross_charge": 669.0, "discounted_cash": 501.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NEEDLE ELCTROMYGRPHY LTD", "code_information": [{"code": "95885", "type": "CPT"}, {"code": "3215851", "type": "CDM"}, {"code": "922", "type": "RC"}], "standard_charges": [{"gross_charge": 543.0, "discounted_cash": 407.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NEFAZODONE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308095", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NEFAZODONE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308095", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NEFAZODONE 150MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308096", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NEFAZODONE 150MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308096", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NEFAZODONE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308094", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NEFAZODONE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308094", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NEG PRESS THRPY <=50CM", "code_information": [{"code": "97605", "type": "CPT"}, {"code": "6907608", "type": "CDM"}], "standard_charges": [{"gross_charge": 702.0, "discounted_cash": 526.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NEG PRESS THRPY >50CM", "code_information": [{"code": "97606", "type": "CPT"}, {"code": "6907609", "type": "CDM"}], "standard_charges": [{"gross_charge": 1416.0, "discounted_cash": 1062.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 75.0, "discounted_cash": 56.25, "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": 75.0, "discounted_cash": 56.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NEO/BAC/POLY/HC 15GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337081", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 445.0, "discounted_cash": 333.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NEO/BAC/POLY/HC 15GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337081", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 445.0, "discounted_cash": 333.75, "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": 49.0, "discounted_cash": 36.75, "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": 49.0, "discounted_cash": 36.75, "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": 62.0, "discounted_cash": 46.5, "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": 62.0, "discounted_cash": 46.5, "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": 226.0, "discounted_cash": 169.5, "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": 226.0, "discounted_cash": 169.5, "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": 90.0, "discounted_cash": 67.5, "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": 90.0, "discounted_cash": 67.5, "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": 175.0, "discounted_cash": 131.25, "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": 175.0, "discounted_cash": 131.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NEOMY/POLY/HCTS 10ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331567", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 234.0, "discounted_cash": 175.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NEOMY/POLY/HCTS 10ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331567", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 234.0, "discounted_cash": 175.5, "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": 295.0, "discounted_cash": 221.25, "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": 295.0, "discounted_cash": 221.25, "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": 39.0, "discounted_cash": 29.25, "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": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NEOMYCIN 5GM PW", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336714", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NEOMYCIN 5GM PW", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336714", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "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": 143.0, "discounted_cash": 107.25, "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": 16.0, "discounted_cash": 12.0, "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": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NEOX 1K 8CM X 3CM PER SQ CM", "code_information": [{"code": "Q4148", "type": "HCPCS"}, {"code": "4028551", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 446.0, "discounted_cash": 334.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NEOX 1K 8CM X 3CM PER SQ CM", "code_information": [{"code": "Q4148", "type": "HCPCS"}, {"code": "4028551", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 446.0, "discounted_cash": 334.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NEOX CORD RT PER SQ CM", "code_information": [{"code": "Q4148", "type": "HCPCS"}, {"code": "4028579", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 518.0, "discounted_cash": 388.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NEOX CORD RT PER SQ CM", "code_information": [{"code": "Q4148", "type": "HCPCS"}, {"code": "4028579", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 518.0, "discounted_cash": 388.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NEOX FLO PER 1MG", "code_information": [{"code": "Q4155", "type": "HCPCS"}, {"code": "4028557", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 13719.0, "discounted_cash": 10289.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NEOX FLO PER 1MG", "code_information": [{"code": "Q4155", "type": "HCPCS"}, {"code": "4028557", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 13719.0, "discounted_cash": 10289.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NERV COND STUDIES 3-4", "code_information": [{"code": "95908", "type": "CPT"}, {"code": "3215908", "type": "CDM"}, {"code": "922", "type": "RC"}], "standard_charges": [{"gross_charge": 3115.0, "discounted_cash": 2336.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NERV COND STUDIES 3-4", "code_information": [{"code": "95908", "type": "CPT"}, {"code": "4705908", "type": "CDM"}, {"code": "922", "type": "RC"}], "standard_charges": [{"gross_charge": 2747.0, "discounted_cash": 2060.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NERVE COND STUDIES 1-2", "code_information": [{"code": "95907", "type": "CPT"}, {"code": "3215907", "type": "CDM"}, {"code": "922", "type": "RC"}], "standard_charges": [{"gross_charge": 1335.0, "discounted_cash": 1001.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NERVE COND STUDIES 1-2", "code_information": [{"code": "95907", "type": "CPT"}, {"code": "4705907", "type": "CDM"}, {"code": "922", "type": "RC"}], "standard_charges": [{"gross_charge": 1163.0, "discounted_cash": 872.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NERVE COND STUDIES 11-12", "code_information": [{"code": "95912", "type": "CPT"}, {"code": "3215912", "type": "CDM"}, {"code": "922", "type": "RC"}], "standard_charges": [{"gross_charge": 11078.0, "discounted_cash": 8308.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NERVE COND STUDIES 11-12", "code_information": [{"code": "95912", "type": "CPT"}, {"code": "4705912", "type": "CDM"}, {"code": "922", "type": "RC"}], "standard_charges": [{"gross_charge": 8221.0, "discounted_cash": 6165.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NERVE COND STUDIES 5-6", "code_information": [{"code": "95909", "type": "CPT"}, {"code": "3215909", "type": "CDM"}, {"code": "922", "type": "RC"}], "standard_charges": [{"gross_charge": 6120.0, "discounted_cash": 4590.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NERVE COND STUDIES 5-6", "code_information": [{"code": "95909", "type": "CPT"}, {"code": "4705909", "type": "CDM"}, {"code": "922", "type": "RC"}], "standard_charges": [{"gross_charge": 4316.0, "discounted_cash": 3237.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NERVE COND STUDIES 7-8", "code_information": [{"code": "95910", "type": "CPT"}, {"code": "3215910", "type": "CDM"}, {"code": "922", "type": "RC"}], "standard_charges": [{"gross_charge": 6676.0, "discounted_cash": 5007.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NERVE COND STUDIES 7-8", "code_information": [{"code": "95910", "type": "CPT"}, {"code": "4705910", "type": "CDM"}, {"code": "922", "type": "RC"}], "standard_charges": [{"gross_charge": 5361.0, "discounted_cash": 4020.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NERVE COND STUDIES 9-10", "code_information": [{"code": "95911", "type": "CPT"}, {"code": "3215911", "type": "CDM"}, {"code": "922", "type": "RC"}], "standard_charges": [{"gross_charge": 7782.0, "discounted_cash": 5836.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NERVE COND STUDIES 9-10", "code_information": [{"code": "95911", "type": "CPT"}, {"code": "4705911", "type": "CDM"}, {"code": "922", "type": "RC"}], "standard_charges": [{"gross_charge": 9222.0, "discounted_cash": 6916.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NERVE COND STUDIES >13", "code_information": [{"code": "95913", "type": "CPT"}, {"code": "3215913", "type": "CDM"}, {"code": "922", "type": "RC"}], "standard_charges": [{"gross_charge": 13350.0, "discounted_cash": 10012.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NERVE COND STUDIES >13", "code_information": [{"code": "95913", "type": "CPT"}, {"code": "4705913", "type": "CDM"}, {"code": "922", "type": "RC"}], "standard_charges": [{"gross_charge": 13166.0, "discounted_cash": 9874.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NESIRITIDE PER .1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2325", "type": "HCPCS"}, {"code": "5322800", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 416.0, "discounted_cash": 312.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NESIRITIDE PER .1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2325", "type": "HCPCS"}, {"code": "5322800", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 416.0, "discounted_cash": 312.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NEUROMUSCULAR JNCTN TEST", "code_information": [{"code": "95937", "type": "CPT"}, {"code": "4705937", "type": "CDM"}, {"code": "922", "type": "RC"}], "standard_charges": [{"gross_charge": 883.0, "discounted_cash": 662.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NEUROMYELITIS OPTICA", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7253501", "type": "CDM"}], "standard_charges": [{"gross_charge": 3071.0, "discounted_cash": 2303.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NEUROMYELITIS OPTICAL AB/2", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "7258628", "type": "CDM"}], "standard_charges": [{"gross_charge": 1122.0, "discounted_cash": 841.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NEURSTIM+EXT ITREL III", "code_information": [{"code": "C1767", "type": "HCPCS"}, {"code": "8242402", "type": "CDM"}], "standard_charges": [{"gross_charge": 67548.0, "discounted_cash": 50661.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NEUTRALIZATN TEST VIRAL", "code_information": [{"code": "86382", "type": "CPT"}, {"code": "7006383", "type": "CDM"}], "standard_charges": [{"gross_charge": 1322.0, "discounted_cash": 991.5, "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": 34.0, "discounted_cash": 25.5, "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": 34.0, "discounted_cash": 25.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 116.0, "discounted_cash": 87.0, "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": 116.0, "discounted_cash": 87.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NEWBORN LEVEL I", "code_information": [{"code": "1990010", "type": "CDM"}, {"code": "171", "type": "RC"}], "standard_charges": [{"gross_charge": 2218.0, "discounted_cash": 1663.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NEWBORN LEVEL I", "code_information": [{"code": "2210010", "type": "CDM"}, {"code": "171", "type": "RC"}], "standard_charges": [{"gross_charge": 2218.0, "discounted_cash": 1663.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NEWBORN LEVEL I", "code_information": [{"code": "2550010", "type": "CDM"}, {"code": "171", "type": "RC"}], "standard_charges": [{"gross_charge": 2218.0, "discounted_cash": 1663.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NEWBORN LEVEL II", "code_information": [{"code": "1990012", "type": "CDM"}, {"code": "172", "type": "RC"}], "standard_charges": [{"gross_charge": 6712.0, "discounted_cash": 5034.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NEWBORN LEVEL II", "code_information": [{"code": "2210012", "type": "CDM"}, {"code": "172", "type": "RC"}], "standard_charges": [{"gross_charge": 6712.0, "discounted_cash": 5034.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NEWBORN LEVEL II", "code_information": [{"code": "2550012", "type": "CDM"}, {"code": "172", "type": "RC"}], "standard_charges": [{"gross_charge": 6712.0, "discounted_cash": 5034.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NEWBORN OTHER", "code_information": [{"code": "1990011", "type": "CDM"}, {"code": "179", "type": "RC"}], "standard_charges": [{"gross_charge": 2139.0, "discounted_cash": 1604.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NEWBORN OTHER", "code_information": [{"code": "2210011", "type": "CDM"}, {"code": "179", "type": "RC"}], "standard_charges": [{"gross_charge": 2139.0, "discounted_cash": 1604.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NEWBORN OTHER", "code_information": [{"code": "2550011", "type": "CDM"}, {"code": "179", "type": "RC"}], "standard_charges": [{"gross_charge": 2139.0, "discounted_cash": 1604.25, "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": 546.0, "discounted_cash": 409.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NIACIN 100MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5308197", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NIACIN 100MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5308197", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NIACIN 250MG XR CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5308251", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NIACIN 250MG XR CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5308251", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": 36.0, "discounted_cash": 27.0, "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": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NIACIN 50MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5308174", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.53, "discounted_cash": 0.4, "setting": "both", "billing_class": "facility"}]}, {"description": "NIACIN 50MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5308174", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 0.53, "discounted_cash": 0.4, "setting": "both", "billing_class": "facility"}]}, {"description": "NIACIN 750MG XR TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5308249", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NIACIN 750MG XR TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5308249", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "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": 3.0, "discounted_cash": 2.25, "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": 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": "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": "NICKEL", "code_information": [{"code": "83885", "type": "CPT"}, {"code": "7253947", "type": "CDM"}], "standard_charges": [{"gross_charge": 251.0, "discounted_cash": 188.25, "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": 137.0, "discounted_cash": 102.75, "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": 137.0, "discounted_cash": 102.75, "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": 134.0, "discounted_cash": 100.5, "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": 134.0, "discounted_cash": 100.5, "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": 113.0, "discounted_cash": 84.75, "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": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NICOTINE NS10MG/ML10MLSP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331620", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 450.0, "discounted_cash": 337.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NICOTINE NS10MG/ML10MLSP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331620", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 450.0, "discounted_cash": 337.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NICU NB LVL III", "code_information": [{"code": "1990070", "type": "CDM"}, {"code": "173", "type": "RC"}], "standard_charges": [{"gross_charge": 8995.0, "discounted_cash": 6746.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NICU NB LVL III", "code_information": [{"code": "2210070", "type": "CDM"}, {"code": "173", "type": "RC"}], "standard_charges": [{"gross_charge": 8995.0, "discounted_cash": 6746.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NICU NB LVL IV", "code_information": [{"code": "1990020", "type": "CDM"}, {"code": "174", "type": "RC"}], "standard_charges": [{"gross_charge": 9436.0, "discounted_cash": 7077.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NICU NB LVL IV", "code_information": [{"code": "2210020", "type": "CDM"}, {"code": "174", "type": "RC"}], "standard_charges": [{"gross_charge": 9436.0, "discounted_cash": 7077.0, "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": 47.0, "discounted_cash": 35.25, "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": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NIFEDIPINE 20MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308313", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NIFEDIPINE 20MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308313", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "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": 59.0, "discounted_cash": 44.25, "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": 59.0, "discounted_cash": 44.25, "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": 86.0, "discounted_cash": 64.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "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": 86.0, "discounted_cash": 64.5, "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": 173.0, "discounted_cash": 129.75, "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": 173.0, "discounted_cash": 129.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NIRSEVIMAB-ALIP RSV MAB .5MLIJ", "code_information": [{"code": "90380", "type": "CPT"}, {"code": "5322870", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2608.0, "discounted_cash": 1956.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NIRSEVIMAB-ALIP RSV MAB .5MLIJ", "code_information": [{"code": "90380", "type": "CPT"}, {"code": "5322870", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 2608.0, "discounted_cash": 1956.0, "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": 672.0, "discounted_cash": 504.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 672.0, "discounted_cash": 504.0, "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": 53.0, "discounted_cash": 39.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROFURANTOIN 25MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308332", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROFURANTOIN 25MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308332", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "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": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROGLYCER .4MG13.8GMSP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331625", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 509.0, "discounted_cash": 381.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROGLYCER .4MG13.8GMSP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331625", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 509.0, "discounted_cash": 381.75, "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": 69.0, "discounted_cash": 51.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 69.0, "discounted_cash": 51.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "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": 64.0, "discounted_cash": 48.0, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "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": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "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": 80.0, "discounted_cash": 60.0, "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": 80.0, "discounted_cash": 60.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROGLYCERIN .6MG SL TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308382", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROGLYCERIN .6MG SL TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308382", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": 90.0, "discounted_cash": 67.5, "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": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROGLYCERIN 2.5MGXR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308358", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROGLYCERIN 2.5MGXR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308358", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROGLYCERIN 6.5MGXR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308362", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROGLYCERIN 6.5MGXR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308362", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROGLYCERIN 9MGXR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308366", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROGLYCERIN 9MGXR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308366", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "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": 11.0, "discounted_cash": 8.25, "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": 11.0, "discounted_cash": 8.25, "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": 31.0, "discounted_cash": 23.25, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROGLYCERIN.3MGSL100TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308373", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 175.0, "discounted_cash": 131.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROGLYCERIN.3MGSL100TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308373", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 175.0, "discounted_cash": 131.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 157.0, "discounted_cash": 117.75, "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": 157.0, "discounted_cash": 117.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROGLYCERIN.4MGSL100TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308376", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 223.0, "discounted_cash": 167.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROGLYCERIN.4MGSL100TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308376", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 223.0, "discounted_cash": 167.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROGLYCERIN.6MGSL100TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308381", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 210.0, "discounted_cash": 157.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROGLYCERIN.6MGSL100TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308381", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 210.0, "discounted_cash": 157.5, "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": 49.0, "discounted_cash": 36.75, "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": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROGLYCERIN2% 30GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336868", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 206.0, "discounted_cash": 154.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROGLYCERIN2% 30GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336868", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 206.0, "discounted_cash": 154.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROGLYCERIN2% 60GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336869", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 433.0, "discounted_cash": 324.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROGLYCERIN2% 60GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336869", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 433.0, "discounted_cash": 324.75, "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": 472.0, "discounted_cash": 354.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROPRUSSIDE 50MG/5MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5322925", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 162.0, "discounted_cash": 121.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NIVOLUMAB PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9299", "type": "HCPCS"}, {"code": "5322881", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 205.0, "discounted_cash": 153.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NIVOLUMAB PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9299", "type": "HCPCS"}, {"code": "5322881", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 205.0, "discounted_cash": 153.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NO DVC W/DEV INTENSVE NO CHG", "code_information": [{"code": "C1890", "type": "HCPCS"}, {"code": "4031889", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 0.01, "discounted_cash": 0.01, "setting": "both", "billing_class": "facility"}]}, {"description": "NONINVS PHYS STDY LE ART", "code_information": [{"code": "93924", "type": "CPT"}, {"code": "4630086", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 990.0, "discounted_cash": 742.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NONINVS PHYS STDY LE ART", "code_information": [{"code": "93924", "type": "CPT"}, {"code": "5062001", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 1652.0, "discounted_cash": 1239.0, "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": 143.0, "discounted_cash": 107.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NOREPIN/NS 4MG/250ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5322914", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 144.0, "discounted_cash": 108.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NOREPINEPH 8MG/250ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5322875", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 199.0, "discounted_cash": 149.25, "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": 238.0, "discounted_cash": 178.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NOREPINEPHR 8MG DRIP IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5322909", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 192.0, "discounted_cash": 144.0, "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": 560.0, "discounted_cash": 420.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NORTRIPT 10MG/5ML 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315868", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NORTRIPT 10MG/5ML 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315868", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "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": 47.0, "discounted_cash": 35.25, "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": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NORTRIPTYLINE 50MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308435", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 58.0, "discounted_cash": 43.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NORTRIPTYLINE 50MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308435", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 58.0, "discounted_cash": 43.5, "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": 1124.0, "discounted_cash": 843.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NOS IMMUNOASSAY NON-RIA", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7002662", "type": "CDM"}], "standard_charges": [{"gross_charge": 520.0, "discounted_cash": 390.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NOS IMMUNOASSAY NON-RIA", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7052662", "type": "CDM"}], "standard_charges": [{"gross_charge": 1966.0, "discounted_cash": 1474.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NOS IMMUNOASSAY NON-RIA/3", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7258357", "type": "CDM"}], "standard_charges": [{"gross_charge": 642.0, "discounted_cash": 481.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NPM1 EXON 12 VARIANTS", "code_information": [{"code": "81310", "type": "CPT"}, {"code": "7050065", "type": "CDM"}], "standard_charges": [{"gross_charge": 1014.0, "discounted_cash": 760.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NSEL DEB WNDS WO ANES B", "code_information": [{"code": "97602", "type": "CPT"}, {"code": "6907605", "type": "CDM"}], "standard_charges": [{"gross_charge": 249.0, "discounted_cash": 186.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NSTIM GASTRIC ENTERRA II", "code_information": [{"code": "C1767", "type": "HCPCS"}, {"code": "4008503", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 84909.0, "discounted_cash": 63681.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NUCLEAR ANTIGEN AB", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "4126238", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 59.0, "discounted_cash": 44.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NUCLEAR ANTIGEN AB/10", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "4106242", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 486.0, "discounted_cash": 364.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NUCLEAR ANTIGEN AB/11", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "7256239", "type": "CDM"}], "standard_charges": [{"gross_charge": 831.0, "discounted_cash": 623.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NUCLEAR ANTIGEN AB/15", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "7256271", "type": "CDM"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NUCLEAR ANTIGEN AB/17", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "7256275", "type": "CDM"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NUCLEAR ANTIGEN AB/2", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "4126239", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NUCLEAR ANTIGEN AB/20", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "7256378", "type": "CDM"}], "standard_charges": [{"gross_charge": 1109.0, "discounted_cash": 831.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NUCLEAR ANTIGEN AB/23", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "7258623", "type": "CDM"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NUCLEAR ANTIGEN AB/25", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "7258629", "type": "CDM"}], "standard_charges": [{"gross_charge": 831.0, "discounted_cash": 623.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NUCLEAR ANTIGEN AB/4", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "4126328", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 59.0, "discounted_cash": 44.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NUCLEAR ANTIGEN AB/4", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "7256224", "type": "CDM"}], "standard_charges": [{"gross_charge": 956.0, "discounted_cash": 717.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NUCLEAR ANTIGEN AB/5", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "7256233", "type": "CDM"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NUCLEAR ANTIGEN AB/7", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "4106238", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 238.0, "discounted_cash": 178.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NUCLEAR ANTIGEN AB/8", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "4106239", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 238.0, "discounted_cash": 178.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NUCLEAR ANTIGEN AB/8", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "7006235", "type": "CDM"}], "standard_charges": [{"gross_charge": 956.0, "discounted_cash": 717.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NUCLEAR ANTIGEN AB/9", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "4106240", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 486.0, "discounted_cash": 364.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NUCLEAR ANTIGEN AB/9", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "7256237", "type": "CDM"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NUCLEOTIDASE 5-", "code_information": [{"code": "83915", "type": "CPT"}, {"code": "7003905", "type": "CDM"}], "standard_charges": [{"gross_charge": 370.0, "discounted_cash": 277.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NUCLEOTIDASE 5-", "code_information": [{"code": "83915", "type": "CPT"}, {"code": "7253905", "type": "CDM"}], "standard_charges": [{"gross_charge": 370.0, "discounted_cash": 277.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NUSHIELD 2X3 PER SQ CM", "code_information": [{"code": "Q4160", "type": "HCPCS"}, {"code": "4028552", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 810.0, "discounted_cash": 607.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NUSHIELD 2X3 PER SQ CM", "code_information": [{"code": "Q4160", "type": "HCPCS"}, {"code": "4028552", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 810.0, "discounted_cash": 607.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NUT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133260", "type": "CDM"}], "standard_charges": [{"gross_charge": 190.0, "discounted_cash": 142.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NV ORTHOPOX VIR DNA AMP PROBE", "code_information": [{"code": "87593", "type": "CPT"}, {"code": "7250413", "type": "CDM"}], "standard_charges": [{"gross_charge": 489.0, "discounted_cash": 366.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NYSTATIN 100MU V TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336934", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NYSTATIN 100MU V TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336934", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 179.0, "discounted_cash": 134.25, "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": 179.0, "discounted_cash": 134.25, "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": 350.0, "discounted_cash": 262.5, "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": 350.0, "discounted_cash": 262.5, "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": 2.0, "discounted_cash": 1.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NYSTATIN 30GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336914", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NYSTATIN 30GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336914", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NYSTATIN 500000U TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308482", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NYSTATIN 500000U TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308482", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "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": 52.0, "discounted_cash": 39.0, "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": 52.0, "discounted_cash": 39.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 256.0, "discounted_cash": 192.0, "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": 256.0, "discounted_cash": 192.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NYSTATIN TOPICAL 60GM PW", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336921", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 421.0, "discounted_cash": 315.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "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": 90.0, "discounted_cash": 67.5, "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": 60.0, "discounted_cash": 45.0, "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": 60.0, "discounted_cash": 45.0, "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": 944.0, "discounted_cash": 708.0, "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": 1703.0, "discounted_cash": 1277.25, "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": 2389.0, "discounted_cash": 1791.75, "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": 3970.0, "discounted_cash": 2977.5, "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": 5041.0, "discounted_cash": 3780.75, "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": 2122.0, "discounted_cash": 1591.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 200 ICU ADD HR", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6240407", "type": "CDM"}, {"code": "762", "type": "RC"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 211 M/S 1/HR", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6240610", "type": "CDM"}, {"code": "762", "type": "RC"}], "standard_charges": [{"gross_charge": 2152.0, "discounted_cash": 1614.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 211 M/S ADD HR", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6240611", "type": "CDM"}, {"code": "762", "type": "RC"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 212 IP HOLD 1/HR", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6241820", "type": "CDM"}], "standard_charges": [{"gross_charge": 2122.0, "discounted_cash": 1591.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 212 IP HOLD ADD HR", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6241821", "type": "CDM"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 212 IP HOLD NON-COV", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6241823", "type": "CDM"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "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": 2039.0, "discounted_cash": 1529.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 215 DOU ADD HR", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6240653", "type": "CDM"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 215 DOU NON-COV", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6240655", "type": "CDM"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 216 SDU 1/HR", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6240656", "type": "CDM"}], "standard_charges": [{"gross_charge": 2122.0, "discounted_cash": 1591.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 216 SDU ADD HR", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6240657", "type": "CDM"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 216 SDU NON-COV", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6240659", "type": "CDM"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 217 SDU 1/HR", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6240660", "type": "CDM"}], "standard_charges": [{"gross_charge": 1977.0, "discounted_cash": 1482.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 217 SDU ADD HR", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6240661", "type": "CDM"}], "standard_charges": [{"gross_charge": 112.0, "discounted_cash": 84.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 217 SDU NON-COV", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6240663", "type": "CDM"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 236 M/S 1/HR", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6240640", "type": "CDM"}, {"code": "762", "type": "RC"}], "standard_charges": [{"gross_charge": 2039.0, "discounted_cash": 1529.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 236 M/S ADD HR", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6240641", "type": "CDM"}, {"code": "762", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 236 M/S NON-COV", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6241641", "type": "CDM"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 237 M/S 1/HR", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6240642", "type": "CDM"}, {"code": "762", "type": "RC"}], "standard_charges": [{"gross_charge": 2152.0, "discounted_cash": 1614.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 237 M/S ADD HR", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6240643", "type": "CDM"}, {"code": "762", "type": "RC"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 239 M/S 1/HR", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6240646", "type": "CDM"}, {"code": "762", "type": "RC"}], "standard_charges": [{"gross_charge": 1977.0, "discounted_cash": 1482.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 239 M/S ADD HR", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6240647", "type": "CDM"}, {"code": "762", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 239 M/S NON-COV", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6241647", "type": "CDM"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "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": 1977.0, "discounted_cash": 1482.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 250 OB ADD HR", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6240625", "type": "CDM"}, {"code": "762", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 250 OB NON-COV", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6241625", "type": "CDM"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 251 OB 1/HR", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6240818", "type": "CDM"}], "standard_charges": [{"gross_charge": 1977.0, "discounted_cash": 1482.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 251 OB ADD HR", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6240819", "type": "CDM"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 280 M/S 1/HR", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6241651", "type": "CDM"}], "standard_charges": [{"gross_charge": 2039.0, "discounted_cash": 1529.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 280 M/S ADD HR", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6241652", "type": "CDM"}], "standard_charges": [{"gross_charge": 112.0, "discounted_cash": 84.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 280 M/S NON-COV", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6241654", "type": "CDM"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 281 ONC 1/HR", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6240626", "type": "CDM"}, {"code": "762", "type": "RC"}], "standard_charges": [{"gross_charge": 2152.0, "discounted_cash": 1614.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 281 ONC ADD HR", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6240627", "type": "CDM"}, {"code": "762", "type": "RC"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 281 ONC NON-COV", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6240629", "type": "CDM"}, {"code": "762", "type": "RC"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GY"}, {"description": "OBSTETRICS PROFILE", "code_information": [{"code": "80055", "type": "CPT"}, {"code": "4150215", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 806.0, "discounted_cash": 604.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OCCLSN/EMBL CATH CNS", "code_information": [{"code": "4917795", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 18711.0, "discounted_cash": 14033.25, "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": 14936.0, "discounted_cash": 11202.0, "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": 154.0, "discounted_cash": 115.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OCCULT BLD FECES ONE SPC", "code_information": [{"code": "82272", "type": "CPT"}, {"code": "4122272", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 11.0, "discounted_cash": 8.25, "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": 141.0, "discounted_cash": 105.75, "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": 173.0, "discounted_cash": 129.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OCTAFLUOROPROP MIC 1MLIJ", "code_information": [{"code": "Q9956", "type": "HCPCS"}, {"code": "5358244", "type": "CDM"}, {"code": "255", "type": "RC"}], "standard_charges": [{"gross_charge": 376.0, "discounted_cash": 282.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OCTAFLUOROPROP MIC 1MLIJ", "code_information": [{"code": "Q9956", "type": "HCPCS"}, {"code": "5358244", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 376.0, "discounted_cash": 282.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OCTREOTIDE DEPO PER1MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2353", "type": "HCPCS"}, {"code": "5322919", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 550.0, "discounted_cash": 412.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OCTREOTIDE DEPO PER1MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2353", "type": "HCPCS"}, {"code": "5322919", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 550.0, "discounted_cash": 412.5, "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": 106.0, "discounted_cash": 79.5, "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": 106.0, "discounted_cash": 79.5, "setting": "both", "billing_class": "facility"}], "modifiers": "JA"}, {"description": "OCULAR LUB 3.5GM OO", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5331635", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1207.0, "discounted_cash": 905.25, "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": 1207.0, "discounted_cash": 905.25, "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": 112.0, "discounted_cash": 84.0, "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": 112.0, "discounted_cash": 84.0, "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": 53.0, "discounted_cash": 39.75, "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": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OFATUMUMAB PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9302", "type": "HCPCS"}, {"code": "5322921", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 462.0, "discounted_cash": 346.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OFATUMUMAB PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9302", "type": "HCPCS"}, {"code": "5322921", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 462.0, "discounted_cash": 346.5, "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": 282.0, "discounted_cash": 211.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 282.0, "discounted_cash": 211.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OH PATCH PERICARDL BOVIN", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8175902", "type": "CDM"}], "standard_charges": [{"gross_charge": 3866.0, "discounted_cash": 2899.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OH RING ANNULOPLASTY", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8143498", "type": "CDM"}], "standard_charges": [{"gross_charge": 24338.0, "discounted_cash": 18253.5, "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": 7520.0, "discounted_cash": 5640.0, "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": 17096.0, "discounted_cash": 12822.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OH VALVE AOR/MIT", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8143510", "type": "CDM"}], "standard_charges": [{"gross_charge": 40875.0, "discounted_cash": 30656.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OH VALVE AORTIC", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8143515", "type": "CDM"}], "standard_charges": [{"gross_charge": 75430.0, "discounted_cash": 56572.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OH VALVE PERICARDIAL", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8143526", "type": "CDM"}], "standard_charges": [{"gross_charge": 41432.0, "discounted_cash": 31074.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OLANZAPINE 10MG DT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308507", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 230.0, "discounted_cash": 172.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OLANZAPINE 10MG DT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308507", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 230.0, "discounted_cash": 172.5, "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": 178.0, "discounted_cash": 133.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 178.0, "discounted_cash": 133.5, "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": 124.0, "discounted_cash": 93.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OLANZAPINE 20MG DT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308508", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 445.0, "discounted_cash": 333.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OLANZAPINE 20MG DT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308508", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 445.0, "discounted_cash": 333.75, "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": 164.0, "discounted_cash": 123.0, "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": 164.0, "discounted_cash": 123.0, "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": 130.0, "discounted_cash": 97.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 130.0, "discounted_cash": 97.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OLANZAPINE 7.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308498", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OLANZAPINE 7.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308498", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 124.0, "discounted_cash": 93.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "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": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OLIGOCLONAL BANDS", "code_information": [{"code": "83916", "type": "CPT"}, {"code": "4103939", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 2145.0, "discounted_cash": 1608.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OLIGOCLONAL BANDS", "code_information": [{"code": "83916", "type": "CPT"}, {"code": "7253925", "type": "CDM"}], "standard_charges": [{"gross_charge": 1607.0, "discounted_cash": 1205.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1070.0, "discounted_cash": 802.5, "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": 1070.0, "discounted_cash": 802.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OLSALAZINE 250MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308490", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OLSALAZINE 250MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308490", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OMEPRAZOLE 10MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308485", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OMEPRAZOLE 10MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308485", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OMEPRAZOLE 20MG DT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5308476", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OMEPRAZOLE 20MG DT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5308476", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OMEPRAZOLE 20MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308486", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 123.0, "discounted_cash": 92.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OMEPRAZOLE 20MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308486", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 123.0, "discounted_cash": 92.25, "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": 206.0, "discounted_cash": 154.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 206.0, "discounted_cash": 154.5, "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": 376.0, "discounted_cash": 282.0, "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": 376.0, "discounted_cash": 282.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ONDANSETRON 8MG DT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308494", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 303.0, "discounted_cash": 227.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ONDANSETRON 8MG DT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308494", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 303.0, "discounted_cash": 227.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ONDANSETRON 8MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308496", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 619.0, "discounted_cash": 464.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ONDANSETRON 8MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308496", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 619.0, "discounted_cash": 464.25, "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": 17.0, "discounted_cash": 12.75, "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": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OP CAPD", "code_information": [{"code": "90999", "type": "CPT"}, {"code": "5600232", "type": "CDM"}, {"code": "841", "type": "RC"}], "standard_charges": [{"gross_charge": 2727.0, "discounted_cash": 2045.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OP CCPD", "code_information": [{"code": "90999", "type": "CPT"}, {"code": "5600238", "type": "CDM"}, {"code": "851", "type": "RC"}], "standard_charges": [{"gross_charge": 2813.0, "discounted_cash": 2109.75, "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": 73768.0, "discounted_cash": 55326.0, "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": 17278.0, "discounted_cash": 12958.5, "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": 84975.0, "discounted_cash": 63731.25, "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": 17278.0, "discounted_cash": 12958.5, "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": 14991.0, "discounted_cash": 11243.25, "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": 15890.0, "discounted_cash": 11917.5, "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": 15890.0, "discounted_cash": 11917.5, "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": 15890.0, "discounted_cash": 11917.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OPIATES/2", "code_information": [{"code": "80361", "type": "CPT"}, {"code": "7002646", "type": "CDM"}], "standard_charges": [{"gross_charge": 242.0, "discounted_cash": 181.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OPIATES/3", "code_information": [{"code": "80361", "type": "CPT"}, {"code": "7253926", "type": "CDM"}], "standard_charges": [{"gross_charge": 207.0, "discounted_cash": 155.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OPIATES/5", "code_information": [{"code": "80361", "type": "CPT"}, {"code": "7253948", "type": "CDM"}], "standard_charges": [{"gross_charge": 339.0, "discounted_cash": 254.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OPIOIDS/OPIATE ANALOGS 1/2 /2", "code_information": [{"code": "80362", "type": "CPT"}, {"code": "7253799", "type": "CDM"}], "standard_charges": [{"gross_charge": 504.0, "discounted_cash": 378.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OPIUM 10% TINC PER DS LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327831", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 525.0, "discounted_cash": 393.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OPIUM 10% TINC PER DS LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327831", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 525.0, "discounted_cash": 393.75, "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": 4703.0, "discounted_cash": 3527.25, "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": 4703.0, "discounted_cash": 3527.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OPTHAL EXAM W/ANES COMP", "code_information": [{"code": "92018", "type": "CPT"}, {"code": "3212018", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 14069.0, "discounted_cash": 10551.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OPTHAL EXAM W/ANES LTD", "code_information": [{"code": "92019", "type": "CPT"}, {"code": "3212019", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 5235.0, "discounted_cash": 3926.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OPTHAL EXAM W/ANES LTD", "code_information": [{"code": "92019", "type": "CPT"}, {"code": "3212019", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 5235.0, "discounted_cash": 3926.25, "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": 736.0, "discounted_cash": 552.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ORBITS 4VW MIN", "code_information": [{"code": "70200", "type": "CPT"}, {"code": "5110200", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 775.0, "discounted_cash": 581.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ORGANIC ACID SNG QNT", "code_information": [{"code": "83921", "type": "CPT"}, {"code": "7252125", "type": "CDM"}], "standard_charges": [{"gross_charge": 1177.0, "discounted_cash": 882.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ORGANIC ACID SNG QNT/2", "code_information": [{"code": "83921", "type": "CPT"}, {"code": "7003854", "type": "CDM"}], "standard_charges": [{"gross_charge": 1177.0, "discounted_cash": 882.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ORGANIC ACIDS QUAL", "code_information": [{"code": "83919", "type": "CPT"}, {"code": "7258391", "type": "CDM"}], "standard_charges": [{"gross_charge": 823.0, "discounted_cash": 617.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ORTH ADD LE VAR/VAL T ST", "code_information": [{"code": "L2270", "type": "HCPCS"}, {"code": "8130080", "type": "CDM"}], "standard_charges": [{"gross_charge": 704.0, "discounted_cash": 528.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ORTH ADD NONCORRS EA BAR", "code_information": [{"code": "L2780", "type": "HCPCS"}, {"code": "8133241", "type": "CDM"}], "standard_charges": [{"gross_charge": 937.0, "discounted_cash": 702.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ORTH AFO DBL UPRGHT CUST", "code_information": [{"code": "L1990", "type": "HCPCS"}, {"code": "8133185", "type": "CDM"}], "standard_charges": [{"gross_charge": 4980.0, "discounted_cash": 3735.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ORTH AFO RIG ANT TIB PF", "code_information": [{"code": "L1932", "type": "HCPCS"}, {"code": "8133237", "type": "CDM"}], "standard_charges": [{"gross_charge": 8845.0, "discounted_cash": 6633.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ORTH BOOT NONPNEU PREFAB", "code_information": [{"code": "L4386", "type": "HCPCS"}, {"code": "8133203", "type": "CDM"}], "standard_charges": [{"gross_charge": 2087.0, "discounted_cash": 1565.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ORTH ELBOW ADJ LCK JNT", "code_information": [{"code": "L3760", "type": "HCPCS"}, {"code": "8133200", "type": "CDM"}], "standard_charges": [{"gross_charge": 4361.0, "discounted_cash": 3270.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ORTH HIP ADJ FLX EXT ABD", "code_information": [{"code": "L2624", "type": "HCPCS"}, {"code": "8130086", "type": "CDM"}], "standard_charges": [{"gross_charge": 11080.0, "discounted_cash": 8310.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ORTH LE ADD DOR/PLNT FLX", "code_information": [{"code": "L2220", "type": "HCPCS"}, {"code": "8133275", "type": "CDM"}], "standard_charges": [{"gross_charge": 2012.0, "discounted_cash": 1509.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ORTH LE ADD FX SH INSRT", "code_information": [{"code": "L2180", "type": "HCPCS"}, {"code": "8133274", "type": "CDM"}], "standard_charges": [{"gross_charge": 1165.0, "discounted_cash": 873.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ORTH LO FLEX LMBR L1 L5", "code_information": [{"code": "L0625", "type": "HCPCS"}, {"code": "8130100", "type": "CDM"}], "standard_charges": [{"gross_charge": 590.0, "discounted_cash": 442.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ORTH LO RGD A/P L1-L5", "code_information": [{"code": "L0627", "type": "HCPCS"}, {"code": "8130131", "type": "CDM"}], "standard_charges": [{"gross_charge": 4043.0, "discounted_cash": 3032.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ORTH LSO SAG CTRL SAC-T9", "code_information": [{"code": "L0637", "type": "HCPCS"}, {"code": "8130109", "type": "CDM"}], "standard_charges": [{"gross_charge": 11480.0, "discounted_cash": 8610.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ORTH TSLO TRPL CTRL 2PC", "code_information": [{"code": "L0486", "type": "HCPCS"}, {"code": "8133267", "type": "CDM"}], "standard_charges": [{"gross_charge": 8231.0, "discounted_cash": 6173.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ORTH WHFO W/O JNTS PREFA", "code_information": [{"code": "L3807", "type": "HCPCS"}, {"code": "8130160", "type": "CDM"}], "standard_charges": [{"gross_charge": 2228.0, "discounted_cash": 1671.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ORTHOPANTOGRAM", "code_information": [{"code": "70355", "type": "CPT"}, {"code": "4900355", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 674.0, "discounted_cash": 505.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ORTHOTECH RESTORE DEPUY", "code_information": [{"code": "C1763", "type": "HCPCS"}, {"code": "8240276", "type": "CDM"}], "standard_charges": [{"gross_charge": 20174.0, "discounted_cash": 15130.5, "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": 2547.0, "discounted_cash": 1910.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OS CALCIS 2 VIEWS", "code_information": [{"code": "73650", "type": "CPT"}, {"code": "5013650", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1257.0, "discounted_cash": 942.75, "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": 1438.0, "discounted_cash": 1078.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OSELTAMIVIR 30MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308477", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 129.0, "discounted_cash": 96.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OSELTAMIVIR 30MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308477", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 129.0, "discounted_cash": 96.75, "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": 161.0, "discounted_cash": 120.75, "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": 161.0, "discounted_cash": 120.75, "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": 471.0, "discounted_cash": 353.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OSMOLALITY BLOOD", "code_information": [{"code": "83930", "type": "CPT"}, {"code": "4123930", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "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": 424.0, "discounted_cash": 318.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OSMOLALITY URINE", "code_information": [{"code": "83935", "type": "CPT"}, {"code": "4123935", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OSMOTIC FRAG RBC UNINC", "code_information": [{"code": "85555", "type": "CPT"}, {"code": "7005555", "type": "CDM"}], "standard_charges": [{"gross_charge": 825.0, "discounted_cash": 618.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OSMOTIC FRAG RBC UNINC", "code_information": [{"code": "85555", "type": "CPT"}, {"code": "7255555", "type": "CDM"}], "standard_charges": [{"gross_charge": 825.0, "discounted_cash": 618.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OST BLT A/S", "code_information": [{"code": "A4367", "type": "HCPCS"}, {"code": "8033055", "type": "CDM"}], "standard_charges": [{"gross_charge": 216.0, "discounted_cash": 162.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OST CLAMP BG", "code_information": [{"code": "A4363", "type": "HCPCS"}, {"code": "8033080", "type": "CDM"}], "standard_charges": [{"gross_charge": 75.0, "discounted_cash": 56.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OST IRR CONE", "code_information": [{"code": "A4399", "type": "HCPCS"}, {"code": "8033125", "type": "CDM"}], "standard_charges": [{"gross_charge": 440.0, "discounted_cash": 330.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OST PASTE STMA", "code_information": [{"code": "A4406", "type": "HCPCS"}, {"code": "8033145", "type": "CDM"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OSTEOCALCIN", "code_information": [{"code": "83937", "type": "CPT"}, {"code": "7003938", "type": "CDM"}], "standard_charges": [{"gross_charge": 765.0, "discounted_cash": 573.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OSTEOCALCIN", "code_information": [{"code": "83937", "type": "CPT"}, {"code": "7253938", "type": "CDM"}], "standard_charges": [{"gross_charge": 765.0, "discounted_cash": 573.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OT COG FUNC ACTIVITY ADDL 15M", "code_information": [{"code": "97130", "type": "CPT"}, {"code": "6057137", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 315.0, "discounted_cash": 236.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"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": 315.0, "discounted_cash": 236.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT COG FUNC ACTIVITY INIT 15M", "code_information": [{"code": "97129", "type": "CPT"}, {"code": "6057116", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 315.0, "discounted_cash": 236.25, "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": 315.0, "discounted_cash": 236.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT COMM/WK REINT TRNG 15", "code_information": [{"code": "97537", "type": "CPT"}, {"code": "6041920", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 189.0, "discounted_cash": 141.75, "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": 325.0, "discounted_cash": 243.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT E-STIM BASIC", "code_information": [{"code": "G0283", "type": "HCPCS"}, {"code": "6057021", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 311.0, "discounted_cash": 233.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT E-STIM MAN EA 15 BSC", "code_information": [{"code": "97032", "type": "CPT"}, {"code": "6041866", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 662.0, "discounted_cash": 496.5, "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": 547.0, "discounted_cash": 410.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT EVAL HIGH COMP", "code_information": [{"code": "97167", "type": "CPT"}, {"code": "6041805", "type": "CDM"}, {"code": "434", "type": "RC"}], "standard_charges": [{"gross_charge": 519.0, "discounted_cash": 389.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT EVAL HIGH COMP", "code_information": [{"code": "97167", "type": "CPT"}, {"code": "6051807", "type": "CDM"}, {"code": "434", "type": "RC"}], "standard_charges": [{"gross_charge": 519.0, "discounted_cash": 389.25, "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": 600.0, "discounted_cash": 450.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT EVAL LOW COMP", "code_information": [{"code": "97165", "type": "CPT"}, {"code": "6041801", "type": "CDM"}, {"code": "434", "type": "RC"}], "standard_charges": [{"gross_charge": 600.0, "discounted_cash": 450.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT EVAL LOW COMP", "code_information": [{"code": "97165", "type": "CPT"}, {"code": "6051801", "type": "CDM"}, {"code": "434", "type": "RC"}], "standard_charges": [{"gross_charge": 524.0, "discounted_cash": 393.0, "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": 608.0, "discounted_cash": 456.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT EVAL MOD COMP", "code_information": [{"code": "97166", "type": "CPT"}, {"code": "6041803", "type": "CDM"}, {"code": "434", "type": "RC"}], "standard_charges": [{"gross_charge": 547.0, "discounted_cash": 410.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT EVAL MOD COMP", "code_information": [{"code": "97166", "type": "CPT"}, {"code": "6051803", "type": "CDM"}, {"code": "434", "type": "RC"}], "standard_charges": [{"gross_charge": 519.0, "discounted_cash": 389.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT IONTOPHOR EA 15 BSC", "code_information": [{"code": "97033", "type": "CPT"}, {"code": "5805272", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 213.0, "discounted_cash": 159.75, "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": 417.0, "discounted_cash": 312.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT NEUROMUSC RE-ED EA15", "code_information": [{"code": "97112", "type": "CPT"}, {"code": "6051900", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 230.0, "discounted_cash": 172.5, "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": 154.0, "discounted_cash": 115.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT NEUROMUSC RE-EDUC EA15", "code_information": [{"code": "97112", "type": "CPT"}, {"code": "6041900", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 138.0, "discounted_cash": 103.5, "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": 152.0, "discounted_cash": 114.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT ORTHO MGMT INIT EA 15MIN", "code_information": [{"code": "97760", "type": "CPT"}, {"code": "6057766", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 173.0, "discounted_cash": 129.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT ORTHO PROS MGMT EA 15MIN", "code_information": [{"code": "97763", "type": "CPT"}, {"code": "5807766", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 1164.0, "discounted_cash": 873.0, "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": 120.0, "discounted_cash": 90.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT PARAFFIN BATH BSC", "code_information": [{"code": "97018", "type": "CPT"}, {"code": "6041848", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 126.0, "discounted_cash": 94.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT PARAFFIN BATH BSC", "code_information": [{"code": "97018", "type": "CPT"}, {"code": "6051848", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 126.0, "discounted_cash": 94.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT PROSTH TRN INIT EA 15MIN", "code_information": [{"code": "97761", "type": "CPT"}, {"code": "5807762", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 193.0, "discounted_cash": 144.75, "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": 619.0, "discounted_cash": 464.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT RE-EVAL", "code_information": [{"code": "97168", "type": "CPT"}, {"code": "6041809", "type": "CDM"}, {"code": "434", "type": "RC"}], "standard_charges": [{"gross_charge": 528.0, "discounted_cash": 396.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT RE-EVAL", "code_information": [{"code": "97168", "type": "CPT"}, {"code": "6051815", "type": "CDM"}, {"code": "434", "type": "RC"}], "standard_charges": [{"gross_charge": 582.0, "discounted_cash": 436.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT SENSRY INTRGRN EA15", "code_information": [{"code": "97533", "type": "CPT"}, {"code": "6047545", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 191.0, "discounted_cash": 143.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT SLF CARE HM MGMT 15#2", "code_information": [{"code": "97535", "type": "CPT"}, {"code": "5805318", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 173.0, "discounted_cash": 129.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT SLF CARE HM MGMT 15#2", "code_information": [{"code": "97535", "type": "CPT"}, {"code": "6041918", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 146.0, "discounted_cash": 109.5, "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": 175.0, "discounted_cash": 131.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT SLF CARE HM MGMT EA15", "code_information": [{"code": "97535", "type": "CPT"}, {"code": "6041916", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 146.0, "discounted_cash": 109.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT SLF CARE/HM MGMT EA15", "code_information": [{"code": "97535", "type": "CPT"}, {"code": "6051916", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 270.0, "discounted_cash": 202.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT THER EX EA 15", "code_information": [{"code": "97110", "type": "CPT"}, {"code": "6051896", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 270.0, "discounted_cash": 202.5, "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": 315.0, "discounted_cash": 236.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT THERAPTC ACT EA 15", "code_information": [{"code": "97530", "type": "CPT"}, {"code": "6041912", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 149.0, "discounted_cash": 111.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT THERAPTC ACT EA 15 #2", "code_information": [{"code": "97530", "type": "CPT"}, {"code": "6041914", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 149.0, "discounted_cash": 111.75, "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": 315.0, "discounted_cash": 236.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT THERAPTC EXER EA 15", "code_information": [{"code": "97110", "type": "CPT"}, {"code": "6041896", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 270.0, "discounted_cash": 202.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT THERAPTC MASSGE EA 15", "code_information": [{"code": "97124", "type": "CPT"}, {"code": "6051908", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 156.0, "discounted_cash": 117.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT THERAPTC MASSGE EA15", "code_information": [{"code": "97124", "type": "CPT"}, {"code": "5805308", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 156.0, "discounted_cash": 117.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT THERAPTC MASSGE EA15", "code_information": [{"code": "97124", "type": "CPT"}, {"code": "6041908", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 156.0, "discounted_cash": 117.0, "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": 173.0, "discounted_cash": 129.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT US EA 15 BASIC", "code_information": [{"code": "97035", "type": "CPT"}, {"code": "6041884", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 173.0, "discounted_cash": 129.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT US EA15 BSC", "code_information": [{"code": "97035", "type": "CPT"}, {"code": "6051884", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 173.0, "discounted_cash": 129.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT WHLCHR TRN EA 15", "code_information": [{"code": "97542", "type": "CPT"}, {"code": "6045664", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 160.0, "discounted_cash": 120.0, "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": 315.0, "discounted_cash": 236.25, "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": 315.0, "discounted_cash": 236.25, "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": 325.0, "discounted_cash": 243.75, "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": 154.0, "discounted_cash": 115.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GO|CO"}, {"description": "OTA ORTHO PROS MGMT EA 15MIN", "code_information": [{"code": "97763", "type": "CPT"}, {"code": "5800058", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 1164.0, "discounted_cash": 873.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GO|CO"}, {"description": "OTA SLF CARE HM MGMT 15#2", "code_information": [{"code": "97535", "type": "CPT"}, {"code": "5800037", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 173.0, "discounted_cash": 129.75, "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": 175.0, "discounted_cash": 131.25, "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": 315.0, "discounted_cash": 236.25, "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": 315.0, "discounted_cash": 236.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GO|CO"}, {"description": "OTA THERAPTC MASSGE EA15", "code_information": [{"code": "97124", "type": "CPT"}, {"code": "5800032", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 156.0, "discounted_cash": 117.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GO|CO"}, {"description": "OVA & PARASITES SMEARS", "code_information": [{"code": "87177", "type": "CPT"}, {"code": "4107177", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 824.0, "discounted_cash": 618.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OVA & PARASITES SMEARS", "code_information": [{"code": "87177", "type": "CPT"}, {"code": "4127177", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OVA & PARASITES SMEARS", "code_information": [{"code": "87177", "type": "CPT"}, {"code": "4157177", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 318.0, "discounted_cash": 238.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OVA & PARASITES SMEARS", "code_information": [{"code": "87177", "type": "CPT"}, {"code": "7077177", "type": "CDM"}], "standard_charges": [{"gross_charge": 289.0, "discounted_cash": 216.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OVA & PARASITES SMEARS/2", "code_information": [{"code": "87177", "type": "CPT"}, {"code": "7257177", "type": "CDM"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OXALATE", "code_information": [{"code": "83945", "type": "CPT"}, {"code": "7003945", "type": "CDM"}], "standard_charges": [{"gross_charge": 825.0, "discounted_cash": 618.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OXALATE", "code_information": [{"code": "83945", "type": "CPT"}, {"code": "7253945", "type": "CDM"}], "standard_charges": [{"gross_charge": 825.0, "discounted_cash": 618.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OXALIPLATIN PER .5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9263", "type": "HCPCS"}, {"code": "5323008", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 156.0, "discounted_cash": 117.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OXALIPLATIN PER .5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9263", "type": "HCPCS"}, {"code": "5323008", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 156.0, "discounted_cash": 117.0, "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": 120.0, "discounted_cash": 90.0, "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": 120.0, "discounted_cash": 90.0, "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": 46.0, "discounted_cash": 34.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OXCARBAZEPINE 300MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308571", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OXCARBAZEPINE 300MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308571", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OXCARBAZEPINE/2", "code_information": [{"code": "80183", "type": "CPT"}, {"code": "7250317", "type": "CDM"}], "standard_charges": [{"gross_charge": 520.0, "discounted_cash": 390.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYBUTYNIN 10MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308642", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYBUTYNIN 10MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308642", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYBUTYNIN 15MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308643", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYBUTYNIN 15MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308643", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYBUTYNIN 1M/M 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315917", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYBUTYNIN 1M/M 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315917", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYBUTYNIN 3.9MG/DAY TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336973", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 193.0, "discounted_cash": 144.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYBUTYNIN 3.9MG/DAY TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336973", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 193.0, "discounted_cash": 144.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "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": "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 10/325 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327844", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYCOD/APAP 10/325 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327844", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "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": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYCOD/APAP 7.5/325 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327842", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYCOD/APAP 7.5/325 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327842", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYCODONE 10MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327857", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYCODONE 10MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327857", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYCODONE 20MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327858", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYCODONE 20MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327858", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 83.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 83.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYCODONE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327855", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYCODONE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327855", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYCODONE 5MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327856", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYCODONE 5MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327856", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYCODONE 80MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327860", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 168.0, "discounted_cash": 126.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYCODONE 80MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327860", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 168.0, "discounted_cash": 126.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYCODONE/ASA 4.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327852", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYCODONE/ASA 4.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327852", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYCODONE/METABOLITE", "code_information": [{"code": "80365", "type": "CPT"}, {"code": "7250365", "type": "CDM"}], "standard_charges": [{"gross_charge": 877.0, "discounted_cash": 657.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYMETAZOLN NS.05%15MLSP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5331682", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 94.0, "discounted_cash": 70.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYMETAZOLN NS.05%15MLSP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5331682", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 94.0, "discounted_cash": 70.5, "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": 32.0, "discounted_cash": 24.0, "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": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYMORPHONE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327870", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYMORPHONE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327870", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYMORPHONE 5MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327875", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYMORPHONE 5MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327875", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYTOCIN PER 10U D5LR IV", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2590", "type": "HCPCS"}, {"code": "5323039", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYTOCIN PER 10U D5LR IV", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2590", "type": "HCPCS"}, {"code": "5323039", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "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": 71.0, "discounted_cash": 53.25, "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": 71.0, "discounted_cash": 53.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 194.0, "discounted_cash": 145.5, "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": 194.0, "discounted_cash": 145.5, "setting": "both", "billing_class": "facility"}]}, {"description": "P/M AICD ELECT REPR LDS", "code_information": [{"code": "4613224", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 20372.0, "discounted_cash": 15279.0, "setting": "both", "billing_class": "facility"}]}, {"description": "P/M AICD ELECTRD RPR", "code_information": [{"code": "4613218", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 13600.0, "discounted_cash": 10200.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PACLITAX PRTBD PER 1MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9264", "type": "HCPCS"}, {"code": "5323052", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PACLITAX PRTBD PER 1MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9264", "type": "HCPCS"}, {"code": "5323052", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PACLITAXEL PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9267", "type": "HCPCS"}, {"code": "5323050", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PACLITAXEL PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9267", "type": "HCPCS"}, {"code": "5323050", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PALIPERIDONE 1.5MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308878", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 229.0, "discounted_cash": 171.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PALIPERIDONE 1.5MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308878", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 229.0, "discounted_cash": 171.75, "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": 144.0, "discounted_cash": 108.0, "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": 144.0, "discounted_cash": 108.0, "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": 144.0, "discounted_cash": 108.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 144.0, "discounted_cash": 108.0, "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": 7603.0, "discounted_cash": 5702.25, "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": 7603.0, "discounted_cash": 5702.25, "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": 3498.0, "discounted_cash": 2623.5, "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": 3498.0, "discounted_cash": 2623.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PANCRELIP 12-38-60 XRCP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306608", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PANCRELIP 12-38-60 XRCP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306608", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PANCRTC POLYPEP (RIA)/2", "code_information": [{"code": "83519", "type": "CPT"}, {"code": "7253519", "type": "CDM"}], "standard_charges": [{"gross_charge": 1056.0, "discounted_cash": 792.0, "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": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PANCURONIUM2MG/ML 5ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5323067", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 179.0, "discounted_cash": 134.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PANITUMUMAB PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9303", "type": "HCPCS"}, {"code": "5323072", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 995.0, "discounted_cash": 746.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PANITUMUMAB PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9303", "type": "HCPCS"}, {"code": "5323072", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 995.0, "discounted_cash": 746.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PANTOPRAZOLE 20MG EC TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308871", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PANTOPRAZOLE 20MG EC TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308871", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 94.0, "discounted_cash": 70.5, "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": 94.0, "discounted_cash": 70.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PANTOPRAZOLE 40MG LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5323071", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PANTOPRAZOLE 40MG LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5323071", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "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": 179.0, "discounted_cash": 134.25, "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": 179.0, "discounted_cash": 134.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PAPAIN/UREA/CHLOR33ML SP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337503", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 931.0, "discounted_cash": 698.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PAPAIN/UREA/CHLOR33ML SP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337503", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 931.0, "discounted_cash": 698.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PAPAVERINE 150MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308890", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PAPAVERINE 150MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308890", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "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": 2645.0, "discounted_cash": 1983.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PARATHORMONE (PTH)/2", "code_information": [{"code": "83970", "type": "CPT"}, {"code": "4123972", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 83.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PARATHORMONE (PTH)/4", "code_information": [{"code": "83970", "type": "CPT"}, {"code": "7023970", "type": "CDM"}], "standard_charges": [{"gross_charge": 928.0, "discounted_cash": 696.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PARATHORMONE (PTH)/5", "code_information": [{"code": "83970", "type": "CPT"}, {"code": "7003970", "type": "CDM"}], "standard_charges": [{"gross_charge": 1988.0, "discounted_cash": 1491.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PARATHYRD IMG W/SPECT", "code_information": [{"code": "78071", "type": "CPT"}, {"code": "5208071", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 3149.0, "discounted_cash": 2361.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PARATHYROID IMAGING", "code_information": [{"code": "78070", "type": "CPT"}, {"code": "5018070", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 4186.0, "discounted_cash": 3139.5, "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": 1071.0, "discounted_cash": 803.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PAREGORIC 2MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315945", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 101.0, "discounted_cash": 75.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PAREGORIC 2MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315945", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 101.0, "discounted_cash": 75.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PARHAN BANDS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8144150", "type": "CDM"}], "standard_charges": [{"gross_charge": 205.0, "discounted_cash": 153.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PARICALCITOL 1MCG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308900", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PARICALCITOL 1MCG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308900", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PARICALCITOL PER 1MCG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2501", "type": "HCPCS"}, {"code": "5323079", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PARICALCITOL PER 1MCG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2501", "type": "HCPCS"}, {"code": "5323079", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PARIETAL CELL AB", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "7258658", "type": "CDM"}], "standard_charges": [{"gross_charge": 880.0, "discounted_cash": 660.0, "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": "250", "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "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": 75.0, "discounted_cash": 56.25, "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": 75.0, "discounted_cash": 56.25, "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": 52.0, "discounted_cash": 39.0, "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": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PAROXETINE 25MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308954", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PAROXETINE 25MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308954", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PAROXETINE 30MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308951", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PAROXETINE 30MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308951", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PAROXETINE QNT", "code_information": [{"code": "80332", "type": "CPT"}, {"code": "7253960", "type": "CDM"}], "standard_charges": [{"gross_charge": 549.0, "discounted_cash": 411.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PART RMVL OF TOE JOINT", "code_information": [{"code": "6900138", "type": "CDM"}], "standard_charges": [{"gross_charge": 22288.0, "discounted_cash": 16716.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PARTIAL REMOVAL OF TOE", "code_information": [{"code": "6900137", "type": "CDM"}], "standard_charges": [{"gross_charge": 11374.0, "discounted_cash": 8530.5, "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": 177.0, "discounted_cash": 132.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PARTICLE AGGLUT AB EA/24", "code_information": [{"code": "86403", "type": "CPT"}, {"code": "4107897", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 165.0, "discounted_cash": 123.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PARTICLE AGGLUT AB EA/3", "code_information": [{"code": "86403", "type": "CPT"}, {"code": "4106399", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 165.0, "discounted_cash": 123.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PARTICLE AGGLUT AB EA/3", "code_information": [{"code": "86403", "type": "CPT"}, {"code": "4126383", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PARTICLE AGGLUT AB EA/5", "code_information": [{"code": "86403", "type": "CPT"}, {"code": "4106402", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 642.0, "discounted_cash": 481.5, "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": 332.0, "discounted_cash": 249.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PARTICLE AGGLUT AB EA/7", "code_information": [{"code": "86403", "type": "CPT"}, {"code": "4156415", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 528.0, "discounted_cash": 396.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PARTICLE AGGLUT AB EA/9", "code_information": [{"code": "86403", "type": "CPT"}, {"code": "4106407", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 129.0, "discounted_cash": 96.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PARTICLE AGGLUT AB EA/9", "code_information": [{"code": "86403", "type": "CPT"}, {"code": "7006405", "type": "CDM"}], "standard_charges": [{"gross_charge": 267.0, "discounted_cash": 200.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PARTICLE EMBOLIZATN PVA", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8033286", "type": "CDM"}], "standard_charges": [{"gross_charge": 1223.0, "discounted_cash": 917.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PARVOVIRUS AB", "code_information": [{"code": "86747", "type": "CPT"}, {"code": "7006246", "type": "CDM"}], "standard_charges": [{"gross_charge": 788.0, "discounted_cash": 591.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PARVOVIRUS AB", "code_information": [{"code": "86747", "type": "CPT"}, {"code": "7256248", "type": "CDM"}], "standard_charges": [{"gross_charge": 788.0, "discounted_cash": 591.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PARVOVIRUS AB/3", "code_information": [{"code": "86747", "type": "CPT"}, {"code": "7256748", "type": "CDM"}], "standard_charges": [{"gross_charge": 788.0, "discounted_cash": 591.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PATELA ANY X3 MCK PFJ STRY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013062", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5439.0, "discounted_cash": 4079.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PATELA PERSN PROLG VIV ZIM CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012996", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3051.0, "discounted_cash": 2288.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PATELLA ALL POLY TJO CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013489", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2432.0, "discounted_cash": 1824.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PATELLA KNEE UNI PFJ STRYK CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013111", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4186.0, "discounted_cash": 3139.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PATELLA METAL CORIN CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013221", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2875.0, "discounted_cash": 2156.25, "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": 2278.0, "discounted_cash": 1708.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PATELLA POLY CONFORMIS CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013327", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2102.0, "discounted_cash": 1576.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PATELLA POLY STRYKER CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013064", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1795.0, "discounted_cash": 1346.25, "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": 2990.0, "discounted_cash": 2242.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PATIROMER SORB 8.4G PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315965", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 282.0, "discounted_cash": 211.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PATIROMER SORB 8.4G PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315965", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 282.0, "discounted_cash": 211.5, "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": 350.0, "discounted_cash": 262.5, "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": 996.0, "discounted_cash": 747.0, "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": 996.0, "discounted_cash": 747.0, "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": 111.0, "discounted_cash": 83.25, "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": 187.0, "discounted_cash": 140.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PE NASAL .25% 15ML DR IS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5331787", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PE NASAL .25% 15ML DR IS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5331787", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "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": 111.0, "discounted_cash": 83.25, "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": 111.0, "discounted_cash": 83.25, "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": 106.0, "discounted_cash": 79.5, "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": 106.0, "discounted_cash": 79.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PE NASAL 1% 15ML SP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5331816", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 129.0, "discounted_cash": 96.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PE NASAL 1% 15ML SP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5331816", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 129.0, "discounted_cash": 96.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PE NASAL 1% 60ML DR TS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337038", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 760.0, "discounted_cash": 570.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PE NASAL 1% 60ML DR TS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337038", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 760.0, "discounted_cash": 570.0, "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": 211.0, "discounted_cash": 158.25, "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": 299.0, "discounted_cash": 224.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PE/HYDROCODON/CPM 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316019", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PE/HYDROCODON/CPM 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316019", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PE/KETOROLAC1%/0.3% PER 1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1097", "type": "HCPCS"}, {"code": "5331846", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 822.0, "discounted_cash": 616.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PE/KETOROLAC1%/0.3% PER 1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1097", "type": "HCPCS"}, {"code": "5331846", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 822.0, "discounted_cash": 616.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PEDIALYTE 960 ML", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5339938", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 134.0, "discounted_cash": 100.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PEDIALYTE 960 ML", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5339938", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 134.0, "discounted_cash": 100.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PEG LOCKING IMP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8134001", "type": "CDM"}], "standard_charges": [{"gross_charge": 1791.0, "discounted_cash": 1343.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PEG ORBITAL COUPLNG POST", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8122164", "type": "CDM"}], "standard_charges": [{"gross_charge": 632.0, "discounted_cash": 474.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PEGINTERF A2APER180MCGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5323104", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 6434.0, "discounted_cash": 4825.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PEGINTERF A2APER180MCGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5323104", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 6434.0, "discounted_cash": 4825.5, "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": 1478.0, "discounted_cash": 1108.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PELVIS 1 VIEW", "code_information": [{"code": "72170", "type": "CPT"}, {"code": "5012170", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1478.0, "discounted_cash": 1108.5, "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": 1546.0, "discounted_cash": 1159.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PELVIS 2 VIEWS", "code_information": [{"code": "72170", "type": "CPT"}, {"code": "4902175", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1478.0, "discounted_cash": 1108.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PELVIS 2 VIEWS", "code_information": [{"code": "72170", "type": "CPT"}, {"code": "5012175", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1478.0, "discounted_cash": 1108.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PELVIS 2 VIEWS", "code_information": [{"code": "72170", "type": "CPT"}, {"code": "5112175", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1510.0, "discounted_cash": 1132.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PEMBROLIZUMAB PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9271", "type": "HCPCS"}, {"code": "5323115", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 384.0, "discounted_cash": 288.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PEMBROLIZUMAB PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9271", "type": "HCPCS"}, {"code": "5323115", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 384.0, "discounted_cash": 288.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PEMETREXED PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9305", "type": "HCPCS"}, {"code": "5323099", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 601.0, "discounted_cash": 450.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PEMETREXED PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9305", "type": "HCPCS"}, {"code": "5323099", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 601.0, "discounted_cash": 450.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PEN G BE/PR PER 100KU IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0558", "type": "HCPCS"}, {"code": "5323135", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PEN G BE/PR PER 100KU IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0558", "type": "HCPCS"}, {"code": "5323135", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 112.0, "discounted_cash": 84.0, "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": 112.0, "discounted_cash": 84.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PEN G K TO 600KU IVPB IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2540", "type": "HCPCS"}, {"code": "5323150", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PEN G K TO 600KU IVPB IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2540", "type": "HCPCS"}, {"code": "5323150", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "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": 11.0, "discounted_cash": 8.25, "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": 11.0, "discounted_cash": 8.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PEN G PROC UPTO 600KU IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2510", "type": "HCPCS"}, {"code": "5323173", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PEN G PROC UPTO 600KU IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2510", "type": "HCPCS"}, {"code": "5323173", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PENCICLOVIR 1% 1.5GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336981", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 396.0, "discounted_cash": 297.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PENCICLOVIR 1% 1.5GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336981", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 396.0, "discounted_cash": 297.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PENCICLOVIR 1% 5GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336986", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2239.0, "discounted_cash": 1679.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PENCICLOVIR 1% 5GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336986", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2239.0, "discounted_cash": 1679.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PENICILLAMINE 125MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308986", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PENICILLAMINE 125MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308986", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PENICILLIN 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309025", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PENICILLIN 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309025", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PENICILLIN 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309029", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PENICILLIN 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309029", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PENICILLIN G NA 5MU IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5323153", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 161.0, "discounted_cash": 120.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PENICILLNVK125/5 100MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315989", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PENICILLNVK125/5 100MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315989", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PENICILLNVK250/5 100MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315995", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 62.0, "discounted_cash": 46.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PENICILLNVK250/5 100MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315995", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 62.0, "discounted_cash": 46.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PENILE ART/VEN FLOW LTD", "code_information": [{"code": "93981", "type": "CPT"}, {"code": "5066853", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 1961.0, "discounted_cash": 1470.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PENILE IMP", "code_information": [{"code": "C2622", "type": "HCPCS"}, {"code": "8154000", "type": "CDM"}], "standard_charges": [{"gross_charge": 54668.0, "discounted_cash": 41001.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PENTAMIDINE 300MG PW IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2545", "type": "HCPCS"}, {"code": "5331740", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1842.0, "discounted_cash": 1381.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PENTAMIDINE PER 300MG IJ", "code_information": [{"code": "S0080", "type": "HCPCS"}, {"code": "5323189", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2092.0, "discounted_cash": 1569.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PENTAMIDINE TREATMENT", "code_information": [{"code": "94642", "type": "CPT"}, {"code": "5500696", "type": "CDM"}, {"code": "410", "type": "RC"}], "standard_charges": [{"gross_charge": 1103.0, "discounted_cash": 827.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PENTAZOCIN/NALOX50/.5 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309063", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PENTAZOCIN/NALOX50/.5 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309063", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PENTAZOCINE PER30MGPFSIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3070", "type": "HCPCS"}, {"code": "5323194", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 177.0, "discounted_cash": 132.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PENTAZOCINE PER30MGPFSIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3070", "type": "HCPCS"}, {"code": "5323194", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 177.0, "discounted_cash": 132.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PENTOBARBIT PER 50MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2515", "type": "HCPCS"}, {"code": "5327901", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 256.0, "discounted_cash": 192.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PENTOBARBIT PER 50MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2515", "type": "HCPCS"}, {"code": "5327901", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 256.0, "discounted_cash": 192.0, "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": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "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": 20477.0, "discounted_cash": 15357.75, "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": 20477.0, "discounted_cash": 15357.75, "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": 78125.0, "discounted_cash": 58593.75, "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": 78125.0, "discounted_cash": 58593.75, "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": 20113.0, "discounted_cash": 15084.75, "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": 20113.0, "discounted_cash": 15084.75, "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": 74404.0, "discounted_cash": 55803.0, "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": 74404.0, "discounted_cash": 55803.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PERAMPANEL 12MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309073", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 190.0, "discounted_cash": 142.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PERAMPANEL 12MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309073", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 190.0, "discounted_cash": 142.5, "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": 9943.0, "discounted_cash": 7457.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC ACCES+DEL GFT+US/UNI", "code_information": [{"code": "4914713", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 11525.0, "discounted_cash": 8643.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC ANTEGR STENT CAR", "code_information": [{"code": "4917218", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 44174.0, "discounted_cash": 33130.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC ASP VRT DISC FOR DX", "code_information": [{"code": "4910162", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2227.0, "discounted_cash": 1670.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC ASP VRT DISC FOR DX", "code_information": [{"code": "5052997", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1842.0, "discounted_cash": 1381.5, "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": 16468.0, "discounted_cash": 12351.0, "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": 17291.0, "discounted_cash": 12968.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC AUG ADD T/L IMG", "code_information": [{"code": "4919719", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 54847.0, "discounted_cash": 41135.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC BIOPSY LYMPH NODE", "code_information": [{"code": "4918500", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1027.0, "discounted_cash": 770.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC BIOPSY LYMPH NODE", "code_information": [{"code": "5010081", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4556.0, "discounted_cash": 3417.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC BIOPSY LYMPH NODE", "code_information": [{"code": "5057516", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1042.0, "discounted_cash": 781.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC BIOPSY LYMPH NODE", "code_information": [{"code": "5068505", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1027.0, "discounted_cash": 770.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC CATH PORTAL VEIN", "code_information": [{"code": "4910163", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6583.0, "discounted_cash": 4937.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC CHOLECYSTOSTOMY", "code_information": [{"code": "5057490", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 17207.0, "discounted_cash": 12905.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC CHOLECYSTOSTOMY", "code_information": [{"code": "5067490", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 21853.0, "discounted_cash": 16389.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC CLS INTRATRL W IMPL", "code_information": [{"code": "93580", "type": "CPT"}, {"code": "4613579", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 106325.0, "discounted_cash": 79743.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC CLS INTRATRL W IMPL", "code_information": [{"code": "93580", "type": "CPT"}, {"code": "4613579", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 106325.0, "discounted_cash": 79743.75, "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": 48485.0, "discounted_cash": 36363.75, "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": 48485.0, "discounted_cash": 36363.75, "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": 20477.0, "discounted_cash": 15357.75, "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": 20477.0, "discounted_cash": 15357.75, "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": 48485.0, "discounted_cash": 36363.75, "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": 48485.0, "discounted_cash": 36363.75, "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": 48485.0, "discounted_cash": 36363.75, "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": 48485.0, "discounted_cash": 36363.75, "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": 3630.0, "discounted_cash": 2722.5, "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": 1370.0, "discounted_cash": 1027.5, "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": 6805.0, "discounted_cash": 5103.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC DEVC BRST 1ST US", "code_information": [{"code": "5069285", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3384.0, "discounted_cash": 2538.0, "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": 1165.0, "discounted_cash": 873.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC DEVC BRST ADD US", "code_information": [{"code": "5069286", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3860.0, "discounted_cash": 2895.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC DRAIN W CATH PLC", "code_information": [{"code": "75989", "type": "CPT"}, {"code": "4905990", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2163.0, "discounted_cash": 1622.25, "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": 2163.0, "discounted_cash": 1622.25, "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": 1850.0, "discounted_cash": 1387.5, "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": 2372.0, "discounted_cash": 1779.0, "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": 19503.0, "discounted_cash": 14627.25, "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": 19503.0, "discounted_cash": 14627.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC IABP REMOVAL", "code_information": [{"code": "4613968", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 825.0, "discounted_cash": 618.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC INSERT IABP DEV", "code_information": [{"code": "4613967", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5227.0, "discounted_cash": 3920.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC MECH THROMBECTMY VN", "code_information": [{"code": "4617187", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 14659.0, "discounted_cash": 10994.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC MECH THROMBECTMY VN", "code_information": [{"code": "4914104", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 17891.0, "discounted_cash": 13418.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC MECH THROMBUS ART", "code_information": [{"code": "4911645", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 27160.0, "discounted_cash": 20370.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC PERICRD DRNG INSRT CATH>6", "code_information": [{"code": "4913017", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 8942.0, "discounted_cash": 6706.5, "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": 15101.0, "discounted_cash": 11325.75, "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": 16103.0, "discounted_cash": 12077.25, "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": 16908.0, "discounted_cash": 12681.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC SACRL AUGMENT BILAT", "code_information": [{"code": "4912288", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 45159.0, "discounted_cash": 33869.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC TRSHEP PORT WO/EVL", "code_information": [{"code": "75887", "type": "CPT"}, {"code": "4915888", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 8284.0, "discounted_cash": 6213.0, "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": 44385.0, "discounted_cash": 33288.75, "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": 19127.0, "discounted_cash": 14345.25, "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": 19127.0, "discounted_cash": 14345.25, "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": 813.0, "discounted_cash": 609.75, "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": 813.0, "discounted_cash": 609.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PERICARDIOCENTESIS W/IMG GUIDE", "code_information": [{"code": "4613016", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 11859.0, "discounted_cash": 8894.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PERITONEOGRAM", "code_information": [{"code": "74190", "type": "CPT"}, {"code": "4917797", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 3940.0, "discounted_cash": 2955.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PERMACOL 15X20 PER SQ CM", "code_information": [{"code": "C9364", "type": "HCPCS"}, {"code": "8242445", "type": "CDM"}], "standard_charges": [{"gross_charge": 251.0, "discounted_cash": 188.25, "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": 65.0, "discounted_cash": 48.75, "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": 65.0, "discounted_cash": 48.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 352.0, "discounted_cash": 264.0, "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": 352.0, "discounted_cash": 264.0, "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": 36.0, "discounted_cash": 27.0, "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": 36.0, "discounted_cash": 27.0, "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": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "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": 19466.0, "discounted_cash": 14599.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PERTUZUMAB PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9306", "type": "HCPCS"}, {"code": "5323232", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 120.0, "discounted_cash": 90.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PERTUZUMAB PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9306", "type": "HCPCS"}, {"code": "5323232", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 120.0, "discounted_cash": 90.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PET MYOCAR METBOL EVAL SGL SDY", "code_information": [{"code": "78459", "type": "CPT"}, {"code": "5238459", "type": "CDM"}, {"code": "404", "type": "RC"}], "standard_charges": [{"gross_charge": 3756.0, "discounted_cash": 2817.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PET SKULL TO THIGH", "code_information": [{"code": "78812", "type": "CPT"}, {"code": "5238812", "type": "CDM"}, {"code": "404", "type": "RC"}], "standard_charges": [{"gross_charge": 8139.0, "discounted_cash": 6104.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PET WHOLE BODY", "code_information": [{"code": "78813", "type": "CPT"}, {"code": "5238813", "type": "CDM"}, {"code": "404", "type": "RC"}], "standard_charges": [{"gross_charge": 8139.0, "discounted_cash": 6104.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PET/CT SKULL TO THIGH", "code_information": [{"code": "78815", "type": "CPT"}, {"code": "5238815", "type": "CDM"}, {"code": "404", "type": "RC"}], "standard_charges": [{"gross_charge": 4321.0, "discounted_cash": 3240.75, "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": 71.0, "discounted_cash": 53.25, "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": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PETROLATUM 5GM UD OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337019", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.34, "discounted_cash": 0.26, "setting": "both", "billing_class": "facility"}]}, {"description": "PETROLATUM 5GM UD OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337019", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 0.34, "discounted_cash": 0.26, "setting": "both", "billing_class": "facility"}]}, {"description": "PETROLATUM 75GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337010", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PETROLATUM 75GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337010", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "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": 145.0, "discounted_cash": 108.75, "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": 145.0, "discounted_cash": 108.75, "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": 195.0, "discounted_cash": 146.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PH BODY FLUID NOS/2", "code_information": [{"code": "83986", "type": "CPT"}, {"code": "4109358", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PHARM AGENT EVAL ADD ON", "code_information": [{"code": "93463", "type": "CPT"}, {"code": "4613462", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 3786.0, "discounted_cash": 2839.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PHARM AGENT EVAL ADD ON", "code_information": [{"code": "93463", "type": "CPT"}, {"code": "4613462", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 3786.0, "discounted_cash": 2839.5, "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": 2851.0, "discounted_cash": 2138.25, "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": 39.0, "discounted_cash": 29.25, "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": 39.0, "discounted_cash": 29.25, "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": 49.0, "discounted_cash": 36.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENAZOPYRIDINE 95MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5309144", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENAZOPYRIDINE 95MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5309144", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENCYCLIDINE(PCP) QUANT", "code_information": [{"code": "83992", "type": "CPT"}, {"code": "7253992", "type": "CDM"}], "standard_charges": [{"gross_charge": 106.0, "discounted_cash": 79.5, "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": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "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": 143.0, "discounted_cash": 107.25, "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": 143.0, "discounted_cash": 107.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENOBARB TO 120MG PFSIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2560", "type": "HCPCS"}, {"code": "5327940", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 94.0, "discounted_cash": 70.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENOBARB TO 120MG PFSIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2560", "type": "HCPCS"}, {"code": "5327940", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 94.0, "discounted_cash": 70.5, "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": 171.0, "discounted_cash": 128.25, "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": 171.0, "discounted_cash": 128.25, "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": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "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": 450.0, "discounted_cash": 337.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENOBARBITAL", "code_information": [{"code": "80184", "type": "CPT"}, {"code": "4124020", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENOBARBITAL", "code_information": [{"code": "80184", "type": "CPT"}, {"code": "4154020", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 126.0, "discounted_cash": 94.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENOBARBITAL 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327943", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENOBARBITAL 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327943", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENOBARBITAL 15MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327931", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENOBARBITAL 15MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327931", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENOBARBITAL 16.2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327932", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENOBARBITAL 16.2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327932", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENOBARBITAL 30MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327935", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENOBARBITAL 30MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327935", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENOBARBITAL 60MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327939", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENOBARBITAL 60MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327939", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENOBARBITAL 64.8MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327938", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENOBARBITAL 64.8MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327938", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENOBARBITAL 97.2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327942", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENOBARBITAL 97.2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327942", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENOBARBITAL/2", "code_information": [{"code": "80184", "type": "CPT"}, {"code": "7254020", "type": "CDM"}], "standard_charges": [{"gross_charge": 261.0, "discounted_cash": 195.75, "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": 58.0, "discounted_cash": 43.5, "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": 58.0, "discounted_cash": 43.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENOL-NA 32.5MG LZ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5309195", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENOL-NA 32.5MG LZ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5309195", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "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": 117.0, "discounted_cash": 87.75, "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": 117.0, "discounted_cash": 87.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENOTHIAZINES QUAN", "code_information": [{"code": "80342", "type": "CPT"}, {"code": "7004022", "type": "CDM"}], "standard_charges": [{"gross_charge": 656.0, "discounted_cash": 492.0, "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": 863.0, "discounted_cash": 647.25, "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": 863.0, "discounted_cash": 647.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENYLEPHRINE HEMOR R OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5338585", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 120.0, "discounted_cash": 90.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENYLEPHRINE HEMOR R OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5338585", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 120.0, "discounted_cash": 90.0, "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": 133.0, "discounted_cash": 99.75, "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": 133.0, "discounted_cash": 99.75, "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": 0.05, "discounted_cash": 0.04, "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": 0.05, "discounted_cash": 0.04, "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": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "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": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENYTOIN 30MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309430", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENYTOIN 30MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309430", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "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": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENYTOIN FREE", "code_information": [{"code": "80186", "type": "CPT"}, {"code": "7004045", "type": "CDM"}], "standard_charges": [{"gross_charge": 985.0, "discounted_cash": 738.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENYTOIN FREE", "code_information": [{"code": "80186", "type": "CPT"}, {"code": "7254045", "type": "CDM"}], "standard_charges": [{"gross_charge": 985.0, "discounted_cash": 738.75, "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": 89.0, "discounted_cash": 66.75, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 89.0, "discounted_cash": 66.75, "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": 583.0, "discounted_cash": 437.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENYTOIN TOTAL", "code_information": [{"code": "80185", "type": "CPT"}, {"code": "4122655", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENYTOIN TOTAL", "code_information": [{"code": "80185", "type": "CPT"}, {"code": "4152655", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 146.0, "discounted_cash": 109.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENYTOIN TOTAL/2", "code_information": [{"code": "80185", "type": "CPT"}, {"code": "7252655", "type": "CDM"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "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": 327.0, "discounted_cash": 245.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PHOSPHATASE ACID TOTAL", "code_information": [{"code": "84060", "type": "CPT"}, {"code": "7024060", "type": "CDM"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "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": 240.0, "discounted_cash": 180.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PHOSPHATASE ALKALINE", "code_information": [{"code": "84075", "type": "CPT"}, {"code": "4124075", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PHOSPHATASE ALKALINE", "code_information": [{"code": "84075", "type": "CPT"}, {"code": "4154075", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 105.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PHOSPHATASE ALKALINE", "code_information": [{"code": "84075", "type": "CPT"}, {"code": "7254075", "type": "CDM"}], "standard_charges": [{"gross_charge": 107.0, "discounted_cash": 80.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PHOSPHATASE ALKALINE/2", "code_information": [{"code": "84075", "type": "CPT"}, {"code": "7254076", "type": "CDM"}], "standard_charges": [{"gross_charge": 482.0, "discounted_cash": 361.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PHOSPHATASE ISO ALK", "code_information": [{"code": "84080", "type": "CPT"}, {"code": "7024080", "type": "CDM"}], "standard_charges": [{"gross_charge": 482.0, "discounted_cash": 361.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PHOSPHATASE ISO ALK", "code_information": [{"code": "84080", "type": "CPT"}, {"code": "7254080", "type": "CDM"}], "standard_charges": [{"gross_charge": 482.0, "discounted_cash": 361.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PHOSPHATIDYLGYCEROL", "code_information": [{"code": "84081", "type": "CPT"}, {"code": "7078408", "type": "CDM"}], "standard_charges": [{"gross_charge": 276.0, "discounted_cash": 207.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PHOSPHATSE PROSTATIC", "code_information": [{"code": "84066", "type": "CPT"}, {"code": "7004066", "type": "CDM"}], "standard_charges": [{"gross_charge": 643.0, "discounted_cash": 482.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PHOSPHATSE PROSTATIC", "code_information": [{"code": "84066", "type": "CPT"}, {"code": "7254066", "type": "CDM"}], "standard_charges": [{"gross_charge": 643.0, "discounted_cash": 482.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PHOSPHOLP NEUT HEXAGONAL", "code_information": [{"code": "85598", "type": "CPT"}, {"code": "7255598", "type": "CDM"}], "standard_charges": [{"gross_charge": 231.0, "discounted_cash": 173.25, "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": 311.0, "discounted_cash": 233.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PHOSPHORUS", "code_information": [{"code": "84100", "type": "CPT"}, {"code": "4124100", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PHOSPHORUS", "code_information": [{"code": "84100", "type": "CPT"}, {"code": "4154100", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 229.0, "discounted_cash": 171.75, "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": 1139.0, "discounted_cash": 854.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PHOSPHORUS URINE/2", "code_information": [{"code": "84105", "type": "CPT"}, {"code": "4124103", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PHYSIOLOGIC IRR SOLN IRR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5419003", "type": "CDM"}, {"code": "270", "type": "RC"}], "standard_charges": [{"gross_charge": 259.0, "discounted_cash": 194.25, "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": 371.0, "discounted_cash": 278.25, "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": 39.0, "discounted_cash": 29.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 274.0, "discounted_cash": 205.5, "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": 274.0, "discounted_cash": 205.5, "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": 86.0, "discounted_cash": 64.5, "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": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PILOCARPINE .25% 15ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331892", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 573.0, "discounted_cash": 429.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PILOCARPINE .25% 15ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331892", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 573.0, "discounted_cash": 429.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PILOCARPINE .5% 15ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331899", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 270.0, "discounted_cash": 202.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PILOCARPINE .5% 15ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331899", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 270.0, "discounted_cash": 202.5, "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": "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 1% 1ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331912", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 69.0, "discounted_cash": 51.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PILOCARPINE 1% 1ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331912", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 69.0, "discounted_cash": 51.75, "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": 289.0, "discounted_cash": 216.75, "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": 289.0, "discounted_cash": 216.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PILOCARPINE 2% 1ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331933", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PILOCARPINE 2% 1ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331933", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PILOCARPINE 3% 15ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331941", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 240.0, "discounted_cash": 180.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PILOCARPINE 3% 15ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331941", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 240.0, "discounted_cash": 180.0, "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": 229.0, "discounted_cash": 171.75, "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": 229.0, "discounted_cash": 171.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PILOCARPINE 4% 5GM GL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331949", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 460.0, "discounted_cash": 345.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PILOCARPINE 4% 5GM GL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331949", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 460.0, "discounted_cash": 345.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PILOCARPINE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309470", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PILOCARPINE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309470", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PILOCARPINE 6% 15ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331962", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 229.0, "discounted_cash": 171.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PILOCARPINE 6% 15ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331962", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 229.0, "discounted_cash": 171.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PIMAVANSERIN 34MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309472", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 788.0, "discounted_cash": 591.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PIMAVANSERIN 34MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309472", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 788.0, "discounted_cash": 591.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PIN ABSORBABLE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133540", "type": "CDM"}], "standard_charges": [{"gross_charge": 3905.0, "discounted_cash": 2928.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PIN AXIAL ELEOS", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8133549", "type": "CDM"}], "standard_charges": [{"gross_charge": 31648.0, "discounted_cash": 23736.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PIN DISTRACTION", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133543", "type": "CDM"}], "standard_charges": [{"gross_charge": 298.0, "discounted_cash": 223.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PIN FIXATION PROVISIONAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133542", "type": "CDM"}], "standard_charges": [{"gross_charge": 1018.0, "discounted_cash": 763.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PIN HALF THREAD", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133546", "type": "CDM"}], "standard_charges": [{"gross_charge": 2044.0, "discounted_cash": 1533.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PIN HOFMAN HALF", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133555", "type": "CDM"}], "standard_charges": [{"gross_charge": 1734.0, "discounted_cash": 1300.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PIN HOFMAN TRNFX", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133570", "type": "CDM"}], "standard_charges": [{"gross_charge": 1093.0, "discounted_cash": 819.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PIN KNOWLES AS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133590", "type": "CDM"}], "standard_charges": [{"gross_charge": 1021.0, "discounted_cash": 765.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PIN ORTHOSORB", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133601", "type": "CDM"}], "standard_charges": [{"gross_charge": 2035.0, "discounted_cash": 1526.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PIN OSS POLY LOCK ZIMMER", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8133548", "type": "CDM"}], "standard_charges": [{"gross_charge": 2407.0, "discounted_cash": 1805.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PIN RUSH 1/8IN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133605", "type": "CDM"}], "standard_charges": [{"gross_charge": 1125.0, "discounted_cash": 843.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PIN STEINMAN II W/HOLE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133634", "type": "CDM"}], "standard_charges": [{"gross_charge": 222.0, "discounted_cash": 166.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PIN STEINMAN PL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133635", "type": "CDM"}], "standard_charges": [{"gross_charge": 2890.0, "discounted_cash": 2167.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PIN STEINMAN THR", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133640", "type": "CDM"}], "standard_charges": [{"gross_charge": 645.0, "discounted_cash": 483.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PIN TYPE I", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133638", "type": "CDM"}], "standard_charges": [{"gross_charge": 3840.0, "discounted_cash": 2880.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PINCH GRAFT UP TO 2CM", "code_information": [{"code": "6909889", "type": "CDM"}], "standard_charges": [{"gross_charge": 4114.0, "discounted_cash": 3085.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PINDOLOL 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309487", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PINDOLOL 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309487", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "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": 52.0, "discounted_cash": 39.0, "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": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PINS LG EXT FIX", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133645", "type": "CDM"}], "standard_charges": [{"gross_charge": 1341.0, "discounted_cash": 1005.75, "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": 43.0, "discounted_cash": 32.25, "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": 77.0, "discounted_cash": 57.75, "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": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PIOGLITAZONE 30MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309502", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PIOGLITAZONE 30MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309502", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PIOGLITAZONE 45MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309504", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 87.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PIOGLITAZONE 45MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309504", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 87.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PIOGLITAZONE 7.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309499", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PIOGLITAZONE 7.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309499", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 112.0, "discounted_cash": 84.0, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 112.0, "discounted_cash": 84.0, "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": 68.0, "discounted_cash": 51.0, "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": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PIPER/TAZPER1.125GMPMXIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2543", "type": "HCPCS"}, {"code": "5323411", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 105.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PIPER/TAZPER1.125GMPMXIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2543", "type": "HCPCS"}, {"code": "5323411", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 105.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PIPERONYL B/PYRETH 1MLKT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337050", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 181.0, "discounted_cash": 135.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PIPERONYL B/PYRETH 1MLKT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337050", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 181.0, "discounted_cash": 135.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PIPERONYL/PYRETH120ML SH", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337054", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PIPERONYL/PYRETH120ML SH", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337054", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PIRBUTEROL .2MG 14GM IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5332025", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1837.0, "discounted_cash": 1377.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PIRBUTEROL .2MG 14GM IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5332025", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1837.0, "discounted_cash": 1377.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PK BARRIGEL PROCEDURE", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8033596", "type": "CDM"}], "standard_charges": [{"gross_charge": 31603.0, "discounted_cash": 23702.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PKNG NASAL MEROGEL", "code_information": [{"code": "C1763", "type": "HCPCS"}, {"code": "8240277", "type": "CDM"}], "standard_charges": [{"gross_charge": 948.0, "discounted_cash": 711.0, "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": 3285.0, "discounted_cash": 2463.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PL GASTRO TUBE W/FLUORO", "code_information": [{"code": "5050023", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3840.0, "discounted_cash": 2880.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PL JEJUNOSTMYTBE WFLUORO", "code_information": [{"code": "4919442", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7667.0, "discounted_cash": 5750.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PL ST CERV CAROTD WO/PRD", "code_information": [{"code": "4617216", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 46383.0, "discounted_cash": 34787.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PL ST CERV CAROTD WO/PRD", "code_information": [{"code": "4917216", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 46383.0, "discounted_cash": 34787.25, "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": 35716.0, "discounted_cash": 26787.0, "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": 11768.0, "discounted_cash": 8826.0, "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": 36964.0, "discounted_cash": 27723.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PL VERT/THORAC STNT INIT", "code_information": [{"code": "4910075", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 46383.0, "discounted_cash": 34787.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PL/VERT/THORAC STNT INIT", "code_information": [{"code": "4610075", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 32030.0, "discounted_cash": 24022.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLACEBO BLUE CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5309557", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLACEBO BLUE CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5309557", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "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": 831.0, "discounted_cash": 623.25, "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": 482.0, "discounted_cash": 361.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLATE LATERAL FIBULA ALL SIZES", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133718", "type": "CDM"}], "standard_charges": [{"gross_charge": 9788.0, "discounted_cash": 7341.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLATE ULNAR", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133186", "type": "CDM"}], "standard_charges": [{"gross_charge": 9866.0, "discounted_cash": 7399.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLATELET AB", "code_information": [{"code": "86022", "type": "CPT"}, {"code": "7006014", "type": "CDM"}], "standard_charges": [{"gross_charge": 901.0, "discounted_cash": 675.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLATELET AB/2", "code_information": [{"code": "86022", "type": "CPT"}, {"code": "7006017", "type": "CDM"}], "standard_charges": [{"gross_charge": 1239.0, "discounted_cash": 929.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLATELET AB/2", "code_information": [{"code": "86022", "type": "CPT"}, {"code": "7256017", "type": "CDM"}], "standard_charges": [{"gross_charge": 1239.0, "discounted_cash": 929.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLATELET AB/3", "code_information": [{"code": "86022", "type": "CPT"}, {"code": "7256022", "type": "CDM"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLATELET AB/6", "code_information": [{"code": "86022", "type": "CPT"}, {"code": "7256027", "type": "CDM"}], "standard_charges": [{"gross_charge": 1128.0, "discounted_cash": 846.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLATELET AB/9", "code_information": [{"code": "86022", "type": "CPT"}, {"code": "7258605", "type": "CDM"}], "standard_charges": [{"gross_charge": 1212.0, "discounted_cash": 909.0, "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": 315.0, "discounted_cash": 236.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLATELET AUTO", "code_information": [{"code": "85049", "type": "CPT"}, {"code": "4125595", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLATELET AUTO", "code_information": [{"code": "85049", "type": "CPT"}, {"code": "4155595", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 164.0, "discounted_cash": 123.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLATELET IMMUNOGL ASSAY/2", "code_information": [{"code": "86023", "type": "CPT"}, {"code": "7006473", "type": "CDM"}], "standard_charges": [{"gross_charge": 211.0, "discounted_cash": 158.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLATELETS IRRAD EA UNIT", "code_information": [{"code": "P9032", "type": "HCPCS"}, {"code": "4500037", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 1416.0, "discounted_cash": 1062.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH AORTA", "code_information": [{"code": "4617800", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3125.0, "discounted_cash": 2343.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH AORTA", "code_information": [{"code": "4917800", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3737.0, "discounted_cash": 2802.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH AORTC TRNSLM", "code_information": [{"code": "4917805", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7213.0, "discounted_cash": 5409.75, "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": 4811.0, "discounted_cash": 3608.25, "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": 2550.0, "discounted_cash": 1912.5, "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": 6266.0, "discounted_cash": 4699.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH ART 2ND ORDR", "code_information": [{"code": "4917840", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2775.0, "discounted_cash": 2081.25, "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": 3354.0, "discounted_cash": 2515.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH ART 3RD ORDR", "code_information": [{"code": "4917845", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3340.0, "discounted_cash": 2505.0, "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": 2339.0, "discounted_cash": 1754.25, "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": 2797.0, "discounted_cash": 2097.75, "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": 2437.0, "discounted_cash": 1827.75, "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": 2437.0, "discounted_cash": 1827.75, "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": 3163.0, "discounted_cash": 2372.25, "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": 3479.0, "discounted_cash": 2609.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH ART ABD ADD", "code_information": [{"code": "4617810", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 736.0, "discounted_cash": 552.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH ART ABD ADD", "code_information": [{"code": "4917810", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 848.0, "discounted_cash": 636.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH ART ADD ORDR", "code_information": [{"code": "4617830", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 881.0, "discounted_cash": 660.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH ART ADD ORDR", "code_information": [{"code": "4917830", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1086.0, "discounted_cash": 814.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH EXTRM ARTERY", "code_information": [{"code": "4617860", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2050.0, "discounted_cash": 1537.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH EXTRM ARTERY", "code_information": [{"code": "4917865", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2426.0, "discounted_cash": 1819.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH LT/RT ARTERY", "code_information": [{"code": "4918125", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2118.0, "discounted_cash": 1588.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH RT HRT/PULM ART", "code_information": [{"code": "4917850", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3272.0, "discounted_cash": 2454.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH SEGMNTL ARTR", "code_information": [{"code": "4918230", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2917.0, "discounted_cash": 2187.75, "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": 2214.0, "discounted_cash": 1660.5, "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": 1997.0, "discounted_cash": 1497.75, "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": 5095.0, "discounted_cash": 3821.25, "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": 2059.0, "discounted_cash": 1544.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH VENACAVA", "code_information": [{"code": "4617870", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5091.0, "discounted_cash": 3818.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH VENACAVA", "code_information": [{"code": "4917870", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4686.0, "discounted_cash": 3514.5, "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": 36523.0, "discounted_cash": 27392.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CERV CAROTD W/PRD", "code_information": [{"code": "4917215", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 36523.0, "discounted_cash": 27392.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CHOLEDOCHAL STENT", "code_information": [{"code": "4918305", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 960.0, "discounted_cash": 720.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC EXT PROS RPR FOR ANEUR+S&I", "code_information": [{"code": "4914709", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2875.0, "discounted_cash": 2156.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC FIDUCL MRKR ABD/PEL", "code_information": [{"code": "4919411", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 10610.0, "discounted_cash": 7957.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC FIDUCL MRKR ABD/PEL", "code_information": [{"code": "5052856", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 8355.0, "discounted_cash": 6266.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC FIDUCL MRKR LUNG", "code_information": [{"code": "5052854", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 8355.0, "discounted_cash": 6266.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC FIDUCL MRKR PROSTATE", "code_information": [{"code": "5052855", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 10103.0, "discounted_cash": 7577.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC FIDUCL MRKR PROSTATE", "code_information": [{"code": "5065876", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 11186.0, "discounted_cash": 8389.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC FISTULA PLUG ENTERCUTANEUS", "code_information": [{"code": "4915399", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7007.0, "discounted_cash": 5255.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC NEPHROSTOMY CATH", "code_information": [{"code": "4917770", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3148.0, "discounted_cash": 2361.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC NEPHROSTOMY CATH", "code_information": [{"code": "5050392", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2666.0, "discounted_cash": 1999.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC NEPHROURETERAL CATH", "code_information": [{"code": "4914334", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 9941.5, "discounted_cash": 7456.13, "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": 1099.0, "discounted_cash": 824.25, "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": 1099.0, "discounted_cash": 824.25, "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": 21339.0, "discounted_cash": 16004.25, "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": 7773.0, "discounted_cash": 5829.75, "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": 18178.0, "discounted_cash": 13633.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC TRANSPERINEAL BIO MATERIAL", "code_information": [{"code": "5065874", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 29461.0, "discounted_cash": 22095.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC VAG APPARATUS BRACHY", "code_information": [{"code": "5107156", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2590.0, "discounted_cash": 1942.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC VASC CLSURE DEVICE", "code_information": [{"code": "G0269", "type": "HCPCS"}, {"code": "4610269", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 978.0, "discounted_cash": 733.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC VASC CLSURE DEVICE", "code_information": [{"code": "G0269", "type": "HCPCS"}, {"code": "4610269", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 978.0, "discounted_cash": 733.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC VASC CLSURE DEVICE", "code_information": [{"code": "G0269", "type": "HCPCS"}, {"code": "4910269", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1106.0, "discounted_cash": 829.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC VASC CLSURE DEVICE", "code_information": [{"code": "G0269", "type": "HCPCS"}, {"code": "4910269", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 1106.0, "discounted_cash": 829.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLEURAL DRAINAGE PERC", "code_information": [{"code": "4902557", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 9452.0, "discounted_cash": 7089.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLEURAL DRAINAGE PERC", "code_information": [{"code": "4912557", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 8285.0, "discounted_cash": 6213.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLEURAL DRAINAGE PERC", "code_information": [{"code": "5052557", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7444.0, "discounted_cash": 5583.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLEURAL DRAINAGE PERC", "code_information": [{"code": "5062557", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 8575.0, "discounted_cash": 6431.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLICAMYCIN PER 2.5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9270", "type": "HCPCS"}, {"code": "5322471", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 7905.0, "discounted_cash": 5928.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLICAMYCIN PER 2.5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9270", "type": "HCPCS"}, {"code": "5322471", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 7905.0, "discounted_cash": 5928.75, "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": 524.0, "discounted_cash": 393.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT AGGREGATION EA AGENT", "code_information": [{"code": "85576", "type": "CPT"}, {"code": "4125574", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT AGGREGATION EA AGENT", "code_information": [{"code": "85576", "type": "CPT"}, {"code": "7055577", "type": "CDM"}], "standard_charges": [{"gross_charge": 810.0, "discounted_cash": 607.5, "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": 1215.0, "discounted_cash": 911.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT AGGREGATION EA AGENT/2", "code_information": [{"code": "85576", "type": "CPT"}, {"code": "4125575", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 69.0, "discounted_cash": 51.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT AGGREGATION EA AGENT/2", "code_information": [{"code": "85576", "type": "CPT"}, {"code": "4155577", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 608.0, "discounted_cash": 456.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT AGGREGATION EA AGENT/3", "code_information": [{"code": "85576", "type": "CPT"}, {"code": "4105578", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 524.0, "discounted_cash": 393.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT AGGREGATION EA AGENT/3", "code_information": [{"code": "85576", "type": "CPT"}, {"code": "4125576", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "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": 542.0, "discounted_cash": 406.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT AGGREGATION EA AGENT/6", "code_information": [{"code": "85576", "type": "CPT"}, {"code": "4105582", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 327.0, "discounted_cash": 245.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT ANT TT HI TALAR NK", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137819", "type": "CDM"}], "standard_charges": [{"gross_charge": 21803.0, "discounted_cash": 16352.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT BN MED", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133675", "type": "CDM"}], "standard_charges": [{"gross_charge": 1627.0, "discounted_cash": 1220.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT BURR HOLE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133664", "type": "CDM"}], "standard_charges": [{"gross_charge": 3689.0, "discounted_cash": 2766.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT CABLE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137820", "type": "CDM"}], "standard_charges": [{"gross_charge": 7643.0, "discounted_cash": 5732.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT CERV SPINE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133685", "type": "CDM"}], "standard_charges": [{"gross_charge": 864.0, "discounted_cash": 648.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT CLAVICLE HOOK", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133687", "type": "CDM"}], "standard_charges": [{"gross_charge": 13586.0, "discounted_cash": 10189.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT COMP LCP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133699", "type": "CDM"}], "standard_charges": [{"gross_charge": 3349.56, "discounted_cash": 2512.17, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT COMP TUBE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133695", "type": "CDM"}], "standard_charges": [{"gross_charge": 751.0, "discounted_cash": 563.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT COMPRESSION", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133700", "type": "CDM"}], "standard_charges": [{"gross_charge": 6184.0, "discounted_cash": 4638.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT CRANI", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133702", "type": "CDM"}], "standard_charges": [{"gross_charge": 1339.0, "discounted_cash": 1004.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT CRANI STRAIGHT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133706", "type": "CDM"}], "standard_charges": [{"gross_charge": 857.0, "discounted_cash": 642.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT DISTL FEMUR LCKNG", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133711", "type": "CDM"}], "standard_charges": [{"gross_charge": 12397.0, "discounted_cash": 9297.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT DISTL FIBULA LCK", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133709", "type": "CDM"}], "standard_charges": [{"gross_charge": 3800.0, "discounted_cash": 2850.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT DORSAL DR", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133714", "type": "CDM"}], "standard_charges": [{"gross_charge": 12488.0, "discounted_cash": 9366.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT E 1/3 TUBE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133825", "type": "CDM"}], "standard_charges": [{"gross_charge": 562.0, "discounted_cash": 421.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT E COMP BRD", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133720", "type": "CDM"}], "standard_charges": [{"gross_charge": 27238.0, "discounted_cash": 20428.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT E T", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133795", "type": "CDM"}], "standard_charges": [{"gross_charge": 8405.0, "discounted_cash": 6303.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT FIBULA COMPOSITE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133829", "type": "CDM"}], "standard_charges": [{"gross_charge": 4028.0, "discounted_cash": 3021.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT GLENOID REVERS SHLDR", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137826", "type": "CDM"}], "standard_charges": [{"gross_charge": 12796.0, "discounted_cash": 9597.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT HAND ROTATION LCK", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137828", "type": "CDM"}], "standard_charges": [{"gross_charge": 5962.0, "discounted_cash": 4471.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT HOOK LATERAL LCK", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137827", "type": "CDM"}], "standard_charges": [{"gross_charge": 7355.0, "discounted_cash": 5516.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT L STERNAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133894", "type": "CDM"}], "standard_charges": [{"gross_charge": 3665.0, "discounted_cash": 2748.75, "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": 1703.0, "discounted_cash": 1277.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT LAPIDUS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137582", "type": "CDM"}], "standard_charges": [{"gross_charge": 3948.0, "discounted_cash": 2961.0, "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": 13388.0, "discounted_cash": 10041.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT LC LAT PROX HUMERAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133897", "type": "CDM"}], "standard_charges": [{"gross_charge": 22961.0, "discounted_cash": 17220.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT LC LAT PROX TIBIAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4014310", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9531.0, "discounted_cash": 7148.25, "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": 6542.0, "discounted_cash": 4906.5, "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": 20573.0, "discounted_cash": 15429.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT LCK STERNAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137830", "type": "CDM"}], "standard_charges": [{"gross_charge": 142.0, "discounted_cash": 106.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT LCP MED PROX TIBIA", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137822", "type": "CDM"}], "standard_charges": [{"gross_charge": 19816.0, "discounted_cash": 14862.0, "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": 429.0, "discounted_cash": 321.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT LOCK MEDIAL HOOK", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137829", "type": "CDM"}], "standard_charges": [{"gross_charge": 8669.0, "discounted_cash": 6501.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT MAX FACL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8154030", "type": "CDM"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT MICRO", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133637", "type": "CDM"}], "standard_charges": [{"gross_charge": 849.0, "discounted_cash": 636.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT MTP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133838", "type": "CDM"}], "standard_charges": [{"gross_charge": 13789.0, "discounted_cash": 10341.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT NEURO", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133783", "type": "CDM"}], "standard_charges": [{"gross_charge": 608.0, "discounted_cash": 456.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT OLECRANON", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133841", "type": "CDM"}], "standard_charges": [{"gross_charge": 6875.0, "discounted_cash": 5156.25, "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": 2660.0, "discounted_cash": 1995.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT PROX HUMERAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133898", "type": "CDM"}], "standard_charges": [{"gross_charge": 19765.0, "discounted_cash": 14823.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT PROX LAT TIB", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133851", "type": "CDM"}], "standard_charges": [{"gross_charge": 17965.0, "discounted_cash": 13473.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT RADIAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4014314", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10817.0, "discounted_cash": 8112.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT RECON MAND", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133848", "type": "CDM"}], "standard_charges": [{"gross_charge": 5727.0, "discounted_cash": 4295.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT RECONTSRCT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133845", "type": "CDM"}], "standard_charges": [{"gross_charge": 8268.0, "discounted_cash": 6201.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT SUPRACOND", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133870", "type": "CDM"}], "standard_charges": [{"gross_charge": 4128.0, "discounted_cash": 3096.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT SYNDESMOSIS TIGHTROPE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137596", "type": "CDM"}], "standard_charges": [{"gross_charge": 31555.0, "discounted_cash": 23666.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT VOLAR DISTAL RADIUS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133899", "type": "CDM"}], "standard_charges": [{"gross_charge": 17211.0, "discounted_cash": 12908.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT VOLAR RADIUS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133888", "type": "CDM"}], "standard_charges": [{"gross_charge": 9866.0, "discounted_cash": 7399.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT WRIST FUSION LCP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8134034", "type": "CDM"}], "standard_charges": [{"gross_charge": 20249.0, "discounted_cash": 15186.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT WRIST LCKNG", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133891", "type": "CDM"}], "standard_charges": [{"gross_charge": 12556.0, "discounted_cash": 9417.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT X STERNAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133892", "type": "CDM"}], "standard_charges": [{"gross_charge": 4409.0, "discounted_cash": 3306.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLTS PATH REDCD PHERESIS", "code_information": [{"code": "P9073", "type": "HCPCS"}, {"code": "4500920", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 3711.0, "discounted_cash": 2783.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLUG EYE TROCAR", "code_information": [{"code": "L8610", "type": "HCPCS"}, {"code": "8123506", "type": "CDM"}], "standard_charges": [{"gross_charge": 367.0, "discounted_cash": 275.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLUG PORT VV/IS-1", "code_information": [{"code": "C1883", "type": "HCPCS"}, {"code": "8176106", "type": "CDM"}], "standard_charges": [{"gross_charge": 216.0, "discounted_cash": 162.0, "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": 6038.0, "discounted_cash": 4528.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PM ACCOLADE DR L301", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4004089", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 22898.0, "discounted_cash": 17173.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PM ACCOLADE DR MRI L311", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4004087", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 53635.0, "discounted_cash": 40226.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PM ACCOLADE EL DR L321", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4004090", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 14845.0, "discounted_cash": 11133.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PM ACCOLADE MRI EL L331", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4004092", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 34359.0, "discounted_cash": 25769.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PM ACCOLADE MRI SR L310", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4004091", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 47796.0, "discounted_cash": 35847.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PM ADVANTIO DR EL K064", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000428", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 26632.0, "discounted_cash": 19974.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PM ADVANTIO DR K063", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000426", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 27200.0, "discounted_cash": 20400.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PM ADVANTIO SR K062", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4000427", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 34963.0, "discounted_cash": 26222.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PM ADVISA DR A4DR01", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4004099", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 31278.0, "discounted_cash": 23458.5, "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": 31928.0, "discounted_cash": 23946.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PM ADVISA SR MRI A3SR01", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4000431", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 42297.0, "discounted_cash": 31722.75, "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": 53914.0, "discounted_cash": 40435.5, "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": 43030.0, "discounted_cash": 32272.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PM ALTRUA DDDR S603", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000424", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 54302.0, "discounted_cash": 40726.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PM ALTRUA SSIR SC S601", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4004113", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 51124.0, "discounted_cash": 38343.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PM ANTHEM RF DC PM3210", "code_information": [{"code": "C2621", "type": "HCPCS"}, {"code": "4004120", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 65109.0, "discounted_cash": 48831.75, "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": 34795.0, "discounted_cash": 26096.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PM ASSURITY MRI PM1272", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4000432", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 52623.0, "discounted_cash": 39467.25, "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": 59736.0, "discounted_cash": 44802.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PM ASSURITY SR-RF PM1240", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4000430", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 30672.0, "discounted_cash": 23004.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PM AZURE XT DR MRI W1DR01", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000434", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 50051.0, "discounted_cash": 37538.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PM AZURE XT SR MRI W1SR01", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4000435", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 43230.0, "discounted_cash": 32422.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PM CONSULTA CRT-P C4TR01", "code_information": [{"code": "C2621", "type": "HCPCS"}, {"code": "4000448", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 70611.0, "discounted_cash": 52958.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PM CONTAK RENEWAL H120", "code_information": [{"code": "C2621", "type": "HCPCS"}, {"code": "4000449", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 87563.0, "discounted_cash": 65672.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PM CONTAK RENEWAL H125", "code_information": [{"code": "C2621", "type": "HCPCS"}, {"code": "4000450", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 87563.0, "discounted_cash": 65672.25, "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": 196152.0, "discounted_cash": 147114.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PM DC ACCENT DR PM2210", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000452", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 69832.0, "discounted_cash": 52374.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PM DC ALTRUA 60 S606", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000457", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 59087.0, "discounted_cash": 44315.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PM DC ENPULSE 2 DR06", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000470", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 53681.0, "discounted_cash": 40260.75, "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": 39336.0, "discounted_cash": 29502.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PM DC PRELIFE", "code_information": [{"code": "C2619", "type": "HCPCS"}, {"code": "8242600", "type": "CDM"}], "standard_charges": [{"gross_charge": 0.01, "discounted_cash": 0.01, "setting": "both", "billing_class": "facility"}]}, {"description": "PM DC RR ADAPTA 0101ID", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000495", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 52801.0, "discounted_cash": 39600.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PM DC RR ADAPTA ADDR01", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000494", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 52801.0, "discounted_cash": 39600.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PM DC RR ADAPTA ADDR06", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000497", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 39433.0, "discounted_cash": 29574.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PM DC RR ADAPTA ADDRL101", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000492", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 30971.0, "discounted_cash": 23228.25, "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": 52801.0, "discounted_cash": 39600.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PM DC RR ADAPTA DR0301", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000496", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 30971.0, "discounted_cash": 23228.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PM DC RR ATR/VNT BI", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000506", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 55399.0, "discounted_cash": 41549.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PM DC RR ATR/VNT BI/UNI", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000507", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 58900.0, "discounted_cash": 44175.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PM DC RR CYLOS DRT", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000514", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 60721.0, "discounted_cash": 45540.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PM DC RR ENPULSE 2", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000526", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 53681.0, "discounted_cash": 40260.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PM DC RR ENPULSE 2 DR21", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000518", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 51482.0, "discounted_cash": 38611.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PM DC RR ENPULSE E1DR21", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000528", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 53681.0, "discounted_cash": 40260.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PM DC RR ENRYTHM P1501", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000517", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 54563.0, "discounted_cash": 40922.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PM DC RR IDENTITY ADX", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000531", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 58900.0, "discounted_cash": 44175.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PM DC RR INSIGN ULTR DR", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000533", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 59403.0, "discounted_cash": 44552.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PM DC RR INSIGNA PLUS", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000536", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 55002.0, "discounted_cash": 41251.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PM DC RR INSIGNA ULTRA", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000534", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 59403.0, "discounted_cash": 44552.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PM DC RR TALENT DR", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000615", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 53681.0, "discounted_cash": 40260.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PM DC RR VERSA VEDR01ID", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000621", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 32931.0, "discounted_cash": 24698.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PM DC RR VICTORY DR", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000622", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 63301.0, "discounted_cash": 47475.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PM DC RR VICTORY XLDR", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000624", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 63301.0, "discounted_cash": 47475.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PM DC RR ZEPHYR 5820", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000642", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 63301.0, "discounted_cash": 47475.75, "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": 67701.0, "discounted_cash": 50775.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PM DUAL CHMB EVAL W PROG", "code_information": [{"code": "93280", "type": "CPT"}, {"code": "4613280", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 836.0, "discounted_cash": 627.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PM EDORA PROMRI 407145", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4004144", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 46555.0, "discounted_cash": 34916.25, "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": 27538.0, "discounted_cash": 20653.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PM INGENIO DR IS-1 K173", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000699", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 26632.0, "discounted_cash": 19974.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PM INGENIO SR IS-1 K172", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4000698", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 23871.0, "discounted_cash": 17903.25, "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": 85606.0, "discounted_cash": 64204.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PM MULTI LEAD EVAL W PRO", "code_information": [{"code": "93281", "type": "CPT"}, {"code": "4613281", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 524.0, "discounted_cash": 393.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PM NOT DC/SC PRELIFE", "code_information": [{"code": "C2621", "type": "HCPCS"}, {"code": "8242681", "type": "CDM"}], "standard_charges": [{"gross_charge": 0.01, "discounted_cash": 0.01, "setting": "both", "billing_class": "facility"}]}, {"description": "PM PERCEPTA MRI CRTP W1TR01", "code_information": [{"code": "C2621", "type": "HCPCS"}, {"code": "4004184", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 75412.0, "discounted_cash": 56559.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PM PERCEPTA QUAD MRI W4TR01", "code_information": [{"code": "C2621", "type": "HCPCS"}, {"code": "4004183", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 57965.0, "discounted_cash": 43473.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PM QUADRA ALLUR MP CRTP PM3562", "code_information": [{"code": "C2621", "type": "HCPCS"}, {"code": "4004181", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 69507.0, "discounted_cash": 52130.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PM QUADRA ALLURE MP 3262", "code_information": [{"code": "C2621", "type": "HCPCS"}, {"code": "4004180", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 104835.0, "discounted_cash": 78626.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PM REVO MRI SRSCN RVDR01", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000901", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 54478.0, "discounted_cash": 40858.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PM SC ACCENT SR PM1210", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4001203", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 53206.0, "discounted_cash": 39904.5, "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": 24382.0, "discounted_cash": 18286.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PM SC PRELIFE", "code_information": [{"code": "C2620", "type": "HCPCS"}, {"code": "8242744", "type": "CDM"}], "standard_charges": [{"gross_charge": 0.01, "discounted_cash": 0.01, "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": 43560.0, "discounted_cash": 32670.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PM SC RR ADAPTA SR01ID", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4001047", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 44882.0, "discounted_cash": 33661.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PM SC RR CYLOS VR", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4001068", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 45760.0, "discounted_cash": 34320.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PM SC RR ENPULSE", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4001080", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 46201.0, "discounted_cash": 34650.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PM SC RR IDENTITY ADX", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4001090", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 43411.0, "discounted_cash": 32558.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PM SC RR INSIGNA", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4001095", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 50602.0, "discounted_cash": 37951.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PM SC RR INSIGNA ENTR", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4001096", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 46201.0, "discounted_cash": 34650.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PM SC RR INSIGNIA ULTRA", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4001099", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 55002.0, "discounted_cash": 41251.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PM SC RR KAPPA", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4001110", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 43120.0, "discounted_cash": 32340.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PM SC RR KAPPA KSR901", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4001111", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 43120.0, "discounted_cash": 32340.0, "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": 40480.0, "discounted_cash": 30360.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PM SC RR VICTORY", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4001199", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 43867.0, "discounted_cash": 32900.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PM SC RR ZEPHYR SR 5620", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4001201", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 52212.0, "discounted_cash": 39159.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PM SC RR ZEPHYR XL 5626", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4001202", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 52212.0, "discounted_cash": 39159.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PM SERENA QUAD MRI W4TR02", "code_information": [{"code": "C2621", "type": "HCPCS"}, {"code": "4004189", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 93288.0, "discounted_cash": 69966.0, "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": 65037.0, "discounted_cash": 48777.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PM SYNCRA CRT-P C2TR01", "code_information": [{"code": "C2621", "type": "HCPCS"}, {"code": "4004193", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 66420.0, "discounted_cash": 49815.0, "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": 1322.0, "discounted_cash": 991.5, "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": 557.0, "discounted_cash": 417.75, "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": 1420.0, "discounted_cash": 1065.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PNEUMOCOCCAL VACC ADM", "code_information": [{"code": "G0009", "type": "HCPCS"}, {"code": "6120009", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 255.0, "discounted_cash": 191.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PNEUMOCOCCAL VACC ADMIN", "code_information": [{"code": "G0009", "type": "HCPCS"}, {"code": "3914120", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 162.0, "discounted_cash": 121.5, "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": 137.0, "discounted_cash": 102.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PNEUMOCOCCAL VACC ADMIN", "code_information": [{"code": "G0009", "type": "HCPCS"}, {"code": "6110009", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 162.0, "discounted_cash": 121.5, "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": 258.0, "discounted_cash": 193.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PNEUMOCOCCAL VACC ADMIN", "code_information": [{"code": "G0009", "type": "HCPCS"}, {"code": "6290009", "type": "CDM"}], "standard_charges": [{"gross_charge": 189.0, "discounted_cash": 141.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PNEUMOCYST CARIN DFA", "code_information": [{"code": "87281", "type": "CPT"}, {"code": "7007281", "type": "CDM"}], "standard_charges": [{"gross_charge": 251.0, "discounted_cash": 188.25, "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": 189.0, "discounted_cash": 141.75, "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": 189.0, "discounted_cash": 141.75, "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": 39.0, "discounted_cash": 29.25, "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": 39.0, "discounted_cash": 29.25, "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": 77.0, "discounted_cash": 57.75, "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": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "POLYETHYLE GLYCOL255GMPW", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316073", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 128.0, "discounted_cash": 96.0, "setting": "both", "billing_class": "facility"}]}, {"description": "POLYETHYLE GLYCOL255GMPW", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316073", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 128.0, "discounted_cash": 96.0, "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": 107.0, "discounted_cash": 80.25, "setting": "both", "billing_class": "facility"}]}, {"description": "POLYSOMNOGRAPHY", "code_information": [{"code": "95810", "type": "CPT"}, {"code": "6912105", "type": "CDM"}], "standard_charges": [{"gross_charge": 10256.0, "discounted_cash": 7692.0, "setting": "both", "billing_class": "facility"}]}, {"description": "POLYSOMNOGRAPHY CPAP 4", "code_information": [{"code": "95811", "type": "CPT"}, {"code": "6912102", "type": "CDM"}], "standard_charges": [{"gross_charge": 10778.0, "discounted_cash": 8083.5, "setting": "both", "billing_class": "facility"}]}, {"description": "POLYSTYREN SULF 100ML RE", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338561", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 741.0, "discounted_cash": 555.75, "setting": "both", "billing_class": "facility"}]}, {"description": "POLYSTYREN SULF 120ML RE", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338560", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 512.0, "discounted_cash": 384.0, "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": 107.0, "discounted_cash": 80.25, "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": 107.0, "discounted_cash": 80.25, "setting": "both", "billing_class": "facility"}]}, {"description": "POLYSTYRENE 30GM PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316074", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "POLYSTYRENE 30GM PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316074", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "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": 156.0, "discounted_cash": 117.0, "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": 156.0, "discounted_cash": 117.0, "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": 2995.0, "discounted_cash": 2246.25, "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": 9936.0, "discounted_cash": 7452.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PORPHOBILINOGEN URINE QN", "code_information": [{"code": "84110", "type": "CPT"}, {"code": "7004110", "type": "CDM"}], "standard_charges": [{"gross_charge": 407.0, "discounted_cash": 305.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PORPHOBILINOGEN URINE QN", "code_information": [{"code": "84110", "type": "CPT"}, {"code": "7254110", "type": "CDM"}], "standard_charges": [{"gross_charge": 407.0, "discounted_cash": 305.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PORPHYRINS URINE QN/FRACT", "code_information": [{"code": "84120", "type": "CPT"}, {"code": "7004120", "type": "CDM"}], "standard_charges": [{"gross_charge": 1086.0, "discounted_cash": 814.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PORPHYRINS URINE QN/FRACT/2", "code_information": [{"code": "84120", "type": "CPT"}, {"code": "7254121", "type": "CDM"}], "standard_charges": [{"gross_charge": 1086.0, "discounted_cash": 814.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PORT FILM", "code_information": [{"code": "77417", "type": "CPT"}, {"code": "5107416", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 965.0, "discounted_cash": 723.75, "setting": "both", "billing_class": "facility"}]}, {"description": "POSACONAZOLE 100MG XRTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309635", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 301.0, "discounted_cash": 225.75, "setting": "both", "billing_class": "facility"}]}, {"description": "POSACONAZOLE 100MG XRTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309635", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 301.0, "discounted_cash": 225.75, "setting": "both", "billing_class": "facility"}]}, {"description": "POSACONAZOLE 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316082", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 269.0, "discounted_cash": 201.75, "setting": "both", "billing_class": "facility"}]}, {"description": "POSACONAZOLE 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316082", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 269.0, "discounted_cash": 201.75, "setting": "both", "billing_class": "facility"}]}, {"description": "POST TAPER", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8134003", "type": "CDM"}], "standard_charges": [{"gross_charge": 3512.0, "discounted_cash": 2634.0, "setting": "both", "billing_class": "facility"}]}, {"description": "POST X TITN", "code_information": [{"code": "L8641", "type": "HCPCS"}, {"code": "4014355", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 7256.0, "discounted_cash": 5442.0, "setting": "both", "billing_class": "facility"}]}, {"description": "POT PHOS 1.45GM PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309685", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "POT PHOS 1.45GM PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309685", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "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": 472.0, "discounted_cash": 354.0, "setting": "both", "billing_class": "facility"}]}, {"description": "POTASSIUM", "code_information": [{"code": "84132", "type": "CPT"}, {"code": "4124132", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "POTASSIUM", "code_information": [{"code": "84132", "type": "CPT"}, {"code": "4154132", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 216.0, "discounted_cash": 162.0, "setting": "both", "billing_class": "facility"}]}, {"description": "POTASSIUM 10MEQ EFF TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316133", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "POTASSIUM 10MEQ EFF TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316133", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "POTASSIUM 20MEQ EFF TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316132", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "POTASSIUM 20MEQ EFF TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316132", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "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": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "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": 49.0, "discounted_cash": 36.75, "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": 49.0, "discounted_cash": 36.75, "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": 690.0, "discounted_cash": 517.5, "setting": "both", "billing_class": "facility"}]}, {"description": "POTASSIUM URINE", "code_information": [{"code": "84133", "type": "CPT"}, {"code": "4124133", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "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": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "POVDN-IOD SKIN CLN 4OZTS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337122", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 120.0, "discounted_cash": 90.0, "setting": "both", "billing_class": "facility"}]}, {"description": "POVDN-IOD SKIN CLN 4OZTS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337122", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 120.0, "discounted_cash": 90.0, "setting": "both", "billing_class": "facility"}]}, {"description": "POVIDON-IOD 5% 50ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337132", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "POVIDON-IODINE10%118MLTS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337115", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "POVIDON-IODINE10%118MLTS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337115", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "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": 171.0, "discounted_cash": 128.25, "setting": "both", "billing_class": "facility"}]}, {"description": "POVIDONE-IOD7.5%120MLSH", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337120", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "POVIDONE-IOD7.5%120MLSH", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337120", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "POVIDONE-IODINE10%15MLTS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337123", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 106.0, "discounted_cash": 79.5, "setting": "both", "billing_class": "facility"}]}, {"description": "POVIDONE-IODINE10%15MLTS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337123", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 106.0, "discounted_cash": 79.5, "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": 59.0, "discounted_cash": 44.25, "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": 59.0, "discounted_cash": 44.25, "setting": "both", "billing_class": "facility"}]}, {"description": "POVIDONE-IODINE10%8OZVTS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337112", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "POVIDONE-IODINE10%8OZVTS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337112", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "POVIDONE-IODINE10%SWABEA", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337116", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "POVIDONE-IODINE10%SWABEA", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337116", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "POVIDONE-IODINE10%UD PK", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337131", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "POVIDONE-IODINE10%UD PK", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337131", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "POVIDONE-IODINE5%88ML SP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337127", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 222.0, "discounted_cash": 166.5, "setting": "both", "billing_class": "facility"}]}, {"description": "POVIDONE-IODINE5%88ML SP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337127", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 222.0, "discounted_cash": 166.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "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": 28.0, "discounted_cash": 21.0, "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": 31.0, "discounted_cash": 23.25, "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": 31.0, "discounted_cash": 23.25, "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": 32.0, "discounted_cash": 24.0, "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": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRAMIPEXOLE 1.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309695", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRAMIPEXOLE 1.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309695", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRAMIPEXOLE 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309694", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PRAMIPEXOLE 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309694", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "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": 339.0, "discounted_cash": 254.25, "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": 339.0, "discounted_cash": 254.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PRAMOXINE HC 1%30GM RCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337138", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 647.0, "discounted_cash": 485.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PRAMOXINE HC 1%30GM RCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337138", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 647.0, "discounted_cash": 485.25, "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": 986.0, "discounted_cash": 739.5, "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": 986.0, "discounted_cash": 739.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PRAMOXINE/ZINC 180ML LT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337134", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRAMOXINE/ZINC 180ML LT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337134", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRAMOXINE/ZINC 30GM R OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5338584", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 123.0, "discounted_cash": 92.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PRAMOXINE/ZINC 30GM R OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5338584", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 123.0, "discounted_cash": 92.25, "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": 75.0, "discounted_cash": 56.25, "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": 75.0, "discounted_cash": 56.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PRASUGREL 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309702", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PRASUGREL 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309702", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "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": 39.0, "discounted_cash": 29.25, "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": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PRAVASTATIN 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309688", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 62.0, "discounted_cash": 46.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PRAVASTATIN 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309688", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 62.0, "discounted_cash": 46.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PRAVASTATIN 80MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309687", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PRAVASTATIN 80MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309687", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "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": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PRAZOSIN 2MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309727", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PRAZOSIN 2MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309727", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "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": 39.0, "discounted_cash": 29.25, "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": 1154.0, "discounted_cash": 865.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PRE-ALBUMIN", "code_information": [{"code": "84134", "type": "CPT"}, {"code": "4124176", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PREDNISOL/GENTAMIC5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332222", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 353.0, "discounted_cash": 264.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PREDNISOL/GENTAMIC5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332222", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 353.0, "discounted_cash": 264.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PREDNISOLONE .12% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332172", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 292.0, "discounted_cash": 219.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PREDNISOLONE .12% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332172", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 292.0, "discounted_cash": 219.0, "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": 230.0, "discounted_cash": 172.5, "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": 230.0, "discounted_cash": 172.5, "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": 409.0, "discounted_cash": 306.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 409.0, "discounted_cash": 306.75, "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": 90.0, "discounted_cash": 67.5, "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": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PREDNISOLONE 5/5 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7510", "type": "HCPCS"}, {"code": "5316122", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PREDNISOLONE 5/5 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7510", "type": "HCPCS"}, {"code": "5316122", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "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": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "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": 47.0, "discounted_cash": 35.25, "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": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PREDNISONE 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309781", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PREDNISONE 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309781", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PREDNISONE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7512", "type": "HCPCS"}, {"code": "5309797", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PREDNISONE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7512", "type": "HCPCS"}, {"code": "5309797", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "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": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PREGABALIN 100MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309802", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 29.0, "discounted_cash": 21.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PREGABALIN 100MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309802", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 29.0, "discounted_cash": 21.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PREGABALIN 150MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309803", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PREGABALIN 150MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309803", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "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": 33.0, "discounted_cash": 24.75, "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": 33.0, "discounted_cash": 24.75, "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": 29.0, "discounted_cash": 21.75, "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": 29.0, "discounted_cash": 21.75, "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": 32.0, "discounted_cash": 24.0, "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": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PREGNENOLONE", "code_information": [{"code": "84140", "type": "CPT"}, {"code": "7254140", "type": "CDM"}], "standard_charges": [{"gross_charge": 238.0, "discounted_cash": 178.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PRESBYOPIA CORRECT FUNCT", "code_information": [{"code": "V2788", "type": "HCPCS"}, {"code": "8122172", "type": "CDM"}], "standard_charges": [{"gross_charge": 6818.0, "discounted_cash": 5113.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PRETX RBC AB W/CHEM EA", "code_information": [{"code": "86970", "type": "CPT"}, {"code": "7016035", "type": "CDM"}], "standard_charges": [{"gross_charge": 779.0, "discounted_cash": 584.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PRETX RBC AB W/CHEM EA/2", "code_information": [{"code": "86970", "type": "CPT"}, {"code": "7016213", "type": "CDM"}], "standard_charges": [{"gross_charge": 312.0, "discounted_cash": 234.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIMIDONE", "code_information": [{"code": "80188", "type": "CPT"}, {"code": "4104141", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 322.0, "discounted_cash": 241.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIMIDONE", "code_information": [{"code": "80188", "type": "CPT"}, {"code": "4124141", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIMIDONE", "code_information": [{"code": "80188", "type": "CPT"}, {"code": "4154141", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 128.0, "discounted_cash": 96.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIMIDONE", "code_information": [{"code": "80188", "type": "CPT"}, {"code": "7250188", "type": "CDM"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "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": 39.0, "discounted_cash": 29.25, "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": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIMIDONE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309819", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIMIDONE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309819", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE DETOXIFICATION", "code_information": [{"code": "1990086", "type": "CDM"}, {"code": "116", "type": "RC"}], "standard_charges": [{"gross_charge": 5403.0, "discounted_cash": 4052.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE OBSTETRICS", "code_information": [{"code": "1990043", "type": "CDM"}, {"code": "112", "type": "RC"}], "standard_charges": [{"gross_charge": 4085.0, "discounted_cash": 3063.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE OBSTETRICS", "code_information": [{"code": "2500043", "type": "CDM"}, {"code": "112", "type": "RC"}], "standard_charges": [{"gross_charge": 4085.0, "discounted_cash": 3063.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE OBSTETRICS", "code_information": [{"code": "2510043", "type": "CDM"}, {"code": "112", "type": "RC"}], "standard_charges": [{"gross_charge": 4085.0, "discounted_cash": 3063.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE ONCOLOGY", "code_information": [{"code": "1990021", "type": "CDM"}, {"code": "117", "type": "RC"}], "standard_charges": [{"gross_charge": 4749.0, "discounted_cash": 3561.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE ONCOLOGY", "code_information": [{"code": "2810021", "type": "CDM"}, {"code": "117", "type": "RC"}], "standard_charges": [{"gross_charge": 4749.0, "discounted_cash": 3561.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE PSYCHIATRIC", "code_information": [{"code": "1990052", "type": "CDM"}, {"code": "114", "type": "RC"}], "standard_charges": [{"gross_charge": 6113.0, "discounted_cash": 4584.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE PSYCHIATRIC", "code_information": [{"code": "2430052", "type": "CDM"}, {"code": "114", "type": "RC"}], "standard_charges": [{"gross_charge": 6113.0, "discounted_cash": 4584.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE REHABILITATION", "code_information": [{"code": "1990065", "type": "CDM"}, {"code": "118", "type": "RC"}], "standard_charges": [{"gross_charge": 6303.0, "discounted_cash": 4727.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE REHABILITATION", "code_information": [{"code": "2700065", "type": "CDM"}, {"code": "118", "type": "RC"}], "standard_charges": [{"gross_charge": 6303.0, "discounted_cash": 4727.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE ROOM", "code_information": [{"code": "1990001", "type": "CDM"}, {"code": "111", "type": "RC"}], "standard_charges": [{"gross_charge": 4324.0, "discounted_cash": 3243.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE ROOM", "code_information": [{"code": "2020001", "type": "CDM"}, {"code": "111", "type": "RC"}], "standard_charges": [{"gross_charge": 4324.0, "discounted_cash": 3243.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE ROOM", "code_information": [{"code": "2120001", "type": "CDM"}, {"code": "111", "type": "RC"}], "standard_charges": [{"gross_charge": 4324.0, "discounted_cash": 3243.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE ROOM", "code_information": [{"code": "2150001", "type": "CDM"}, {"code": "111", "type": "RC"}], "standard_charges": [{"gross_charge": 4324.0, "discounted_cash": 3243.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE ROOM", "code_information": [{"code": "2160001", "type": "CDM"}, {"code": "111", "type": "RC"}], "standard_charges": [{"gross_charge": 4324.0, "discounted_cash": 3243.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE ROOM", "code_information": [{"code": "2170001", "type": "CDM"}, {"code": "111", "type": "RC"}], "standard_charges": [{"gross_charge": 4324.0, "discounted_cash": 3243.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE ROOM", "code_information": [{"code": "2180001", "type": "CDM"}, {"code": "111", "type": "RC"}], "standard_charges": [{"gross_charge": 4324.0, "discounted_cash": 3243.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE ROOM", "code_information": [{"code": "2190001", "type": "CDM"}, {"code": "111", "type": "RC"}], "standard_charges": [{"gross_charge": 4324.0, "discounted_cash": 3243.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE ROOM", "code_information": [{"code": "2360001", "type": "CDM"}, {"code": "111", "type": "RC"}], "standard_charges": [{"gross_charge": 4324.0, "discounted_cash": 3243.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE ROOM", "code_information": [{"code": "2500001", "type": "CDM"}, {"code": "111", "type": "RC"}], "standard_charges": [{"gross_charge": 4324.0, "discounted_cash": 3243.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE ROOM", "code_information": [{"code": "2510001", "type": "CDM"}, {"code": "111", "type": "RC"}], "standard_charges": [{"gross_charge": 4324.0, "discounted_cash": 3243.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE ROOM", "code_information": [{"code": "2800001", "type": "CDM"}, {"code": "111", "type": "RC"}], "standard_charges": [{"gross_charge": 4324.0, "discounted_cash": 3243.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE ROOM", "code_information": [{"code": "2810001", "type": "CDM"}, {"code": "111", "type": "RC"}], "standard_charges": [{"gross_charge": 4324.0, "discounted_cash": 3243.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRO-INSULIN", "code_information": [{"code": "84206", "type": "CPT"}, {"code": "7003526", "type": "CDM"}], "standard_charges": [{"gross_charge": 694.0, "discounted_cash": 520.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PRO-INSULIN", "code_information": [{"code": "84206", "type": "CPT"}, {"code": "7253526", "type": "CDM"}], "standard_charges": [{"gross_charge": 694.0, "discounted_cash": 520.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROBE BIOROBOT HNDPC AQUABEAM", "code_information": [{"code": "C2596", "type": "HCPCS"}, {"code": "8176161", "type": "CDM"}], "standard_charges": [{"gross_charge": 34149.0, "discounted_cash": 25611.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROBE CRYOABLATION", "code_information": [{"code": "C2618", "type": "HCPCS"}, {"code": "8240355", "type": "CDM"}], "standard_charges": [{"gross_charge": 4041.0, "discounted_cash": 3030.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROBE CRYOABLATION 2", "code_information": [{"code": "C2618", "type": "HCPCS"}, {"code": "8240353", "type": "CDM"}], "standard_charges": [{"gross_charge": 17969.0, "discounted_cash": 13476.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROBE RADIOFREQUENCY INTRACEPT", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8176160", "type": "CDM"}], "standard_charges": [{"gross_charge": 37704.0, "discounted_cash": 28278.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROBENECID 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309847", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROBENECID 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309847", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROBIOTIC FLORA CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5305082", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROBIOTIC FLORA CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5305082", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROCAINAMIDE 250MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309909", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROCAINAMIDE 250MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309909", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROCAINAMIDE 500MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309901", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROCAINAMIDE 500MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309901", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "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": 649.0, "discounted_cash": 486.75, "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": 649.0, "discounted_cash": 486.75, "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": 213.0, "discounted_cash": 159.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROCALCITONIN", "code_information": [{"code": "84145", "type": "CPT"}, {"code": "7258374", "type": "CDM"}], "standard_charges": [{"gross_charge": 862.0, "discounted_cash": 646.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROCARBAZINE 50MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309956", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 557.0, "discounted_cash": 417.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROCARBAZINE 50MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309956", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 557.0, "discounted_cash": 417.75, "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": 252.0, "discounted_cash": 189.0, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 252.0, "discounted_cash": 189.0, "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": 252.0, "discounted_cash": 189.0, "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": 252.0, "discounted_cash": 189.0, "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": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "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": 86.0, "discounted_cash": 64.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROCHLORPERAZINE 5MG SU", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338609", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 94.0, "discounted_cash": 70.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROCHLORPERAZINE 5MG SU", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338609", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 94.0, "discounted_cash": 70.5, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROG/EVAL PERIPROC PM OR LDLES", "code_information": [{"code": "93286", "type": "CPT"}, {"code": "4612986", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 137.0, "discounted_cash": 102.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROG/EVAL SNGL LD OR LDLES PM", "code_information": [{"code": "93279", "type": "CPT"}, {"code": "4613279", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 742.0, "discounted_cash": 556.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROGESTERONE", "code_information": [{"code": "84144", "type": "CPT"}, {"code": "7004144", "type": "CDM"}], "standard_charges": [{"gross_charge": 1002.0, "discounted_cash": 751.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROGESTERONE", "code_information": [{"code": "84144", "type": "CPT"}, {"code": "7254144", "type": "CDM"}], "standard_charges": [{"gross_charge": 1002.0, "discounted_cash": 751.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROGESTERONE PER 50MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2675", "type": "HCPCS"}, {"code": "5323746", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROGESTERONE PER 50MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2675", "type": "HCPCS"}, {"code": "5323746", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROGRAMMER PT NEUROSTIM", "code_information": [{"code": "C1787", "type": "HCPCS"}, {"code": "8240357", "type": "CDM"}], "standard_charges": [{"gross_charge": 5843.0, "discounted_cash": 4382.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROGRAMMER PT NSTIM 2", "code_information": [{"code": "C1787", "type": "HCPCS"}, {"code": "8242820", "type": "CDM"}], "standard_charges": [{"gross_charge": 7805.0, "discounted_cash": 5853.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROGRMR PT NSTIM ALGOVITA PCKT", "code_information": [{"code": "C1787", "type": "HCPCS"}, {"code": "8176159", "type": "CDM"}], "standard_charges": [{"gross_charge": 8433.0, "discounted_cash": 6324.75, "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": 1113.0, "discounted_cash": 834.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROLACTIN", "code_information": [{"code": "84146", "type": "CPT"}, {"code": "4154146", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 432.0, "discounted_cash": 324.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROLACTIN", "code_information": [{"code": "84146", "type": "CPT"}, {"code": "7254146", "type": "CDM"}], "standard_charges": [{"gross_charge": 238.0, "discounted_cash": 178.5, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "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": 90.0, "discounted_cash": 67.5, "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": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROMETHAZINE 12.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310065", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROMETHAZINE 12.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310065", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "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": 93.0, "discounted_cash": 69.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "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": 113.0, "discounted_cash": 84.75, "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": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROMETHAZINE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310072", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROMETHAZINE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310072", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "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": 158.0, "discounted_cash": 118.5, "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": 158.0, "discounted_cash": 118.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROMETHAZINE12.5MGIVPBIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2550", "type": "HCPCS"}, {"code": "5323796", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROMETHAZINE12.5MGIVPBIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2550", "type": "HCPCS"}, {"code": "5323796", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPAFENONE", "code_information": [{"code": "80299", "type": "CPT"}, {"code": "7000283", "type": "CDM"}], "standard_charges": [{"gross_charge": 520.0, "discounted_cash": 390.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPAFENONE", "code_information": [{"code": "80299", "type": "CPT"}, {"code": "7250283", "type": "CDM"}], "standard_charges": [{"gross_charge": 512.0, "discounted_cash": 384.0, "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": 58.0, "discounted_cash": 43.5, "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": 58.0, "discounted_cash": 43.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPAFENONE 225MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310092", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPAFENONE 225MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310092", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPAFENONE 300MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310091", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPAFENONE 300MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310091", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPAFENONE 75MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310089", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 11.0, "discounted_cash": 8.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPAFENONE 75MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310089", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 11.0, "discounted_cash": 8.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPARACAINE .5% 15ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332242", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 339.0, "discounted_cash": 254.25, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPRANOLOL", "code_information": [{"code": "80299", "type": "CPT"}, {"code": "7254149", "type": "CDM"}], "standard_charges": [{"gross_charge": 549.0, "discounted_cash": 411.75, "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": 38.0, "discounted_cash": 28.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPRANOLOL 120MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310211", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPRANOLOL 120MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310211", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPRANOLOL 160MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310212", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPRANOLOL 160MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310212", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "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": 34.0, "discounted_cash": 25.5, "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": 3.0, "discounted_cash": 2.25, "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": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPRANOLOL 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310203", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPRANOLOL 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310203", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPRANOLOL 60MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310205", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPRANOLOL 60MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310205", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPRANOLOL 80MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310207", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPRANOLOL 80MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310207", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPRANOLOL 80MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310210", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPRANOLOL 80MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310210", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPRANOLOL UPTO 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1800", "type": "HCPCS"}, {"code": "5323819", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 137.0, "discounted_cash": 102.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPRANOLOL UPTO 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1800", "type": "HCPCS"}, {"code": "5323819", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 137.0, "discounted_cash": 102.75, "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": 34.0, "discounted_cash": 25.5, "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": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS ADD BK/AK SCK INSRT", "code_information": [{"code": "L5673", "type": "HCPCS"}, {"code": "8133310", "type": "CDM"}], "standard_charges": [{"gross_charge": 3339.0, "discounted_cash": 2504.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS AK KN DISART ISH SK", "code_information": [{"code": "L5585", "type": "HCPCS"}, {"code": "8133285", "type": "CDM"}], "standard_charges": [{"gross_charge": 27792.0, "discounted_cash": 20844.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS AK KN DISART THRMPL", "code_information": [{"code": "L5580", "type": "HCPCS"}, {"code": "8134145", "type": "CDM"}], "standard_charges": [{"gross_charge": 22579.0, "discounted_cash": 16934.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS AUGMENTATION", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134155", "type": "CDM"}], "standard_charges": [{"gross_charge": 7586.0, "discounted_cash": 5689.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS BK NONWT RGD DRSNG", "code_information": [{"code": "L5450", "type": "HCPCS"}, {"code": "8133306", "type": "CDM"}], "standard_charges": [{"gross_charge": 6554.0, "discounted_cash": 4915.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS BRST MENTR SALINE", "code_information": [{"code": "C1789", "type": "HCPCS"}, {"code": "8242871", "type": "CDM"}], "standard_charges": [{"gross_charge": 5053.0, "discounted_cash": 3789.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS BRST MENTR SILTX GL", "code_information": [{"code": "C1789", "type": "HCPCS"}, {"code": "8242870", "type": "CDM"}], "standard_charges": [{"gross_charge": 7011.0, "discounted_cash": 5258.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS BRST SMOOTHSURF GEL", "code_information": [{"code": "C1789", "type": "HCPCS"}, {"code": "8242876", "type": "CDM"}], "standard_charges": [{"gross_charge": 7464.0, "discounted_cash": 5598.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS BRST TE MENTOR CNTR", "code_information": [{"code": "C1789", "type": "HCPCS"}, {"code": "8248282", "type": "CDM"}], "standard_charges": [{"gross_charge": 20274.0, "discounted_cash": 15205.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS EAR", "code_information": [{"code": "L8613", "type": "HCPCS"}, {"code": "8134267", "type": "CDM"}], "standard_charges": [{"gross_charge": 2308.0, "discounted_cash": 1731.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS FEMORAL HEAD", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134204", "type": "CDM"}], "standard_charges": [{"gross_charge": 8112.0, "discounted_cash": 6084.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS FEMORAL MODULE", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134200", "type": "CDM"}], "standard_charges": [{"gross_charge": 50209.0, "discounted_cash": 37656.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS GLENOSPH UNIV REVRS", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134282", "type": "CDM"}], "standard_charges": [{"gross_charge": 24166.0, "discounted_cash": 18124.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS GLENOSPHERE LATERALIZED", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134283", "type": "CDM"}], "standard_charges": [{"gross_charge": 24166.0, "discounted_cash": 18124.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS HIP ACTBCU", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134300", "type": "CDM"}], "standard_charges": [{"gross_charge": 9457.0, "discounted_cash": 7092.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS HIP BEARIN", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134305", "type": "CDM"}], "standard_charges": [{"gross_charge": 12369.0, "discounted_cash": 9276.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS HIP CENTRA", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134310", "type": "CDM"}], "standard_charges": [{"gross_charge": 1071.0, "discounted_cash": 803.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS HIP FEMSTE", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134315", "type": "CDM"}], "standard_charges": [{"gross_charge": 20787.75, "discounted_cash": 15590.81, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS HIP LINER", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134338", "type": "CDM"}], "standard_charges": [{"gross_charge": 7881.0, "discounted_cash": 5910.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS HIP/FEMSTE", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134345", "type": "CDM"}], "standard_charges": [{"gross_charge": 53303.0, "discounted_cash": 39977.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS HUMERAL ASSEMBLY", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134351", "type": "CDM"}], "standard_charges": [{"gross_charge": 5119.0, "discounted_cash": 3839.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS HUMERAL COMPONENT", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134353", "type": "CDM"}], "standard_charges": [{"gross_charge": 10666.0, "discounted_cash": 7999.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS HUMERAL HD", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134352", "type": "CDM"}], "standard_charges": [{"gross_charge": 25587.0, "discounted_cash": 19190.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS HUMERAL STEM", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134354", "type": "CDM"}], "standard_charges": [{"gross_charge": 28001.0, "discounted_cash": 21000.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS KNE/INSERT", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134380", "type": "CDM"}], "standard_charges": [{"gross_charge": 3919.0, "discounted_cash": 2939.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS KNE/PATELA", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134385", "type": "CDM"}], "standard_charges": [{"gross_charge": 15741.0, "discounted_cash": 11805.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS KNE/TIBIAL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134400", "type": "CDM"}], "standard_charges": [{"gross_charge": 11269.15, "discounted_cash": 8451.86, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS KNE/TIBIAL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134405", "type": "CDM"}], "standard_charges": [{"gross_charge": 4485.78, "discounted_cash": 3364.34, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS KNE/TIBIAL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134415", "type": "CDM"}], "standard_charges": [{"gross_charge": 4286.0, "discounted_cash": 3214.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS KNEE", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134425", "type": "CDM"}], "standard_charges": [{"gross_charge": 5694.0, "discounted_cash": 4270.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS MAMRY GEL", "code_information": [{"code": "L8030", "type": "HCPCS"}, {"code": "8154115", "type": "CDM"}], "standard_charges": [{"gross_charge": 7110.0, "discounted_cash": 5332.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS OCULR TELESCOP MINI", "code_information": [{"code": "C1840", "type": "HCPCS"}, {"code": "8133316", "type": "CDM"}], "standard_charges": [{"gross_charge": 108811.0, "discounted_cash": 81608.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS PENILE", "code_information": [{"code": "C2622", "type": "HCPCS"}, {"code": "8154135", "type": "CDM"}], "standard_charges": [{"gross_charge": 0.09, "discounted_cash": 0.07, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS PENILE AMS 700", "code_information": [{"code": "C1813", "type": "HCPCS"}, {"code": "8240360", "type": "CDM"}], "standard_charges": [{"gross_charge": 53292.0, "discounted_cash": 39969.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS PENILE INHIBIZONE/PRECONN", "code_information": [{"code": "C1813", "type": "HCPCS"}, {"code": "8240363", "type": "CDM"}], "standard_charges": [{"gross_charge": 29556.0, "discounted_cash": 22167.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS PENILE MALLEABLE TACTRA", "code_information": [{"code": "C2622", "type": "HCPCS"}, {"code": "8154146", "type": "CDM"}], "standard_charges": [{"gross_charge": 96668.0, "discounted_cash": 72501.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS PENILE PUM", "code_information": [{"code": "C1813", "type": "HCPCS"}, {"code": "8154155", "type": "CDM"}], "standard_charges": [{"gross_charge": 114868.0, "discounted_cash": 86151.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS PSTSURG APPL RGD", "code_information": [{"code": "L5400", "type": "HCPCS"}, {"code": "8134434", "type": "CDM"}], "standard_charges": [{"gross_charge": 11379.0, "discounted_cash": 8534.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS RADIAL HEAD", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134435", "type": "CDM"}], "standard_charges": [{"gross_charge": 17993.0, "discounted_cash": 13494.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS RADIAL STEM", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8130236", "type": "CDM"}], "standard_charges": [{"gross_charge": 17835.0, "discounted_cash": 13376.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS SHOULDER", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134450", "type": "CDM"}], "standard_charges": [{"gross_charge": 18756.0, "discounted_cash": 14067.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS SOCK MULT PLY AK EA", "code_information": [{"code": "L8430", "type": "HCPCS"}, {"code": "8130067", "type": "CDM"}], "standard_charges": [{"gross_charge": 343.0, "discounted_cash": 257.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS SOCK SNGL PLY BK", "code_information": [{"code": "L8470", "type": "HCPCS"}, {"code": "8134456", "type": "CDM"}], "standard_charges": [{"gross_charge": 133.0, "discounted_cash": 99.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS TESTICULAR", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8154190", "type": "CDM"}], "standard_charges": [{"gross_charge": 13829.0, "discounted_cash": 10371.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS TIB BEARING", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134472", "type": "CDM"}], "standard_charges": [{"gross_charge": 16472.0, "discounted_cash": 12354.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS TIB STEM", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134480", "type": "CDM"}], "standard_charges": [{"gross_charge": 10978.0, "discounted_cash": 8233.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS TIBIAL TRAY", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8133305", "type": "CDM"}], "standard_charges": [{"gross_charge": 13029.0, "discounted_cash": 9771.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS TOE GREAT", "code_information": [{"code": "L8641", "type": "HCPCS"}, {"code": "8134490", "type": "CDM"}], "standard_charges": [{"gross_charge": 9218.0, "discounted_cash": 6913.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS TOE HAMMER", "code_information": [{"code": "L8641", "type": "HCPCS"}, {"code": "8134495", "type": "CDM"}], "standard_charges": [{"gross_charge": 9397.0, "discounted_cash": 7047.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS TOE HINGE", "code_information": [{"code": "L8641", "type": "HCPCS"}, {"code": "8134500", "type": "CDM"}], "standard_charges": [{"gross_charge": 9338.0, "discounted_cash": 7003.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS ULNAR ASSEMBLY", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134509", "type": "CDM"}], "standard_charges": [{"gross_charge": 30027.0, "discounted_cash": 22520.25, "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": 178.0, "discounted_cash": 133.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "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": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN C ACTIVITY", "code_information": [{"code": "85303", "type": "CPT"}, {"code": "4105303", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 2676.0, "discounted_cash": 2007.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN C ACTIVITY", "code_information": [{"code": "85303", "type": "CPT"}, {"code": "4125303", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN C ACTIVITY/2", "code_information": [{"code": "85303", "type": "CPT"}, {"code": "7255304", "type": "CDM"}], "standard_charges": [{"gross_charge": 332.0, "discounted_cash": 249.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN C ANTIGEN", "code_information": [{"code": "85302", "type": "CPT"}, {"code": "7255302", "type": "CDM"}], "standard_charges": [{"gross_charge": 445.0, "discounted_cash": 333.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN C RESIST", "code_information": [{"code": "85307", "type": "CPT"}, {"code": "4105307", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1428.0, "discounted_cash": 1071.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN C RESIST", "code_information": [{"code": "85307", "type": "CPT"}, {"code": "4125307", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN C RESIST", "code_information": [{"code": "85307", "type": "CPT"}, {"code": "7255307", "type": "CDM"}], "standard_charges": [{"gross_charge": 266.0, "discounted_cash": 199.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN ELCTRO OTHER FLUIDS", "code_information": [{"code": "84166", "type": "CPT"}, {"code": "4124166", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN ELCTRO OTHER FLUIDS", "code_information": [{"code": "84166", "type": "CPT"}, {"code": "7254167", "type": "CDM"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN ELCTRO OTHER FLUIDS/2", "code_information": [{"code": "84166", "type": "CPT"}, {"code": "7254168", "type": "CDM"}], "standard_charges": [{"gross_charge": 438.0, "discounted_cash": 328.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN ELCTRO OTHER FLUIDS/3", "code_information": [{"code": "84166", "type": "CPT"}, {"code": "4104191", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1161.0, "discounted_cash": 870.75, "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": 1292.0, "discounted_cash": 969.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN ELCTRO SERUM", "code_information": [{"code": "84165", "type": "CPT"}, {"code": "4124165", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 29.0, "discounted_cash": 21.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN ELCTRO SERUM", "code_information": [{"code": "84165", "type": "CPT"}, {"code": "4154165", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 452.0, "discounted_cash": 339.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN ELCTRO SERUM", "code_information": [{"code": "84165", "type": "CPT"}, {"code": "7254165", "type": "CDM"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN ELCTRO SERUM/2", "code_information": [{"code": "84165", "type": "CPT"}, {"code": "7258425", "type": "CDM"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN S FREE", "code_information": [{"code": "85306", "type": "CPT"}, {"code": "4105308", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 229.0, "discounted_cash": 171.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN S FREE", "code_information": [{"code": "85306", "type": "CPT"}, {"code": "4125306", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "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": 1187.0, "discounted_cash": 890.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN S FREE/2", "code_information": [{"code": "85306", "type": "CPT"}, {"code": "7255306", "type": "CDM"}], "standard_charges": [{"gross_charge": 806.0, "discounted_cash": 604.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN S FREE/4", "code_information": [{"code": "85306", "type": "CPT"}, {"code": "7256898", "type": "CDM"}], "standard_charges": [{"gross_charge": 126.0, "discounted_cash": 94.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN S TOTAL", "code_information": [{"code": "85305", "type": "CPT"}, {"code": "7005305", "type": "CDM"}], "standard_charges": [{"gross_charge": 407.0, "discounted_cash": 305.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN S TOTAL", "code_information": [{"code": "85305", "type": "CPT"}, {"code": "7255305", "type": "CDM"}], "standard_charges": [{"gross_charge": 407.0, "discounted_cash": 305.25, "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": 59.0, "discounted_cash": 44.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN TOTAL", "code_information": [{"code": "84155", "type": "CPT"}, {"code": "4124155", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 11.0, "discounted_cash": 8.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN TOTAL", "code_information": [{"code": "84155", "type": "CPT"}, {"code": "4154155", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN TOTAL", "code_information": [{"code": "84155", "type": "CPT"}, {"code": "7254155", "type": "CDM"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "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": 560.0, "discounted_cash": 420.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN TOTAL OTHER SOURCE", "code_information": [{"code": "84157", "type": "CPT"}, {"code": "4124154", "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", "code_information": [{"code": "84157", "type": "CPT"}, {"code": "4154154", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 174.0, "discounted_cash": 130.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN TOTAL OTHER SOURCE", "code_information": [{"code": "84157", "type": "CPT"}, {"code": "7254154", "type": "CDM"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "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": 614.0, "discounted_cash": 460.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN TOTAL OTHER SOURCE/3", "code_information": [{"code": "84157", "type": "CPT"}, {"code": "4124196", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN TOTAL OTHER SOURCE/3", "code_information": [{"code": "84157", "type": "CPT"}, {"code": "7254195", "type": "CDM"}], "standard_charges": [{"gross_charge": 438.0, "discounted_cash": 328.5, "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": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN URINE/2", "code_information": [{"code": "84156", "type": "CPT"}, {"code": "4124180", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 11.0, "discounted_cash": 8.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN URINE/2", "code_information": [{"code": "84156", "type": "CPT"}, {"code": "7254157", "type": "CDM"}], "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": 519.0, "discounted_cash": 389.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN URINE/4", "code_information": [{"code": "84156", "type": "CPT"}, {"code": "7254180", "type": "CDM"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN WESTERN BLOT/3", "code_information": [{"code": "84181", "type": "CPT"}, {"code": "7004189", "type": "CDM"}], "standard_charges": [{"gross_charge": 1092.0, "discounted_cash": 819.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTH BK FORK STRAP", "code_information": [{"code": "L5684", "type": "HCPCS"}, {"code": "8133312", "type": "CDM"}], "standard_charges": [{"gross_charge": 717.0, "discounted_cash": 537.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTH BK WST BELT WEB", "code_information": [{"code": "L5688", "type": "HCPCS"}, {"code": "8133313", "type": "CDM"}], "standard_charges": [{"gross_charge": 1012.0, "discounted_cash": 759.0, "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": 22.0, "discounted_cash": 16.5, "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": 22.0, "discounted_cash": 16.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "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": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTHROMBIN FRAGMENT 1.1", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7258760", "type": "CDM"}], "standard_charges": [{"gross_charge": 722.0, "discounted_cash": 541.5, "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": 371.0, "discounted_cash": 278.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTHROMBIN TIME", "code_information": [{"code": "85610", "type": "CPT"}, {"code": "4125610", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTHROMBIN TIME", "code_information": [{"code": "85610", "type": "CPT"}, {"code": "4155610", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 145.0, "discounted_cash": 108.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTOPORPHYRIN RBC QN", "code_information": [{"code": "84202", "type": "CPT"}, {"code": "7254128", "type": "CDM"}], "standard_charges": [{"gross_charge": 205.0, "discounted_cash": 153.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTOZOA AB NES/3", "code_information": [{"code": "86753", "type": "CPT"}, {"code": "7006040", "type": "CDM"}], "standard_charges": [{"gross_charge": 604.0, "discounted_cash": 453.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTOZOA AB NES/6", "code_information": [{"code": "86753", "type": "CPT"}, {"code": "7256713", "type": "CDM"}], "standard_charges": [{"gross_charge": 604.0, "discounted_cash": 453.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTOZOA AB NES/8", "code_information": [{"code": "86753", "type": "CPT"}, {"code": "7256753", "type": "CDM"}], "standard_charges": [{"gross_charge": 270.0, "discounted_cash": 202.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PRQ AV FSTL CRTJ UXTR SGL ACC", "code_information": [{"code": "4916386", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 109196.0, "discounted_cash": 81897.0, "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": 66428.0, "discounted_cash": 49821.0, "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": 28507.6, "discounted_cash": 21380.7, "setting": "both", "billing_class": "facility"}]}, {"description": "PSA FREE", "code_information": [{"code": "84154", "type": "CPT"}, {"code": "7004200", "type": "CDM"}], "standard_charges": [{"gross_charge": 349.0, "discounted_cash": 261.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PSA FREE", "code_information": [{"code": "84154", "type": "CPT"}, {"code": "7254200", "type": "CDM"}], "standard_charges": [{"gross_charge": 349.0, "discounted_cash": 261.75, "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": 900.0, "discounted_cash": 675.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PSA TOTAL", "code_information": [{"code": "84153", "type": "CPT"}, {"code": "4126316", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PSA TOTAL", "code_information": [{"code": "84153", "type": "CPT"}, {"code": "4156316", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 293.0, "discounted_cash": 219.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PSA TOTAL", "code_information": [{"code": "84153", "type": "CPT"}, {"code": "7256316", "type": "CDM"}], "standard_charges": [{"gross_charge": 604.0, "discounted_cash": 453.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PSEUDO/BRMPH120/12 XR CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301717", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PSEUDO/BRMPH120/12 XR CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301717", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PSEUDOEPHED 60MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5310270", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PSEUDOEPHED 60MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5310270", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PST TEF VCL CHD", "code_information": [{"code": "C1878", "type": "HCPCS"}, {"code": "8033761", "type": "CDM"}], "standard_charges": [{"gross_charge": 3974.0, "discounted_cash": 2980.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PSY THRPY 30 MIN PT", "code_information": [{"code": "90832", "type": "CPT"}, {"code": "6400832", "type": "CDM"}], "standard_charges": [{"gross_charge": 2239.0, "discounted_cash": 1679.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PSY THRPY 45MIN PT", "code_information": [{"code": "90834", "type": "CPT"}, {"code": "6400834", "type": "CDM"}], "standard_charges": [{"gross_charge": 2412.0, "discounted_cash": 1809.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PSYCH DIAG EVAL", "code_information": [{"code": "90791", "type": "CPT"}, {"code": "6400791", "type": "CDM"}], "standard_charges": [{"gross_charge": 2239.0, "discounted_cash": 1679.25, "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": 34.0, "discounted_cash": 25.5, "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": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PT AQUA THER W/EXER EA15", "code_information": [{"code": "97113", "type": "CPT"}, {"code": "6051546", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 210.0, "discounted_cash": 157.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT AQUA THER W/EXER EA15M #2", "code_information": [{"code": "97113", "type": "CPT"}, {"code": "6051548", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 249.0, "discounted_cash": 186.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT COMM/WK REINT TRN EA15M", "code_information": [{"code": "97537", "type": "CPT"}, {"code": "6041570", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 197.0, "discounted_cash": 147.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT CPM INIT APPL EA15MN", "code_information": [{"code": "97039", "type": "CPT"}, {"code": "5707039", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 337.0, "discounted_cash": 252.75, "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": 311.0, "discounted_cash": 233.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT E-STIM BASIC", "code_information": [{"code": "G0283", "type": "HCPCS"}, {"code": "5730283", "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 E-STIM BASIC", "code_information": [{"code": "G0283", "type": "HCPCS"}, {"code": "6057013", "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 E-STIM MAN EA 15 BSC", "code_information": [{"code": "97032", "type": "CPT"}, {"code": "6041496", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 662.0, "discounted_cash": 496.5, "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": 614.0, "discounted_cash": 460.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT EVAL HIGH COMP", "code_information": [{"code": "97163", "type": "CPT"}, {"code": "5735205", "type": "CDM"}, {"code": "424", "type": "RC"}], "standard_charges": [{"gross_charge": 614.0, "discounted_cash": 460.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT EVAL HIGH COMP", "code_information": [{"code": "97163", "type": "CPT"}, {"code": "6041405", "type": "CDM"}, {"code": "424", "type": "RC"}], "standard_charges": [{"gross_charge": 614.0, "discounted_cash": 460.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT EVAL HIGH COMP", "code_information": [{"code": "97163", "type": "CPT"}, {"code": "6051405", "type": "CDM"}, {"code": "424", "type": "RC"}], "standard_charges": [{"gross_charge": 614.0, "discounted_cash": 460.5, "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": 614.0, "discounted_cash": 460.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT EVAL LOW COMP", "code_information": [{"code": "97161", "type": "CPT"}, {"code": "5735201", "type": "CDM"}, {"code": "424", "type": "RC"}], "standard_charges": [{"gross_charge": 560.0, "discounted_cash": 420.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT EVAL LOW COMP", "code_information": [{"code": "97161", "type": "CPT"}, {"code": "6041401", "type": "CDM"}, {"code": "424", "type": "RC"}], "standard_charges": [{"gross_charge": 560.0, "discounted_cash": 420.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT EVAL LOW COMP", "code_information": [{"code": "97161", "type": "CPT"}, {"code": "6051401", "type": "CDM"}, {"code": "424", "type": "RC"}], "standard_charges": [{"gross_charge": 560.0, "discounted_cash": 420.0, "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": 614.0, "discounted_cash": 460.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT EVAL MOD COMP", "code_information": [{"code": "97162", "type": "CPT"}, {"code": "5735203", "type": "CDM"}, {"code": "424", "type": "RC"}], "standard_charges": [{"gross_charge": 614.0, "discounted_cash": 460.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT EVAL MOD COMP", "code_information": [{"code": "97162", "type": "CPT"}, {"code": "6041403", "type": "CDM"}, {"code": "424", "type": "RC"}], "standard_charges": [{"gross_charge": 614.0, "discounted_cash": 460.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT EVAL MOD COMP", "code_information": [{"code": "97162", "type": "CPT"}, {"code": "6051403", "type": "CDM"}, {"code": "424", "type": "RC"}], "standard_charges": [{"gross_charge": 614.0, "discounted_cash": 460.5, "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": 607.0, "discounted_cash": 455.25, "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": 550.0, "discounted_cash": 412.5, "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": 607.0, "discounted_cash": 455.25, "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": 395.0, "discounted_cash": 296.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT GAIT/STR TRN EA 15", "code_information": [{"code": "97116", "type": "CPT"}, {"code": "5735656", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 339.0, "discounted_cash": 254.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT GAIT/STR TRN EA15", "code_information": [{"code": "97116", "type": "CPT"}, {"code": "6041550", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 274.0, "discounted_cash": 205.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT GAIT/STR TRN EA15", "code_information": [{"code": "97116", "type": "CPT"}, {"code": "6051550", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 339.0, "discounted_cash": 254.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT GAIT/STR TRN EA15 #2", "code_information": [{"code": "97116", "type": "CPT"}, {"code": "5705658", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 392.0, "discounted_cash": 294.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT GAIT/STR TRN EA15 #2", "code_information": [{"code": "97116", "type": "CPT"}, {"code": "6041552", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 274.0, "discounted_cash": 205.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT IONTOPHOR EA 15 BSC", "code_information": [{"code": "97033", "type": "CPT"}, {"code": "6051502", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 213.0, "discounted_cash": 159.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT IONTOPHORESIS 15 BSC", "code_information": [{"code": "97033", "type": "CPT"}, {"code": "5735272", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 213.0, "discounted_cash": 159.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT MAN THERAPY EA15#2", "code_information": [{"code": "97140", "type": "CPT"}, {"code": "5735179", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 383.0, "discounted_cash": 287.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT MANUAL THERAPY EA 15M", "code_information": [{"code": "97140", "type": "CPT"}, {"code": "5735178", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 439.0, "discounted_cash": 329.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT MANUAL THERAPY EA 15M", "code_information": [{"code": "97140", "type": "CPT"}, {"code": "6055178", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 417.0, "discounted_cash": 312.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT MANUAL THRPY EA 15 #2", "code_information": [{"code": "97140", "type": "CPT"}, {"code": "6055179", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 439.0, "discounted_cash": 329.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT MECH TRACTION BSC", "code_information": [{"code": "97012", "type": "CPT"}, {"code": "5735600", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 355.0, "discounted_cash": 266.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT MECH TRACTION BSC", "code_information": [{"code": "97012", "type": "CPT"}, {"code": "6051436", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 355.0, "discounted_cash": 266.25, "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": 338.0, "discounted_cash": 253.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT NEUROMUSC RE-ED EA15", "code_information": [{"code": "97112", "type": "CPT"}, {"code": "5735300", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 154.0, "discounted_cash": 115.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT NEUROMUSC RE-ED EA15", "code_information": [{"code": "97112", "type": "CPT"}, {"code": "6041542", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 138.0, "discounted_cash": 103.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT NEUROMUSC RE-ED EA15", "code_information": [{"code": "97112", "type": "CPT"}, {"code": "6051542", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 154.0, "discounted_cash": 115.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT NEUROMUSC RE-ED EA15#2", "code_information": [{"code": "97112", "type": "CPT"}, {"code": "5735302", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 154.0, "discounted_cash": 115.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT NEUROMUSC RE-EDEA15#2", "code_information": [{"code": "97112", "type": "CPT"}, {"code": "6051544", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 154.0, "discounted_cash": 115.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT NSL WD DEB WO ANES COMPLEX", "code_information": [{"code": "97602", "type": "CPT"}, {"code": "6057612", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 641.0, "discounted_cash": 480.75, "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": 641.0, "discounted_cash": 480.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT NSL WD/S DEB WO AN CO", "code_information": [{"code": "97602", "type": "CPT"}, {"code": "6047607", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 641.0, "discounted_cash": 480.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT ORTHO MGMT INIT EA 15MIN", "code_information": [{"code": "97760", "type": "CPT"}, {"code": "5737760", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 193.0, "discounted_cash": 144.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT PARAFFIN BATH BSC", "code_information": [{"code": "97018", "type": "CPT"}, {"code": "5732524", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 126.0, "discounted_cash": 94.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT PARAFFIN BATH BSC", "code_information": [{"code": "97018", "type": "CPT"}, {"code": "6051454", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 126.0, "discounted_cash": 94.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT PHYS PERF TST 15MIN", "code_information": [{"code": "97750", "type": "CPT"}, {"code": "5735224", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 647.0, "discounted_cash": 485.25, "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": 495.0, "discounted_cash": 371.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT RE-EVAL", "code_information": [{"code": "97164", "type": "CPT"}, {"code": "5735213", "type": "CDM"}, {"code": "424", "type": "RC"}], "standard_charges": [{"gross_charge": 495.0, "discounted_cash": 371.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT RE-EVAL", "code_information": [{"code": "97164", "type": "CPT"}, {"code": "6041409", "type": "CDM"}, {"code": "424", "type": "RC"}], "standard_charges": [{"gross_charge": 495.0, "discounted_cash": 371.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT RE-EVAL", "code_information": [{"code": "97164", "type": "CPT"}, {"code": "6051409", "type": "CDM"}, {"code": "424", "type": "RC"}], "standard_charges": [{"gross_charge": 495.0, "discounted_cash": 371.25, "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": 1271.0, "discounted_cash": 953.25, "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": 706.0, "discounted_cash": 529.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT SLF CARE/HM MGMT EA 15M #2", "code_information": [{"code": "97535", "type": "CPT"}, {"code": "6050855", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 173.0, "discounted_cash": 129.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT SLF CR/HM MGMT EA 15", "code_information": [{"code": "97535", "type": "CPT"}, {"code": "5735316", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 175.0, "discounted_cash": 131.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT SLF CR/HM MGMT EA15#2", "code_information": [{"code": "97535", "type": "CPT"}, {"code": "5735318", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 173.0, "discounted_cash": 129.75, "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": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PT SUBST PLSMA FRCT EA", "code_information": [{"code": "85611", "type": "CPT"}, {"code": "4124200", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PT THER ACT EA 15", "code_information": [{"code": "97530", "type": "CPT"}, {"code": "6041562", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 149.0, "discounted_cash": 111.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT THER ACT EA 15", "code_information": [{"code": "97530", "type": "CPT"}, {"code": "6051562", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 402.0, "discounted_cash": 301.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT THER ACT EA15 #2", "code_information": [{"code": "97530", "type": "CPT"}, {"code": "6041564", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 149.0, "discounted_cash": 111.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT THER EX EA 15", "code_information": [{"code": "97110", "type": "CPT"}, {"code": "5705296", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 366.0, "discounted_cash": 274.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT THER EX EA 15", "code_information": [{"code": "97110", "type": "CPT"}, {"code": "6041538", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 270.0, "discounted_cash": 202.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT THER EX EA 15 #2", "code_information": [{"code": "97110", "type": "CPT"}, {"code": "5705298", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 314.0, "discounted_cash": 235.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT THER MASSGE EA 15", "code_information": [{"code": "97124", "type": "CPT"}, {"code": "6041558", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 147.0, "discounted_cash": 110.25, "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": 402.0, "discounted_cash": 301.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT THERAPEUTC ACT EA 15", "code_information": [{"code": "97530", "type": "CPT"}, {"code": "5735312", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 402.0, "discounted_cash": 301.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT THERAPEUTC ACT EA15#2", "code_information": [{"code": "97530", "type": "CPT"}, {"code": "5705314", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 402.0, "discounted_cash": 301.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT THERAPEUTC EXER EA15", "code_information": [{"code": "97110", "type": "CPT"}, {"code": "6051538", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 339.0, "discounted_cash": 254.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT THERAPEUTC MASSG EA15", "code_information": [{"code": "97124", "type": "CPT"}, {"code": "5735308", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 189.0, "discounted_cash": 141.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT THERAPEUTIC EXER EA15", "code_information": [{"code": "97110", "type": "CPT"}, {"code": "5735296", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 368.0, "discounted_cash": 276.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT THERAPTC MASSGE EA15", "code_information": [{"code": "97124", "type": "CPT"}, {"code": "6051558", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 162.0, "discounted_cash": 121.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT US EA 15 BSC", "code_information": [{"code": "97035", "type": "CPT"}, {"code": "5735284", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 146.0, "discounted_cash": 109.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT US EA15 BSC", "code_information": [{"code": "97035", "type": "CPT"}, {"code": "6041514", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 173.0, "discounted_cash": 129.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT US EA15 BSC", "code_information": [{"code": "97035", "type": "CPT"}, {"code": "6051514", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 146.0, "discounted_cash": 109.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT WHEELCHR TRN EA15", "code_information": [{"code": "97542", "type": "CPT"}, {"code": "6041574", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 146.0, "discounted_cash": 109.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT WHIRLPOOL BSC", "code_information": [{"code": "97022", "type": "CPT"}, {"code": "5735254", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 976.0, "discounted_cash": 732.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT WHIRLPOOL COMPLEX", "code_information": [{"code": "97022", "type": "CPT"}, {"code": "5735258", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 976.0, "discounted_cash": 732.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT WHIRLPOOL INTERM", "code_information": [{"code": "97022", "type": "CPT"}, {"code": "5735256", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 976.0, "discounted_cash": 732.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT WK HRD/COND ADDL HR", "code_information": [{"code": "97546", "type": "CPT"}, {"code": "5735362", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 311.0, "discounted_cash": 233.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT WK HRD/COND ADDL HR", "code_information": [{"code": "97546", "type": "CPT"}, {"code": "6051616", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 311.0, "discounted_cash": 233.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT WK HRD/COND INIT 2 HR", "code_information": [{"code": "97545", "type": "CPT"}, {"code": "5735360", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 673.0, "discounted_cash": 504.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT WK HRD/COND INIT 2HR", "code_information": [{"code": "97545", "type": "CPT"}, {"code": "6051614", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 673.0, "discounted_cash": 504.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT WK HRD/COND INIT 2HR #2", "code_information": [{"code": "97545", "type": "CPT"}, {"code": "6050856", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 175.0, "discounted_cash": 131.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PTA AQUA THER W/EXER 15#2", "code_information": [{"code": "97113", "type": "CPT"}, {"code": "6050060", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 249.0, "discounted_cash": 186.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA AQUA THER W/EXER EA15", "code_information": [{"code": "97113", "type": "CPT"}, {"code": "6050059", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 210.0, "discounted_cash": 157.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA CPM INIT APPL EA15MN", "code_information": [{"code": "97039", "type": "CPT"}, {"code": "5700044", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 337.0, "discounted_cash": 252.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA E-STIM BASIC", "code_information": [{"code": "G0283", "type": "HCPCS"}, {"code": "5730022", "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 E-STIM BASIC", "code_information": [{"code": "G0283", "type": "HCPCS"}, {"code": "6050037", "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 GAIT/STR TRN EA 15", "code_information": [{"code": "97116", "type": "CPT"}, {"code": "5700053", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 395.0, "discounted_cash": 296.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA GAIT/STR TRN EA 15", "code_information": [{"code": "97116", "type": "CPT"}, {"code": "5730050", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 339.0, "discounted_cash": 254.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA GAIT/STR TRN EA 15MIN#2", "code_information": [{"code": "97116", "type": "CPT"}, {"code": "5700054", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 392.0, "discounted_cash": 294.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA GAIT/STR TRN EA15", "code_information": [{"code": "97116", "type": "CPT"}, {"code": "6050061", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 339.0, "discounted_cash": 254.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA INTRACRANIAL", "code_information": [{"code": "4915702", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 32611.0, "discounted_cash": 24458.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PTA INTRACRANIAL W/STENT", "code_information": [{"code": "4915704", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 36523.0, "discounted_cash": 27392.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PTA MANUAL THERAPY EA 15M", "code_information": [{"code": "97140", "type": "CPT"}, {"code": "5730054", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 439.0, "discounted_cash": 329.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA MANUAL THERAPY EA 15M", "code_information": [{"code": "97140", "type": "CPT"}, {"code": "6050065", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 417.0, "discounted_cash": 312.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA MECH TRACTION BSC", "code_information": [{"code": "97012", "type": "CPT"}, {"code": "5730023", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 355.0, "discounted_cash": 266.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA MECH TRACTION BSC", "code_information": [{"code": "97012", "type": "CPT"}, {"code": "6050038", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 355.0, "discounted_cash": 266.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA NEUROMUSC RE-ED EA15", "code_information": [{"code": "97112", "type": "CPT"}, {"code": "5730046", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 338.0, "discounted_cash": 253.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA NEUROMUSC RE-ED EA15", "code_information": [{"code": "97112", "type": "CPT"}, {"code": "6050056", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 339.0, "discounted_cash": 254.25, "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": 338.0, "discounted_cash": 253.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA SLF CARE/HM MGMT EA 15M #2", "code_information": [{"code": "97535", "type": "CPT"}, {"code": "6050072", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 173.0, "discounted_cash": 129.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA SLF CARE/HM MGMT EA15", "code_information": [{"code": "97535", "type": "CPT"}, {"code": "6050073", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 175.0, "discounted_cash": 131.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA SLF CR/HM MGMT EA 15", "code_information": [{"code": "97535", "type": "CPT"}, {"code": "5730064", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 175.0, "discounted_cash": 131.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA SLF CR/HM MGMT EA15#2", "code_information": [{"code": "97535", "type": "CPT"}, {"code": "5730065", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 173.0, "discounted_cash": 129.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA THER ACT EA 15", "code_information": [{"code": "97530", "type": "CPT"}, {"code": "6050070", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 402.0, "discounted_cash": 301.5, "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": 366.0, "discounted_cash": 274.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA THERAPEUTC ACT EA 15", "code_information": [{"code": "97530", "type": "CPT"}, {"code": "5730059", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 402.0, "discounted_cash": 301.5, "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": 402.0, "discounted_cash": 301.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA THERAPEUTC ACT EA15M #2", "code_information": [{"code": "97530", "type": "CPT"}, {"code": "5700064", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 402.0, "discounted_cash": 301.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA THERAPEUTC EXER EA15", "code_information": [{"code": "97110", "type": "CPT"}, {"code": "6050053", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 339.0, "discounted_cash": 254.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA THERAPEUTIC EXER EA15", "code_information": [{"code": "97110", "type": "CPT"}, {"code": "5730043", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 368.0, "discounted_cash": 276.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA THERAPTC MASSGE EA15", "code_information": [{"code": "97124", "type": "CPT"}, {"code": "6050064", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 162.0, "discounted_cash": 121.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA US EA 15 BSC", "code_information": [{"code": "97035", "type": "CPT"}, {"code": "5730040", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 146.0, "discounted_cash": 109.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA US EA15 BSC", "code_information": [{"code": "97035", "type": "CPT"}, {"code": "6050052", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 146.0, "discounted_cash": 109.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTH ANTIBODY", "code_information": [{"code": "83519", "type": "CPT"}, {"code": "7003978", "type": "CDM"}], "standard_charges": [{"gross_charge": 1312.0, "discounted_cash": 984.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PTH ANTIBODY/2", "code_information": [{"code": "83519", "type": "CPT"}, {"code": "7259381", "type": "CDM"}], "standard_charges": [{"gross_charge": 1312.0, "discounted_cash": 984.0, "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": 320.0, "discounted_cash": 240.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PTT", "code_information": [{"code": "85730", "type": "CPT"}, {"code": "4125700", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PTT", "code_information": [{"code": "85730", "type": "CPT"}, {"code": "4155700", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "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": 106.0, "discounted_cash": 79.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PTT SUB EA FRACTION", "code_information": [{"code": "85732", "type": "CPT"}, {"code": "4125732", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PTT SUB EA FRACTION/2", "code_information": [{"code": "85732", "type": "CPT"}, {"code": "7252732", "type": "CDM"}], "standard_charges": [{"gross_charge": 150.0, "discounted_cash": 112.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PTT SUB EA FRACTION/3", "code_information": [{"code": "85732", "type": "CPT"}, {"code": "7255617", "type": "CDM"}], "standard_charges": [{"gross_charge": 150.0, "discounted_cash": 112.5, "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": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PULSE OXIMETRY-INIT", "code_information": [{"code": "94760", "type": "CPT"}, {"code": "3110660", "type": "CDM"}, {"code": "460", "type": "RC"}], "standard_charges": [{"gross_charge": 191.0, "discounted_cash": 143.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PUNCT SHUNT TB/RESERV", "code_information": [{"code": "4901070", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4563.0, "discounted_cash": 3422.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PUTTY BN GRFT STRIP ATTRAX", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4021052", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5374.0, "discounted_cash": 4030.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PUTTY BN STRIP ATTRAX 10CC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4021051", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9399.0, "discounted_cash": 7049.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PUTTY DBM GRAFTON", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8134886", "type": "CDM"}], "standard_charges": [{"gross_charge": 9457.0, "discounted_cash": 7092.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PUTTY OP1 BMP7 3.5MG", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4014500", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 46201.0, "discounted_cash": 34650.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PYRAZINAMIDE 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310294", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PYRAZINAMIDE 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310294", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "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": 49.0, "discounted_cash": 36.75, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PYRIDOSTIGMINE10MG/2MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5323908", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 149.0, "discounted_cash": 111.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PYRIDOSTIGMINE180MGXRTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310301", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PYRIDOSTIGMINE180MGXRTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310301", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PYRIDOSTIGMNE60/5 25MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316220", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PYRIDOSTIGMNE60/5 25MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316220", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PYRIDOXINE 100MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5310332", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PYRIDOXINE 100MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5310332", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PYRIDOXINE 25MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5310324", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.32, "discounted_cash": 0.24, "setting": "both", "billing_class": "facility"}]}, {"description": "PYRIDOXINE 25MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5310324", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 0.32, "discounted_cash": 0.24, "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": 36.0, "discounted_cash": 27.0, "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": 36.0, "discounted_cash": 27.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "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": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PYRIDOXL PHOSPH VIT B6", "code_information": [{"code": "84207", "type": "CPT"}, {"code": "7004207", "type": "CDM"}], "standard_charges": [{"gross_charge": 1429.0, "discounted_cash": 1071.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PYRIDOXL PHOSPH VIT B6", "code_information": [{"code": "84207", "type": "CPT"}, {"code": "7254207", "type": "CDM"}], "standard_charges": [{"gross_charge": 1429.0, "discounted_cash": 1071.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PYRIMETHAMINE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310335", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 11.0, "discounted_cash": 8.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PYRIMETHAMINE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310335", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 11.0, "discounted_cash": 8.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PYRIMETHAMINE PER 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316228", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.26, "discounted_cash": 0.2, "setting": "both", "billing_class": "facility"}]}, {"description": "PYRIMETHAMINE PER 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316228", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 0.26, "discounted_cash": 0.2, "setting": "both", "billing_class": "facility"}]}, {"description": "PYRUVATE", "code_information": [{"code": "84210", "type": "CPT"}, {"code": "7004210", "type": "CDM"}], "standard_charges": [{"gross_charge": 895.0, "discounted_cash": 671.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PYRUVATE", "code_information": [{"code": "84210", "type": "CPT"}, {"code": "7254210", "type": "CDM"}], "standard_charges": [{"gross_charge": 895.0, "discounted_cash": 671.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PYRUVATE KINASE", "code_information": [{"code": "84220", "type": "CPT"}, {"code": "7254220", "type": "CDM"}], "standard_charges": [{"gross_charge": 162.0, "discounted_cash": 121.5, "setting": "both", "billing_class": "facility"}]}, {"description": "Q FEVER AB", "code_information": [{"code": "86638", "type": "CPT"}, {"code": "7016174", "type": "CDM"}], "standard_charges": [{"gross_charge": 657.0, "discounted_cash": 492.75, "setting": "both", "billing_class": "facility"}]}, {"description": "Q FEVER AB", "code_information": [{"code": "86638", "type": "CPT"}, {"code": "7256541", "type": "CDM"}], "standard_charges": [{"gross_charge": 657.0, "discounted_cash": 492.75, "setting": "both", "billing_class": "facility"}]}, {"description": "QUANT OF DRUG NES", "code_information": [{"code": "80299", "type": "CPT"}, {"code": "7046369", "type": "CDM"}], "standard_charges": [{"gross_charge": 719.0, "discounted_cash": 539.25, "setting": "both", "billing_class": "facility"}]}, {"description": "QUANT OF DRUG NES", "code_information": [{"code": "80299", "type": "CPT"}, {"code": "7250299", "type": "CDM"}], "standard_charges": [{"gross_charge": 252.0, "discounted_cash": 189.0, "setting": "both", "billing_class": "facility"}]}, {"description": "QUANT OF DRUG NES/3", "code_information": [{"code": "80299", "type": "CPT"}, {"code": "7004420", "type": "CDM"}], "standard_charges": [{"gross_charge": 512.0, "discounted_cash": 384.0, "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": 71.0, "discounted_cash": 53.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "QUETIAPINE 12.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310369", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "QUETIAPINE 12.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310369", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "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": 116.0, "discounted_cash": 87.0, "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": 116.0, "discounted_cash": 87.0, "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": 116.0, "discounted_cash": 87.0, "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": 116.0, "discounted_cash": 87.0, "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": 95.0, "discounted_cash": 71.25, "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": 95.0, "discounted_cash": 71.25, "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": 55.0, "discounted_cash": 41.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "QUETIAPINE 300MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310374", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 173.0, "discounted_cash": 129.75, "setting": "both", "billing_class": "facility"}]}, {"description": "QUETIAPINE 300MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310374", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 173.0, "discounted_cash": 129.75, "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": 126.0, "discounted_cash": 94.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 126.0, "discounted_cash": 94.5, "setting": "both", "billing_class": "facility"}]}, {"description": "QUETIAPINE 400MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310375", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 134.0, "discounted_cash": 100.5, "setting": "both", "billing_class": "facility"}]}, {"description": "QUETIAPINE 400MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310375", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 134.0, "discounted_cash": 100.5, "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": 147.0, "discounted_cash": 110.25, "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": 147.0, "discounted_cash": 110.25, "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": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "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": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "QUINAPRIL 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310398", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "QUINAPRIL 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310398", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "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": 48.0, "discounted_cash": 36.0, "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": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "QUINAPRIL 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310400", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "QUINAPRIL 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310400", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "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": 50.0, "discounted_cash": 37.5, "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": 50.0, "discounted_cash": 37.5, "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": 49.0, "discounted_cash": 36.75, "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": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "QUINIDINE", "code_information": [{"code": "80194", "type": "CPT"}, {"code": "4104230", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 225.0, "discounted_cash": 168.75, "setting": "both", "billing_class": "facility"}]}, {"description": "QUINIDINE", "code_information": [{"code": "80194", "type": "CPT"}, {"code": "4124230", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "QUINIDINE", "code_information": [{"code": "80194", "type": "CPT"}, {"code": "4154230", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 75.0, "discounted_cash": 56.25, "setting": "both", "billing_class": "facility"}]}, {"description": "QUINIDINE", "code_information": [{"code": "80194", "type": "CPT"}, {"code": "7254230", "type": "CDM"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "setting": "both", "billing_class": "facility"}]}, {"description": "QUINIDINE 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310447", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "QUINIDINE 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310447", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "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": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "QUINIDINE 300MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310455", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "QUINIDINE 300MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310455", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "QUINIDINE/DM10MG/20MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310460", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 87.75, "setting": "both", "billing_class": "facility"}]}, {"description": "QUINIDINE/DM10MG/20MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310460", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 87.75, "setting": "both", "billing_class": "facility"}]}, {"description": "QUININE", "code_information": [{"code": "84228", "type": "CPT"}, {"code": "7004228", "type": "CDM"}], "standard_charges": [{"gross_charge": 229.0, "discounted_cash": 171.75, "setting": "both", "billing_class": "facility"}]}, {"description": "QUININE 260MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310484", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "QUININE 260MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310484", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "QUININE 300MG CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5310481", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "QUININE 300MG CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5310481", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "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": 68.0, "discounted_cash": 51.0, "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": 2154.0, "discounted_cash": 1615.5, "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": 2154.0, "discounted_cash": 1615.5, "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": 2008.0, "discounted_cash": 1506.0, "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": 2008.0, "discounted_cash": 1506.0, "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": 3050.0, "discounted_cash": 2287.5, "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": 3050.0, "discounted_cash": 2287.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RAD SORCE SUPV HANDLG", "code_information": [{"code": "77790", "type": "CPT"}, {"code": "5107419", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 6622.0, "discounted_cash": 4966.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RAD TX DLVR>1MEV COMPLX", "code_information": [{"code": "77412", "type": "CPT"}, {"code": "5107744", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 3181.0, "discounted_cash": 2385.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RAD TX DLVR>1MEV INTER", "code_information": [{"code": "77407", "type": "CPT"}, {"code": "5107741", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 2795.0, "discounted_cash": 2096.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RAD TX DLVR>1MEV SIMPLE", "code_information": [{"code": "77402", "type": "CPT"}, {"code": "5107740", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 2149.0, "discounted_cash": 1611.75, "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": 0.01, "discounted_cash": 0.01, "setting": "both", "billing_class": "facility"}]}, {"description": "RADPHARM TX INTRA-ARTERL", "code_information": [{"code": "79445", "type": "CPT"}, {"code": "4919445", "type": "CDM"}, {"code": "342", "type": "RC"}], "standard_charges": [{"gross_charge": 2736.0, "discounted_cash": 2052.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RADPHARM TX INTRA-ARTERL", "code_information": [{"code": "79445", "type": "CPT"}, {"code": "5209445", "type": "CDM"}, {"code": "342", "type": "RC"}], "standard_charges": [{"gross_charge": 2736.0, "discounted_cash": 2052.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RADPHARM TX IV", "code_information": [{"code": "79101", "type": "CPT"}, {"code": "5209101", "type": "CDM"}, {"code": "342", "type": "RC"}], "standard_charges": [{"gross_charge": 1990.0, "discounted_cash": 1492.5, "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": 5417.0, "discounted_cash": 4062.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RADPHYSICS CONSULT P/WK", "code_information": [{"code": "77336", "type": "CPT"}, {"code": "5107336", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 2559.0, "discounted_cash": 1919.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RADPHYSICS SPEC CONSULT", "code_information": [{"code": "77370", "type": "CPT"}, {"code": "5107370", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 3223.0, "discounted_cash": 2417.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RADTHER SIMULATION CMPLX", "code_information": [{"code": "77290", "type": "CPT"}, {"code": "5107290", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 6043.0, "discounted_cash": 4532.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RADTHER SIMULATION INTER", "code_information": [{"code": "77285", "type": "CPT"}, {"code": "5107285", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 5163.0, "discounted_cash": 3872.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RADTHER SIMULATION SMPLE", "code_information": [{"code": "77280", "type": "CPT"}, {"code": "5107280", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 3078.0, "discounted_cash": 2308.5, "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": 62.0, "discounted_cash": 46.5, "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": 62.0, "discounted_cash": 46.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RALTEGRAVIR 400MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310493", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 219.0, "discounted_cash": 164.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RALTEGRAVIR 400MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310493", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 219.0, "discounted_cash": 164.25, "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": 36.0, "discounted_cash": 27.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RAMIPRIL 1.25MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310489", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RAMIPRIL 1.25MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310489", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RAMIPRIL 10MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310492", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RAMIPRIL 10MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310492", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "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": 46.0, "discounted_cash": 34.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RANITIDINE 150MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310505", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RANITIDINE 150MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310505", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RANITIDINE 300MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310506", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 75.0, "discounted_cash": 56.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RANITIDINE 300MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310506", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 75.0, "discounted_cash": 56.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RASAGILINE 0.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310524", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 120.0, "discounted_cash": 90.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RASAGILINE 0.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310524", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 120.0, "discounted_cash": 90.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RASAGILINE 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310525", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 120.0, "discounted_cash": 90.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RASAGILINE 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310525", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 120.0, "discounted_cash": 90.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RASBURICASE PER .5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2783", "type": "HCPCS"}, {"code": "5323996", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2143.0, "discounted_cash": 1607.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RASBURICASE PER .5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2783", "type": "HCPCS"}, {"code": "5323996", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 2143.0, "discounted_cash": 1607.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RATE ADJUSTMENT - ATB", "code_information": [{"code": "9970001", "type": "CDM"}], "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": 1711.0, "discounted_cash": 1283.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RBC AG EXCPT ABO/RHO EA", "code_information": [{"code": "86905", "type": "CPT"}, {"code": "4126095", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "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": 609.0, "discounted_cash": 456.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RBC ANTIBDY ELUTION EACH", "code_information": [{"code": "86860", "type": "CPT"}, {"code": "7016019", "type": "CDM"}], "standard_charges": [{"gross_charge": 737.0, "discounted_cash": 552.75, "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": 289.0, "discounted_cash": 216.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RBC ANTIBODIES SCREEN", "code_information": [{"code": "86850", "type": "CPT"}, {"code": "7016016", "type": "CDM"}], "standard_charges": [{"gross_charge": 411.0, "discounted_cash": 308.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RBC ANTIBODIES SCREEN", "code_information": [{"code": "86850", "type": "CPT"}, {"code": "7256305", "type": "CDM"}], "standard_charges": [{"gross_charge": 720.0, "discounted_cash": 540.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RBC AUTO", "code_information": [{"code": "85041", "type": "CPT"}, {"code": "7255041", "type": "CDM"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RBC L/R CMV IRR", "code_information": [{"code": "P9058", "type": "HCPCS"}, {"code": "4509058", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 1161.0, "discounted_cash": 870.75, "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": 1226.0, "discounted_cash": 919.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RBC WASHED AUTO", "code_information": [{"code": "P9022", "type": "HCPCS"}, {"code": "3219022", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 972.0, "discounted_cash": 729.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RBC WASHED AUTO", "code_information": [{"code": "P9022", "type": "HCPCS"}, {"code": "3309022", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 831.0, "discounted_cash": 623.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RBTCS AQUABM LV III INT 30 MIN", "code_information": [{"code": "3213598", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 14886.0, "discounted_cash": 11164.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RBTCS AQUABM LVL II EA 15 MIN", "code_information": [{"code": "3213597", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5485.0, "discounted_cash": 4113.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RBTCS AQUABM LVL II INT 30 MIN", "code_information": [{"code": "3213596", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 12925.0, "discounted_cash": 9693.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RBTCS AQUABM LVL III EA 15 MIN", "code_information": [{"code": "3213599", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6268.0, "discounted_cash": 4701.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RBTCS AQUABM LVL IV EA 15 MIN", "code_information": [{"code": "3213601", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7052.0, "discounted_cash": 5289.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RBTCS AQUABM LVL IV INT 30 MIN", "code_information": [{"code": "3213600", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 16845.0, "discounted_cash": 12633.75, "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": 5485.0, "discounted_cash": 4113.75, "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": 12925.0, "discounted_cash": 9693.75, "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": 6268.0, "discounted_cash": 4701.0, "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": 15333.0, "discounted_cash": 11499.75, "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": 7052.0, "discounted_cash": 5289.0, "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": 16845.0, "discounted_cash": 12633.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RBTCS GLOBUS LVL II EA 15 MIN", "code_information": [{"code": "3213585", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5485.0, "discounted_cash": 4113.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RBTCS GLOBUS LVL II INT 30 MIN", "code_information": [{"code": "3213584", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 12043.0, "discounted_cash": 9032.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RBTCS GLOBUS LVL III EA 15 MIN", "code_information": [{"code": "3213587", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6898.0, "discounted_cash": 5173.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RBTCS GLOBUS LVL IV EA 15 MIN", "code_information": [{"code": "3213589", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7052.0, "discounted_cash": 5289.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RBTCS GLOBUS LVL IV INT 30 MIN", "code_information": [{"code": "3213588", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 16845.0, "discounted_cash": 12633.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RBTCS GLOBUS LVLIII INT 30 MIN", "code_information": [{"code": "3213586", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 16375.0, "discounted_cash": 12281.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RBTCS ION LVL II EA 15 MIN", "code_information": [{"code": "3210021", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5485.0, "discounted_cash": 4113.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RBTCS ION LVL II INT 30 MIN", "code_information": [{"code": "3210020", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 12925.0, "discounted_cash": 9693.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RBTCS ION LVL III EA 15 MIN", "code_information": [{"code": "3210023", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6268.0, "discounted_cash": 4701.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RBTCS ION LVL III INT 30 MIN", "code_information": [{"code": "3210022", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 15333.0, "discounted_cash": 11499.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RBTCS MAKO LVL II EA 15 MIN", "code_information": [{"code": "3213561", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5485.0, "discounted_cash": 4113.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RBTCS MAKO LVL II INT 30 MIN", "code_information": [{"code": "3213560", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 12925.0, "discounted_cash": 9693.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RBTCS MAKO LVL III EA 15 MIN", "code_information": [{"code": "3213563", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6268.0, "discounted_cash": 4701.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RBTCS MAKO LVL III INT 30 MIN", "code_information": [{"code": "3213562", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 14886.0, "discounted_cash": 11164.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RBTCS MAKO LVL IV EA 15 MIN", "code_information": [{"code": "3213565", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7052.0, "discounted_cash": 5289.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RBTCS MAKO LVL IV INT 30 MIN", "code_information": [{"code": "3213564", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 16845.0, "discounted_cash": 12633.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RBTCS MAZR LVL II EA 15 MIN", "code_information": [{"code": "3213567", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5485.0, "discounted_cash": 4113.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RBTCS MAZR LVL II INT 30 MIN", "code_information": [{"code": "3213566", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 12925.0, "discounted_cash": 9693.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RBTCS MAZR LVL III EA 15 MIN", "code_information": [{"code": "3213569", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6898.0, "discounted_cash": 5173.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RBTCS MAZR LVL III INT 30 MIN", "code_information": [{"code": "3213568", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 16375.0, "discounted_cash": 12281.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RBTCS MAZR LVL IV EA 15 MIN", "code_information": [{"code": "3213571", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3795.0, "discounted_cash": 2846.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RBTCS MAZR LVL IV INT 30 MIN", "code_information": [{"code": "3213570", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 9062.0, "discounted_cash": 6796.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RCRDR LOOP REVEAL", "code_information": [{"code": "C1764", "type": "HCPCS"}, {"code": "4001500", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 30811.0, "discounted_cash": 23108.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RD CARBON", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8135003", "type": "CDM"}], "standard_charges": [{"gross_charge": 861.0, "discounted_cash": 645.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RD SPINAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8135030", "type": "CDM"}], "standard_charges": [{"gross_charge": 1382.0, "discounted_cash": 1036.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RD SPINAL 1", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8135035", "type": "CDM"}], "standard_charges": [{"gross_charge": 3334.0, "discounted_cash": 2500.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RD TYPE I", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8135002", "type": "CDM"}], "standard_charges": [{"gross_charge": 4265.0, "discounted_cash": 3198.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RECEPT ASSAY NON-ENDOCRN/2", "code_information": [{"code": "84238", "type": "CPT"}, {"code": "7254451", "type": "CDM"}], "standard_charges": [{"gross_charge": 1201.0, "discounted_cash": 900.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RECEPT ASSAY NON-ENDOCRN/4", "code_information": [{"code": "84238", "type": "CPT"}, {"code": "7254453", "type": "CDM"}], "standard_charges": [{"gross_charge": 1056.0, "discounted_cash": 792.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RECEPT ASSAY NON-ENDOCRN/5", "code_information": [{"code": "84238", "type": "CPT"}, {"code": "7006685", "type": "CDM"}], "standard_charges": [{"gross_charge": 1201.0, "discounted_cash": 900.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RECEPT ASSAY NON-ENDOCRN/7", "code_information": [{"code": "84238", "type": "CPT"}, {"code": "7258443", "type": "CDM"}], "standard_charges": [{"gross_charge": 193.0, "discounted_cash": 144.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RECORDER EVENT CARDIAC", "code_information": [{"code": "C1764", "type": "HCPCS"}, {"code": "8240369", "type": "CDM"}], "standard_charges": [{"gross_charge": 17280.0, "discounted_cash": 12960.0, "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": 1812.0, "discounted_cash": 1359.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RECOVERY INIT 30 MIN", "code_information": [{"code": "3223570", "type": "CDM"}, {"code": "710", "type": "RC"}], "standard_charges": [{"gross_charge": 5357.0, "discounted_cash": 4017.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RECTAL SENSATION TEST", "code_information": [{"code": "91120", "type": "CPT"}, {"code": "6211120", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 1135.0, "discounted_cash": 851.25, "setting": "both", "billing_class": "facility"}]}, {"description": "REFILL IMP PMP/RSV SYST", "code_information": [{"code": "96522", "type": "CPT"}, {"code": "6923000", "type": "CDM"}], "standard_charges": [{"gross_charge": 617.0, "discounted_cash": 462.75, "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": 665.0, "discounted_cash": 498.75, "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": 665.0, "discounted_cash": 498.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RELOCATE SKIN PKT AICD", "code_information": [{"code": "4613223", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 9712.0, "discounted_cash": 7284.0, "setting": "both", "billing_class": "facility"}]}, {"description": "REM AICD LDS TRANSVEN", "code_information": [{"code": "4613243", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 18184.0, "discounted_cash": 13638.0, "setting": "both", "billing_class": "facility"}]}, {"description": "REM AICD PULS GEN", "code_information": [{"code": "4613241", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 12429.0, "discounted_cash": 9321.75, "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": 35833.0, "discounted_cash": 26874.75, "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": 32194.0, "discounted_cash": 24145.5, "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": 2920.0, "discounted_cash": 2190.0, "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": 4581.0, "discounted_cash": 3435.75, "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": 12426.0, "discounted_cash": 9319.5, "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": 16229.0, "discounted_cash": 12171.75, "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": 4380.0, "discounted_cash": 3285.0, "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": 6805.0, "discounted_cash": 5103.75, "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": 12729.0, "discounted_cash": 9546.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REM TUNNLD INTRAPER CATH", "code_information": [{"code": "4919422", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 21898.0, "discounted_cash": 16423.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REM TUNNLD PLEURL CATH", "code_information": [{"code": "4910025", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6440.0, "discounted_cash": 4830.0, "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": 471515.0, "discounted_cash": 353636.25, "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": 471515.0, "discounted_cash": 353636.25, "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": 492627.0, "discounted_cash": 369470.25, "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": 150456.0, "discounted_cash": 112842.0, "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": 137178.0, "discounted_cash": 102883.5, "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": 149037.0, "discounted_cash": 111777.75, "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": "REMIFENTANIL 1MG/3ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5327960", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 371.0, "discounted_cash": 278.25, "setting": "both", "billing_class": "facility"}]}, {"description": "REMIFENTANIL 2MG/5ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5327961", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 698.0, "discounted_cash": 523.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REMOVAL OF NAIL BED", "code_information": [{"code": "6900034", "type": "CDM"}], "standard_charges": [{"gross_charge": 3285.0, "discounted_cash": 2463.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REMOVE BILI DRAIN CATH", "code_information": [{"code": "4917537", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4573.0, "discounted_cash": 3429.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REMOVE FOREIGN BODY COMPLEX", "code_information": [{"code": "4910121", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 10289.0, "discounted_cash": 7716.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REMOVE FOREIGN BODY COMPLEX", "code_information": [{"code": "6900121", "type": "CDM"}], "standard_charges": [{"gross_charge": 10289.0, "discounted_cash": 7716.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REMOVE SINGLE NAIL PLATE", "code_information": [{"code": "6900033", "type": "CDM"}], "standard_charges": [{"gross_charge": 1785.0, "discounted_cash": 1338.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REMOVE URETER STENT PERC", "code_information": [{"code": "4917528", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 12683.0, "discounted_cash": 9512.25, "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": 4309.0, "discounted_cash": 3231.75, "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": 584.0, "discounted_cash": 438.0, "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": 632.0, "discounted_cash": 474.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RENAL FUNCTION PANEL", "code_information": [{"code": "80069", "type": "CPT"}, {"code": "4120069", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RENAL FUNCTION PANEL", "code_information": [{"code": "80069", "type": "CPT"}, {"code": "4150069", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RENIN", "code_information": [{"code": "84244", "type": "CPT"}, {"code": "7004244", "type": "CDM"}], "standard_charges": [{"gross_charge": 1585.0, "discounted_cash": 1188.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RENIN", "code_information": [{"code": "84244", "type": "CPT"}, {"code": "7258424", "type": "CDM"}], "standard_charges": [{"gross_charge": 1585.0, "discounted_cash": 1188.75, "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": 19.0, "discounted_cash": 14.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "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": 16.0, "discounted_cash": 12.0, "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": 16.0, "discounted_cash": 12.0, "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": 19.0, "discounted_cash": 14.25, "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": 19.0, "discounted_cash": 14.25, "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": 2056.0, "discounted_cash": 1542.0, "setting": "both", "billing_class": "facility"}]}, {"description": "REPAIR OF NAIL BED", "code_information": [{"code": "6900139", "type": "CDM"}], "standard_charges": [{"gross_charge": 4114.0, "discounted_cash": 3085.5, "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": 5218.0, "discounted_cash": 3913.5, "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": 5218.0, "discounted_cash": 3913.5, "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": 5218.0, "discounted_cash": 3913.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REPLACE TUNNELED CV CATH", "code_information": [{"code": "4916581", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 11804.0, "discounted_cash": 8853.0, "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": 3279.0, "discounted_cash": 2459.25, "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": 1873.0, "discounted_cash": 1404.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REPR THOR AORTA N SUBCLV", "code_information": [{"code": "4613881", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 44636.0, "discounted_cash": 33477.0, "setting": "both", "billing_class": "facility"}]}, {"description": "REPR THOR AORTA N SUBCLV", "code_information": [{"code": "4912402", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 9558.0, "discounted_cash": 7168.5, "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": 13582.0, "discounted_cash": 10186.5, "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": 10027.0, "discounted_cash": 7520.25, "setting": "both", "billing_class": "facility"}]}, {"description": "REPTILASE TEST", "code_information": [{"code": "85635", "type": "CPT"}, {"code": "7005635", "type": "CDM"}], "standard_charges": [{"gross_charge": 332.0, "discounted_cash": 249.0, "setting": "both", "billing_class": "facility"}]}, {"description": "REPTILASE TEST", "code_information": [{"code": "85635", "type": "CPT"}, {"code": "7255635", "type": "CDM"}], "standard_charges": [{"gross_charge": 1389.0, "discounted_cash": 1041.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RESERV CLOVERLEAF TITAN", "code_information": [{"code": "C1813", "type": "HCPCS"}, {"code": "8155033", "type": "CDM"}], "standard_charges": [{"gross_charge": 11865.0, "discounted_cash": 8898.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RESERV PENL PROSTH FLAT", "code_information": [{"code": "C1813", "type": "HCPCS"}, {"code": "8155034", "type": "CDM"}], "standard_charges": [{"gross_charge": 13562.0, "discounted_cash": 10171.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RESP VIRUS 3-5 AMP PROBE", "code_information": [{"code": "87631", "type": "CPT"}, {"code": "4107631", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1127.0, "discounted_cash": 845.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RESPI SYNC VIRUS DIR OPT", "code_information": [{"code": "87807", "type": "CPT"}, {"code": "7250025", "type": "CDM"}], "standard_charges": [{"gross_charge": 252.0, "discounted_cash": 189.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RESPIRATORY MOT MGMT SIM", "code_information": [{"code": "77293", "type": "CPT"}, {"code": "5107293", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 2809.0, "discounted_cash": 2106.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RETAPAMULIN 1% 5G OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337159", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 450.0, "discounted_cash": 337.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RETAPAMULIN 1% 5G OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337159", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 450.0, "discounted_cash": 337.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RETEPLASE PER18.1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2993", "type": "HCPCS"}, {"code": "5323980", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 27928.0, "discounted_cash": 20946.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RETEPLASE PER18.1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2993", "type": "HCPCS"}, {"code": "5323980", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 27928.0, "discounted_cash": 20946.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RETICULIN AB", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "7256935", "type": "CDM"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RETICULIN AB/2", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "7258670", "type": "CDM"}], "standard_charges": [{"gross_charge": 629.0, "discounted_cash": 471.75, "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": 315.0, "discounted_cash": 236.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RETICULOCYTE COUNT AUTO", "code_information": [{"code": "85045", "type": "CPT"}, {"code": "4125045", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RETICULOCYTE COUNT AUTO", "code_information": [{"code": "85045", "type": "CPT"}, {"code": "4155045", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 106.0, "discounted_cash": 79.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RETRIEVER VASCULR 4-LOOP", "code_information": [{"code": "C1773", "type": "HCPCS"}, {"code": "8184821", "type": "CDM"}], "standard_charges": [{"gross_charge": 4243.0, "discounted_cash": 3182.25, "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": 59682.0, "discounted_cash": 44761.5, "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": 68286.0, "discounted_cash": 51214.5, "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": 71701.0, "discounted_cash": 53775.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC FEMPOP STNT ATHER", "code_information": [{"code": "4610235", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 71167.0, "discounted_cash": 53375.25, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC FEMPOP STNT ATHER", "code_information": [{"code": "4918182", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 72718.0, "discounted_cash": 54538.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC FEMPOP W/ATHER", "code_information": [{"code": "4610233", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 65599.0, "discounted_cash": 49199.25, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC FEMPOP W/ATHER", "code_information": [{"code": "4918180", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 35700.0, "discounted_cash": 26775.0, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC FEMPOP W/STENT", "code_information": [{"code": "4610231", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 69056.0, "discounted_cash": 51792.0, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC FEMPOP W/STENT", "code_information": [{"code": "4918178", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 69056.0, "discounted_cash": 51792.0, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC FEMPOP W/TLA", "code_information": [{"code": "4610229", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 33568.0, "discounted_cash": 25176.0, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC FEMPOP W/TLA", "code_information": [{"code": "4918176", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 33568.0, "discounted_cash": 25176.0, "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": 66912.0, "discounted_cash": 50184.0, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC ILI W/STENT ADD/O", "code_information": [{"code": "4918174", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 61573.0, "discounted_cash": 46179.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC ILIAC ADD ON", "code_information": [{"code": "4610223", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 40889.0, "discounted_cash": 30666.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC ILIAC ADD ON", "code_information": [{"code": "4918170", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 41877.0, "discounted_cash": 31407.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC ILIAC INITIAL", "code_information": [{"code": "4610221", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 33427.0, "discounted_cash": 25070.25, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC ILIAC INITIAL", "code_information": [{"code": "4918168", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 33427.0, "discounted_cash": 25070.25, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC ILIAC W/STENT", "code_information": [{"code": "4610225", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 71814.0, "discounted_cash": 53860.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC ILIAC W/STENT", "code_information": [{"code": "4918172", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 71814.0, "discounted_cash": 53860.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC INSTRAVASC LITHO+PLASTY", "code_information": [{"code": "4919772", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 36755.0, "discounted_cash": 27566.25, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC INTRAVASC LITHO+ATHER", "code_information": [{"code": "4619766", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 94621.0, "discounted_cash": 70965.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC INTRAVASC LITHO+ATHER", "code_information": [{"code": "4619774", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 94621.0, "discounted_cash": 70965.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC INTRAVASC LITHO+ATHER", "code_information": [{"code": "4919766", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 53220.0, "discounted_cash": 39915.0, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC INTRAVASC LITHO+ATHER", "code_information": [{"code": "4919774", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 62165.0, "discounted_cash": 46623.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC INTRAVASC LITHO+PLASTY", "code_information": [{"code": "4619772", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 59179.0, "discounted_cash": 44384.25, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC INTRAVASC LITHO+STENT", "code_information": [{"code": "4619765", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 94621.0, "discounted_cash": 70965.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC INTRAVASC LITHO+STENT", "code_information": [{"code": "4919765", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 50732.0, "discounted_cash": 38049.0, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC INTRAVASC LITHO+STNT", "code_information": [{"code": "4619773", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 94621.0, "discounted_cash": 70965.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC INTRAVASC LITHO+STNT", "code_information": [{"code": "4919773", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 57248.0, "discounted_cash": 42936.0, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC INTRAVASC LITHOTRIP", "code_information": [{"code": "4619764", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 59179.0, "discounted_cash": 44384.25, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC INTRAVASC LITHOTRIP", "code_information": [{"code": "4919764", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 31181.0, "discounted_cash": 23385.75, "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": 94621.0, "discounted_cash": 70965.75, "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": 94621.0, "discounted_cash": 70965.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC INTVASC LITH+STNT+ATHER", "code_information": [{"code": "4919767", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 61790.0, "discounted_cash": 46342.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC INTVASC LITH+STNT+ATHER", "code_information": [{"code": "4919775", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 57593.0, "discounted_cash": 43194.75, "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": 43907.0, "discounted_cash": 32930.25, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC TIB PER ADD ON", "code_information": [{"code": "4918186", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 46103.0, "discounted_cash": 34577.25, "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": 57290.0, "discounted_cash": 42967.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC TIBPER W/ATHER", "code_information": [{"code": "4610241", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 60193.0, "discounted_cash": 45144.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC TIBPER W/ATHER", "code_information": [{"code": "4918188", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 72803.0, "discounted_cash": 54602.25, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC TIBPER W/STENT", "code_information": [{"code": "4610245", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 82502.0, "discounted_cash": 61876.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC TIBPER W/TLA", "code_information": [{"code": "4610237", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 39345.0, "discounted_cash": 29508.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC TIBPER W/TLA", "code_information": [{"code": "4918184", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 39345.0, "discounted_cash": 29508.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC TIBPER WSTENTADD", "code_information": [{"code": "4610247", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 87055.0, "discounted_cash": 65291.25, "setting": "both", "billing_class": "facility"}]}, {"description": "REVERSE T3", "code_information": [{"code": "84482", "type": "CPT"}, {"code": "7004905", "type": "CDM"}], "standard_charges": [{"gross_charge": 1082.0, "discounted_cash": 811.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REVERSE T3", "code_information": [{"code": "84482", "type": "CPT"}, {"code": "7254905", "type": "CDM"}], "standard_charges": [{"gross_charge": 1082.0, "discounted_cash": 811.5, "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": 7780.0, "discounted_cash": 5835.0, "setting": "both", "billing_class": "facility"}]}, {"description": "REVSN/REPLCE PERC NEURO ELECT", "code_information": [{"code": "4913663", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 44984.0, "discounted_cash": 33738.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RF ABLATION LYMPH NODE", "code_information": [{"code": "38999", "type": "CPT"}, {"code": "5010104", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 15202.0, "discounted_cash": 11401.5, "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": 702.0, "discounted_cash": 526.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RHEUMATOID FACTOR QUANT", "code_information": [{"code": "86431", "type": "CPT"}, {"code": "4126432", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RHEUMATOID FACTOR QUANT", "code_information": [{"code": "86431", "type": "CPT"}, {"code": "4156432", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 194.0, "discounted_cash": 145.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RHO(D) IG IM PER 50MCGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2788", "type": "HCPCS"}, {"code": "5324011", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 470.0, "discounted_cash": 352.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RHO(D) IG IM PER 50MCGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2788", "type": "HCPCS"}, {"code": "5324011", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 470.0, "discounted_cash": 352.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RHO(D) IG IV PER100U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2792", "type": "HCPCS"}, {"code": "5321354", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 366.0, "discounted_cash": 274.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RHO(D) IG IV PER100U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2792", "type": "HCPCS"}, {"code": "5321354", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 366.0, "discounted_cash": 274.5, "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": 85.0, "discounted_cash": 63.75, "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": 85.0, "discounted_cash": 63.75, "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": 847.0, "discounted_cash": 635.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RIA NONANTIBODY/3", "code_information": [{"code": "83519", "type": "CPT"}, {"code": "7004231", "type": "CDM"}], "standard_charges": [{"gross_charge": 1056.0, "discounted_cash": 792.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RIBAVIRIN 200MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310630", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 138.0, "discounted_cash": 103.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RIBAVIRIN 200MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310630", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 138.0, "discounted_cash": 103.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RIBOFLAVIN(VITAMIN B2)", "code_information": [{"code": "84252", "type": "CPT"}, {"code": "7254252", "type": "CDM"}], "standard_charges": [{"gross_charge": 915.0, "discounted_cash": 686.25, "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": 2377.0, "discounted_cash": 1782.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RIBS BI 4V MIN W/PA CXR", "code_information": [{"code": "71111", "type": "CPT"}, {"code": "5011111", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2479.0, "discounted_cash": 1859.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RIBS BI 4V MIN W/PA CXR", "code_information": [{"code": "71111", "type": "CPT"}, {"code": "5111111", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2694.0, "discounted_cash": 2020.5, "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": 1912.0, "discounted_cash": 1434.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RIBS BILAT 3VW MIN", "code_information": [{"code": "71110", "type": "CPT"}, {"code": "5011110", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1912.0, "discounted_cash": 1434.0, "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": 2056.0, "discounted_cash": 1542.0, "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": 1912.0, "discounted_cash": 1434.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RIBS UNI 3V MIN W/PA CXR", "code_information": [{"code": "71101", "type": "CPT"}, {"code": "5011101", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1848.0, "discounted_cash": 1386.0, "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": 2056.0, "discounted_cash": 1542.0, "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": 1590.0, "discounted_cash": 1192.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RIBS UNILAT 2VW", "code_information": [{"code": "71100", "type": "CPT"}, {"code": "5011100", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1590.0, "discounted_cash": 1192.5, "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": 1896.0, "discounted_cash": 1422.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RICKETTSIA AB", "code_information": [{"code": "86757", "type": "CPT"}, {"code": "7006747", "type": "CDM"}], "standard_charges": [{"gross_charge": 1109.0, "discounted_cash": 831.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RICKETTSIA AB/2", "code_information": [{"code": "86757", "type": "CPT"}, {"code": "7256437", "type": "CDM"}], "standard_charges": [{"gross_charge": 1109.0, "discounted_cash": 831.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RICKETTSIA AB/3", "code_information": [{"code": "86757", "type": "CPT"}, {"code": "7256439", "type": "CDM"}], "standard_charges": [{"gross_charge": 1109.0, "discounted_cash": 831.75, "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": 120.0, "discounted_cash": 90.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 120.0, "discounted_cash": 90.0, "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": 29.0, "discounted_cash": 21.75, "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": 29.0, "discounted_cash": 21.75, "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": 71.0, "discounted_cash": 53.25, "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": 71.0, "discounted_cash": 53.25, "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": "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": 55.0, "discounted_cash": 41.25, "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": 55.0, "discounted_cash": 41.25, "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": 306.0, "discounted_cash": 229.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 306.0, "discounted_cash": 229.5, "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": 338.4, "discounted_cash": 253.8, "setting": "both", "billing_class": "facility"}]}, {"description": "RILPIVIRINE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310628", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 264.0, "discounted_cash": 198.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RILPIVIRINE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310628", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 264.0, "discounted_cash": 198.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RING CAPSULAR TENSION", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8123700", "type": "CDM"}], "standard_charges": [{"gross_charge": 2226.0, "discounted_cash": 1669.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RINGERS 1000ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412605", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 407.0, "discounted_cash": 305.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RINGERS 500ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412600", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 244.0, "discounted_cash": 183.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RISPERIDONE", "code_information": [{"code": "80342", "type": "CPT"}, {"code": "7258029", "type": "CDM"}], "standard_charges": [{"gross_charge": 477.0, "discounted_cash": 357.75, "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": 77.0, "discounted_cash": 57.75, "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": 77.0, "discounted_cash": 57.75, "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": 101.0, "discounted_cash": 75.75, "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": 101.0, "discounted_cash": 75.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "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": 77.0, "discounted_cash": 57.75, "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": 47.0, "discounted_cash": 35.25, "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": 47.0, "discounted_cash": 35.25, "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": 1265.0, "discounted_cash": 948.75, "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": 1265.0, "discounted_cash": 948.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RISPERIDONE 1M/M 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316235", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 69.0, "discounted_cash": 51.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RISPERIDONE 1M/M 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316235", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 69.0, "discounted_cash": 51.75, "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": 118.0, "discounted_cash": 88.5, "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": 118.0, "discounted_cash": 88.5, "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": 77.0, "discounted_cash": 57.75, "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": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RISPERIDONE 2MG DT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310635", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 191.0, "discounted_cash": 143.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RISPERIDONE 2MG DT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310635", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 191.0, "discounted_cash": 143.25, "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": 90.0, "discounted_cash": 67.5, "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": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RISPERIDONE 3MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310653", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RISPERIDONE 3MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310653", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "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": 143.0, "discounted_cash": 107.25, "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": 143.0, "discounted_cash": 107.25, "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": 64.0, "discounted_cash": 48.0, "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": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RISPERIDONE QUANT", "code_information": [{"code": "80342", "type": "CPT"}, {"code": "7004243", "type": "CDM"}], "standard_charges": [{"gross_charge": 477.0, "discounted_cash": 357.75, "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": 75.0, "discounted_cash": 56.25, "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": 75.0, "discounted_cash": 56.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RITONAVIR 100 MG PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310710", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 80.0, "discounted_cash": 60.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RITONAVIR 100 MG PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310710", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 80.0, "discounted_cash": 60.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RITONAVIR 100 MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310639", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RITONAVIR 100 MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310639", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RITUXIMAB PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9312", "type": "HCPCS"}, {"code": "5324007", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 718.0, "discounted_cash": 538.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RITUXIMAB PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9312", "type": "HCPCS"}, {"code": "5324007", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 718.0, "discounted_cash": 538.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RITUXIMAB-ABBS PER 10MG IJ", "code_information": [{"code": "Q5115", "type": "HCPCS"}, {"code": "5324002", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 600.0, "discounted_cash": 450.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RITUXIMAB-ABBS PER 10MG IJ", "code_information": [{"code": "Q5115", "type": "HCPCS"}, {"code": "5324002", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 600.0, "discounted_cash": 450.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RITUXIMAB-PVVR PER 10MG IJ", "code_information": [{"code": "Q5119", "type": "HCPCS"}, {"code": "5324006", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 443.0, "discounted_cash": 332.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RITUXIMAB-PVVR PER 10MG IJ", "code_information": [{"code": "Q5119", "type": "HCPCS"}, {"code": "5324006", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 443.0, "discounted_cash": 332.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RIVAROXABAN", "code_information": [{"code": "80299", "type": "CPT"}, {"code": "7070314", "type": "CDM"}], "standard_charges": [{"gross_charge": 3036.0, "discounted_cash": 2277.0, "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": 95.0, "discounted_cash": 71.25, "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": 95.0, "discounted_cash": 71.25, "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": 102.0, "discounted_cash": 76.5, "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": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RIVAROXABAN 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310624", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RIVAROXABAN 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310624", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 94.0, "discounted_cash": 70.5, "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": 94.0, "discounted_cash": 70.5, "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": 64.0, "discounted_cash": 48.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RIVASTIGMINE 13.3MG TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337162", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 122.0, "discounted_cash": 91.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RIVASTIGMINE 13.3MG TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337162", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 122.0, "discounted_cash": 91.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RIVASTIGMINE 4.5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310667", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RIVASTIGMINE 4.5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310667", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RIVASTIGMINE 4.6MG TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338009", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 82.0, "discounted_cash": 61.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RIVASTIGMINE 4.6MG TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338009", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 82.0, "discounted_cash": 61.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RIVASTIGMINE 9.5MG TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338010", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 82.0, "discounted_cash": 61.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RIVASTIGMINE 9.5MG TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338010", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 82.0, "discounted_cash": 61.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RMV STNT VIA TRANSUR", "code_information": [{"code": "4910386", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6417.0, "discounted_cash": 4812.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RMV TUNLD CVAD W SQ PORT", "code_information": [{"code": "4616590", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 10947.0, "discounted_cash": 8210.25, "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": 9953.0, "discounted_cash": 7464.75, "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": 4225.0, "discounted_cash": 3168.75, "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": 643.0, "discounted_cash": 482.25, "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": 222.0, "discounted_cash": 166.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ROD EXT CURVED CARBON FIBER", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8135052", "type": "CDM"}], "standard_charges": [{"gross_charge": 2015.0, "discounted_cash": 1511.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ROPINIROLE 0.25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310675", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 29.0, "discounted_cash": 21.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ROPINIROLE 0.25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310675", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 29.0, "discounted_cash": 21.75, "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": 29.0, "discounted_cash": 21.75, "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": 29.0, "discounted_cash": 21.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ROPINIROLE 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310677", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 29.0, "discounted_cash": 21.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ROPINIROLE 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310677", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 29.0, "discounted_cash": 21.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ROPINIROLE 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310678", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 29.0, "discounted_cash": 21.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ROPINIROLE 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310678", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 29.0, "discounted_cash": 21.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ROPINIROLE 3MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310688", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 29.0, "discounted_cash": 21.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ROPINIROLE 3MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310688", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 29.0, "discounted_cash": 21.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ROPINIROLE 4MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310682", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 29.0, "discounted_cash": 21.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ROPINIROLE 4MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310682", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 29.0, "discounted_cash": 21.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ROPINIROLE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310679", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 29.0, "discounted_cash": 21.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ROPINIROLE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310679", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 29.0, "discounted_cash": 21.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ROPIVACAIN EPID PER1MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5324054", "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ROSIGLITAZONE 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310662", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ROSIGLITAZONE 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310662", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ROSIGLITAZONE 4MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310663", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ROSIGLITAZONE 4MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310663", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ROSIGLITAZONE 8MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310664", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 105.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ROSIGLITAZONE 8MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310664", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 105.75, "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": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ROSUVASTATIN 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310694", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ROSUVASTATIN 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310694", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ROSUVASTATIN 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310695", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ROSUVASTATIN 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310695", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ROSUVASTATIN 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310692", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ROSUVASTATIN 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310692", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ROTAVIRUS IA", "code_information": [{"code": "87425", "type": "CPT"}, {"code": "7256318", "type": "CDM"}], "standard_charges": [{"gross_charge": 436.0, "discounted_cash": 327.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ROTAVIRUS VAC PNTV3DS LQ", "code_information": [{"code": "90680", "type": "CPT"}, {"code": "5324048", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 665.0, "discounted_cash": 498.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ROTAVIRUS VAC PNTV3DS LQ", "code_information": [{"code": "90680", "type": "CPT"}, {"code": "5324048", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 665.0, "discounted_cash": 498.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ROTOVIRUS AB", "code_information": [{"code": "86759", "type": "CPT"}, {"code": "7006759", "type": "CDM"}], "standard_charges": [{"gross_charge": 436.0, "discounted_cash": 327.0, "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": 8466.0, "discounted_cash": 6349.5, "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": 12582.6, "discounted_cash": 9436.95, "setting": "both", "billing_class": "facility"}]}, {"description": "RPR SMPL NONFACE 2.6-7.5", "code_information": [{"code": "6909895", "type": "CDM"}], "standard_charges": [{"gross_charge": 1425.0, "discounted_cash": 1068.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RPR SMPL NONFACE 7.6-12.", "code_information": [{"code": "6909890", "type": "CDM"}], "standard_charges": [{"gross_charge": 1425.0, "discounted_cash": 1068.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RPR SMPL NONFACE <2.6CM", "code_information": [{"code": "6909891", "type": "CDM"}], "standard_charges": [{"gross_charge": 1425.0, "discounted_cash": 1068.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RSV AG DFA", "code_information": [{"code": "87280", "type": "CPT"}, {"code": "7257280", "type": "CDM"}], "standard_charges": [{"gross_charge": 252.0, "discounted_cash": 189.0, "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": 147.0, "discounted_cash": 110.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RSV IA", "code_information": [{"code": "87420", "type": "CPT"}, {"code": "7006199", "type": "CDM"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RT CPR", "code_information": [{"code": "92950", "type": "CPT"}, {"code": "3110690", "type": "CDM"}, {"code": "410", "type": "RC"}], "standard_charges": [{"gross_charge": 2005.0, "discounted_cash": 1503.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RT GONADAL FLUORO", "code_information": [{"code": "76496", "type": "CPT"}, {"code": "4916496", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1812.0, "discounted_cash": 1359.0, "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": 9701.0, "discounted_cash": 7275.75, "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": 683.0, "discounted_cash": 512.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RUBELLA AB", "code_information": [{"code": "86762", "type": "CPT"}, {"code": "4126318", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RUBELLA AB", "code_information": [{"code": "86762", "type": "CPT"}, {"code": "4156318", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 191.0, "discounted_cash": 143.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RUBELLA AB/2", "code_information": [{"code": "86762", "type": "CPT"}, {"code": "7256324", "type": "CDM"}], "standard_charges": [{"gross_charge": 549.0, "discounted_cash": 411.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RUBELLA AB/3", "code_information": [{"code": "86762", "type": "CPT"}, {"code": "7256762", "type": "CDM"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "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": 931.0, "discounted_cash": 698.25, "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": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RUBEOLA AB", "code_information": [{"code": "86765", "type": "CPT"}, {"code": "7256715", "type": "CDM"}], "standard_charges": [{"gross_charge": 23.0, "discounted_cash": 17.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RUBEOLA AB/5", "code_information": [{"code": "86765", "type": "CPT"}, {"code": "7256806", "type": "CDM"}], "standard_charges": [{"gross_charge": 23.0, "discounted_cash": 17.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RUFINAMIDE 400MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310698", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 82.0, "discounted_cash": 61.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RUFINAMIDE 400MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310698", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 82.0, "discounted_cash": 61.5, "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": 435.0, "discounted_cash": 326.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RUSSL VIPR VEN TIME DIL", "code_information": [{"code": "85613", "type": "CPT"}, {"code": "4125613", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RUSSL VIPR VEN TIME DIL", "code_information": [{"code": "85613", "type": "CPT"}, {"code": "7255613", "type": "CDM"}], "standard_charges": [{"gross_charge": 177.0, "discounted_cash": 132.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RUSSL VIPR VEN TIME DIL/4", "code_information": [{"code": "85613", "type": "CPT"}, {"code": "7255619", "type": "CDM"}], "standard_charges": [{"gross_charge": 177.0, "discounted_cash": 132.75, "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": 585.0, "discounted_cash": 438.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SACROILIAC JOINTS 3 VWS", "code_information": [{"code": "72202", "type": "CPT"}, {"code": "5012202", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 585.0, "discounted_cash": 438.75, "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": 679.0, "discounted_cash": 509.25, "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": 1602.0, "discounted_cash": 1201.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SACRUM COCCYX 2 VWS", "code_information": [{"code": "72220", "type": "CPT"}, {"code": "5012220", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1602.0, "discounted_cash": 1201.5, "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": 1778.0, "discounted_cash": 1333.5, "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": 70.0, "discounted_cash": 52.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "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": 70.0, "discounted_cash": 52.5, "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": 70.0, "discounted_cash": 52.5, "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": 69.0, "discounted_cash": 51.75, "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": 69.0, "discounted_cash": 51.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SALICYLATE", "code_information": [{"code": "80179", "type": "CPT"}, {"code": "7252011", "type": "CDM"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SALIVA SUBST 120ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316258", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SALIVA SUBST 120ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316258", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SALIVA SUBST 180ML SP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316259", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 154.0, "discounted_cash": 115.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SALIVA SUBST 180ML SP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316259", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 154.0, "discounted_cash": 115.5, "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": 908.0, "discounted_cash": 681.0, "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": 908.0, "discounted_cash": 681.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SALMONELLA AB", "code_information": [{"code": "86768", "type": "CPT"}, {"code": "7006716", "type": "CDM"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "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": 47.0, "discounted_cash": 35.25, "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": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SAQUINAVIR 200MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310690", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SAQUINAVIR 200MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310690", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SARGRAMOSTIM PER 50MCGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2820", "type": "HCPCS"}, {"code": "5320788", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 637.0, "discounted_cash": 477.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SARGRAMOSTIM PER 50MCGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2820", "type": "HCPCS"}, {"code": "5320788", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 637.0, "discounted_cash": 477.75, "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": 180.0, "discounted_cash": 135.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCAN HEMO COMP PREOP BI STDY", "code_information": [{"code": "93985", "type": "CPT"}, {"code": "4633985", "type": "CDM"}, {"code": "920", "type": "RC"}], "standard_charges": [{"gross_charge": 1695.0, "discounted_cash": 1271.25, "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": 1939.0, "discounted_cash": 1454.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCAN HEMO COMP PREOP UNI STD", "code_information": [{"code": "93986", "type": "CPT"}, {"code": "4633986", "type": "CDM"}, {"code": "920", "type": "RC"}], "standard_charges": [{"gross_charge": 814.0, "discounted_cash": 610.5, "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": 1296.0, "discounted_cash": 972.0, "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": 1474.0, "discounted_cash": 1105.5, "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": 1331.0, "discounted_cash": 998.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCAPULA COMPLETE", "code_information": [{"code": "73010", "type": "CPT"}, {"code": "5013010", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1688.0, "discounted_cash": 1266.0, "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": 1592.0, "discounted_cash": 1194.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCLEROTHERAPY FLUID COLL", "code_information": [{"code": "4919186", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4518.0, "discounted_cash": 3388.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCLEROTHERAPY FLUID COLL", "code_information": [{"code": "5050918", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6105.0, "discounted_cash": 4578.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SCOPOLAMINE .25% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332326", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 335.0, "discounted_cash": 251.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCOPOLAMINE .25% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332326", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 335.0, "discounted_cash": 251.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCOPOLAMINE.4MG/1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5324060", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 168.0, "discounted_cash": 126.0, "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": 111.0, "discounted_cash": 83.25, "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": 111.0, "discounted_cash": 83.25, "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": 195.0, "discounted_cash": 146.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCREEN TOMO BILAT", "code_information": [{"code": "77063", "type": "CPT"}, {"code": "5017063", "type": "CDM"}, {"code": "403", "type": "RC"}], "standard_charges": [{"gross_charge": 184.0, "discounted_cash": 138.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCREW CANN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136031", "type": "CDM"}], "standard_charges": [{"gross_charge": 14471.0, "discounted_cash": 10853.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCREW CORTX", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136069", "type": "CDM"}], "standard_charges": [{"gross_charge": 291.0, "discounted_cash": 218.25, "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": 658.0, "discounted_cash": 493.5, "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": 788.0, "discounted_cash": 591.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCREW SPECIALITY TYPEII", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136267", "type": "CDM"}], "standard_charges": [{"gross_charge": 6547.0, "discounted_cash": 4910.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCREW SPINAL PREASSEMBLED", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136212", "type": "CDM"}], "standard_charges": [{"gross_charge": 7109.0, "discounted_cash": 5331.75, "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": 1091.0, "discounted_cash": 818.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRN MAMMO+CAD BILAT", "code_information": [{"code": "77067", "type": "CPT"}, {"code": "5010208", "type": "CDM"}, {"code": "403", "type": "RC"}], "standard_charges": [{"gross_charge": 824.0, "discounted_cash": 618.0, "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": 1091.0, "discounted_cash": 818.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW 4.5", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136310", "type": "CDM"}], "standard_charges": [{"gross_charge": 1814.0, "discounted_cash": 1360.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW ACCESS ATEC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8130260", "type": "CDM"}], "standard_charges": [{"gross_charge": 5687.0, "discounted_cash": 4265.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW ANTI-ROTATION", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8135990", "type": "CDM"}], "standard_charges": [{"gross_charge": 4571.0, "discounted_cash": 3428.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW BIOINTERFER ARTHREX", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8248410", "type": "CDM"}], "standard_charges": [{"gross_charge": 2020.0, "discounted_cash": 1515.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW BN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136005", "type": "CDM"}], "standard_charges": [{"gross_charge": 1576.0, "discounted_cash": 1182.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW BN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136006", "type": "CDM"}], "standard_charges": [{"gross_charge": 2153.0, "discounted_cash": 1614.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW BN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136007", "type": "CDM"}], "standard_charges": [{"gross_charge": 4770.0, "discounted_cash": 3577.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW BN HYBRID MANDIBLE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136013", "type": "CDM"}], "standard_charges": [{"gross_charge": 1102.0, "discounted_cash": 826.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW BN HYBRID SELF LOCKING", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136012", "type": "CDM"}], "standard_charges": [{"gross_charge": 2333.0, "discounted_cash": 1749.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW CAGE ECLIPSE ANY SZ", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136079", "type": "CDM"}], "standard_charges": [{"gross_charge": 43051.0, "discounted_cash": 32288.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW CANC LCK", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136022", "type": "CDM"}], "standard_charges": [{"gross_charge": 2280.0, "discounted_cash": 1710.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW CANCL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136020", "type": "CDM"}], "standard_charges": [{"gross_charge": 1734.0, "discounted_cash": 1300.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW CANCL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136021", "type": "CDM"}], "standard_charges": [{"gross_charge": 1658.0, "discounted_cash": 1243.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW CANN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136030", "type": "CDM"}], "standard_charges": [{"gross_charge": 1257.0, "discounted_cash": 942.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW CERV INTFIX BONE SD", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8130181", "type": "CDM"}], "standard_charges": [{"gross_charge": 1027.0, "discounted_cash": 770.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW CERVICAL SD DUAL LEAD", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136041", "type": "CDM"}], "standard_charges": [{"gross_charge": 1550.0, "discounted_cash": 1162.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW CMP MULTITHRD SKELETL DYN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136064", "type": "CDM"}], "standard_charges": [{"gross_charge": 1109.0, "discounted_cash": 831.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW COMPRESS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136050", "type": "CDM"}], "standard_charges": [{"gross_charge": 7302.0, "discounted_cash": 5476.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW COMPRESS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136055", "type": "CDM"}], "standard_charges": [{"gross_charge": 502.0, "discounted_cash": 376.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW CORTICAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136071", "type": "CDM"}], "standard_charges": [{"gross_charge": 322.0, "discounted_cash": 241.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW CORTICAL II", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8135011", "type": "CDM"}], "standard_charges": [{"gross_charge": 784.0, "discounted_cash": 588.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW CORTX", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136067", "type": "CDM"}], "standard_charges": [{"gross_charge": 337.0, "discounted_cash": 252.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW E NUT CRTX", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136110", "type": "CDM"}], "standard_charges": [{"gross_charge": 388.0, "discounted_cash": 291.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW E SCHANZ", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136115", "type": "CDM"}], "standard_charges": [{"gross_charge": 1313.0, "discounted_cash": 984.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW E WASHER", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136120", "type": "CDM"}], "standard_charges": [{"gross_charge": 973.0, "discounted_cash": 729.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW FIXATION", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136140", "type": "CDM"}], "standard_charges": [{"gross_charge": 865.0, "discounted_cash": 648.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW FRAGMNT HEXALOBE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136256", "type": "CDM"}], "standard_charges": [{"gross_charge": 1041.0, "discounted_cash": 780.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW HEADLESS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132806", "type": "CDM"}], "standard_charges": [{"gross_charge": 2285.0, "discounted_cash": 1713.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW HI-TORQUE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136155", "type": "CDM"}], "standard_charges": [{"gross_charge": 1025.0, "discounted_cash": 768.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW HIP LAG", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136180", "type": "CDM"}], "standard_charges": [{"gross_charge": 3772.0, "discounted_cash": 2829.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW HUMERAL STEM FRACTURE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136161", "type": "CDM"}], "standard_charges": [{"gross_charge": 395.0, "discounted_cash": 296.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW INTERFEREN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8034015", "type": "CDM"}], "standard_charges": [{"gross_charge": 1772.0, "discounted_cash": 1329.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW LCK CROSS DRIVE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136198", "type": "CDM"}], "standard_charges": [{"gross_charge": 578.0, "discounted_cash": 433.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW LCK SLF TAP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136199", "type": "CDM"}], "standard_charges": [{"gross_charge": 984.0, "discounted_cash": 738.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW LCK TIT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136194", "type": "CDM"}], "standard_charges": [{"gross_charge": 2886.0, "discounted_cash": 2164.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW LIFE SPINE VARIOUS SZ", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136301", "type": "CDM"}], "standard_charges": [{"gross_charge": 5332.0, "discounted_cash": 3999.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW LOCK NON-LCK STRYKER CL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4013033", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 540.0, "discounted_cash": 405.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW LOCK NON-LCK ZIMMER CL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4012943", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 820.0, "discounted_cash": 615.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW LOCK NON-LOCK EXACT CL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4012849", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 584.0, "discounted_cash": 438.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW LOCKG/NONLCKNG TORNIER CL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4013516", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 557.0, "discounted_cash": 417.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW LOCKING", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136196", "type": "CDM"}], "standard_charges": [{"gross_charge": 2412.0, "discounted_cash": 1809.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW MAX FACIAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136106", "type": "CDM"}], "standard_charges": [{"gross_charge": 743.0, "discounted_cash": 557.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW MINI", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136204", "type": "CDM"}], "standard_charges": [{"gross_charge": 2378.0, "discounted_cash": 1783.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW MODULAR CENTRAL FIXATION", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8130273", "type": "CDM"}], "standard_charges": [{"gross_charge": 8104.0, "discounted_cash": 6078.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW MULTIAXIAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136206", "type": "CDM"}], "standard_charges": [{"gross_charge": 2815.0, "discounted_cash": 2111.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW NEURO SLF-TAP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136208", "type": "CDM"}], "standard_charges": [{"gross_charge": 1557.0, "discounted_cash": 1167.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW NON LOCKING TI VARIES", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133817", "type": "CDM"}], "standard_charges": [{"gross_charge": 788.0, "discounted_cash": 591.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW POLYAXIAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136223", "type": "CDM"}], "standard_charges": [{"gross_charge": 7677.0, "discounted_cash": 5757.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW POLYAXIAL INFINITI MP-AXL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136229", "type": "CDM"}], "standard_charges": [{"gross_charge": 8348.0, "discounted_cash": 6261.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW POYAXIAL LOCKING SKELETAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136227", "type": "CDM"}], "standard_charges": [{"gross_charge": 5331.0, "discounted_cash": 3998.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW RELINE C MA", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8130281", "type": "CDM"}], "standard_charges": [{"gross_charge": 5332.0, "discounted_cash": 3999.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW SACRAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136225", "type": "CDM"}], "standard_charges": [{"gross_charge": 26268.0, "discounted_cash": 19701.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW SET INVICTUS CLOSED", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136318", "type": "CDM"}], "standard_charges": [{"gross_charge": 775.0, "discounted_cash": 581.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW SET SPINAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136245", "type": "CDM"}], "standard_charges": [{"gross_charge": 32199.0, "discounted_cash": 24149.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW SHAFT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136251", "type": "CDM"}], "standard_charges": [{"gross_charge": 535.0, "discounted_cash": 401.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW SHANK MOD RELINE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8130277", "type": "CDM"}], "standard_charges": [{"gross_charge": 5758.0, "discounted_cash": 4318.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW SHANTZ 2", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136252", "type": "CDM"}], "standard_charges": [{"gross_charge": 8756.0, "discounted_cash": 6567.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW SI CORE FAVORED ANGLED", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136222", "type": "CDM"}], "standard_charges": [{"gross_charge": 23491.0, "discounted_cash": 17618.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW SPINAL LOCKING RELINE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8130278", "type": "CDM"}], "standard_charges": [{"gross_charge": 474.0, "discounted_cash": 355.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW SPINE TRACTION RELINE-O", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136258", "type": "CDM"}], "standard_charges": [{"gross_charge": 7038.0, "discounted_cash": 5278.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW THR HIP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136275", "type": "CDM"}], "standard_charges": [{"gross_charge": 947.0, "discounted_cash": 710.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW TITAN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136280", "type": "CDM"}], "standard_charges": [{"gross_charge": 1110.0, "discounted_cash": 832.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW TRAC PACS RELINE-O", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8130282", "type": "CDM"}], "standard_charges": [{"gross_charge": 6516.0, "discounted_cash": 4887.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW VARIABLE ANGLE REGATTA", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136213", "type": "CDM"}], "standard_charges": [{"gross_charge": 1258.21, "discounted_cash": 943.66, "setting": "both", "billing_class": "facility"}]}, {"description": "SECRETIN HUMAN PER1MCGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2850", "type": "HCPCS"}, {"code": "5324080", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 292.0, "discounted_cash": 219.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SECRETIN HUMAN PER1MCGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2850", "type": "HCPCS"}, {"code": "5324080", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 292.0, "discounted_cash": 219.0, "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": 409.0, "discounted_cash": 306.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SEDIMENTN RATE-NON-AUTO", "code_information": [{"code": "85651", "type": "CPT"}, {"code": "4125651", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SEDIMENTN RATE-NON-AUTO", "code_information": [{"code": "85651", "type": "CPT"}, {"code": "4155651", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 128.0, "discounted_cash": 96.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SEL DEB 1ST 20CM OR LESS", "code_information": [{"code": "97597", "type": "CPT"}, {"code": "3217597", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1443.0, "discounted_cash": 1082.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SEL DEB 1ST 20CM OR LESS", "code_information": [{"code": "97597", "type": "CPT"}, {"code": "5737591", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 1189.0, "discounted_cash": 891.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "SEL DEB 1ST 20CM OR LESS", "code_information": [{"code": "97597", "type": "CPT"}, {"code": "6907597", "type": "CDM"}], "standard_charges": [{"gross_charge": 1383.0, "discounted_cash": 1037.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SEL DEB EAADD UPTO 20CM", "code_information": [{"code": "97598", "type": "CPT"}, {"code": "3217598", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 820.0, "discounted_cash": 615.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SEL DEB EAADD UPTO 20CM", "code_information": [{"code": "97598", "type": "CPT"}, {"code": "5737592", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 620.0, "discounted_cash": 465.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "SEL DEB EAADD UPTO 20CM", "code_information": [{"code": "97598", "type": "CPT"}, {"code": "6907598", "type": "CDM"}], "standard_charges": [{"gross_charge": 785.0, "discounted_cash": 588.75, "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": 76.0, "discounted_cash": 57.0, "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": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SELEGILINE 6MG/24HR TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337240", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 238.0, "discounted_cash": 178.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SELEGILINE 6MG/24HR TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337240", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 238.0, "discounted_cash": 178.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SELEGILINE 9MG/24HR TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337241", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 208.0, "discounted_cash": 156.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SELEGILINE 9MG/24HR TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337241", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 208.0, "discounted_cash": 156.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SELENIUM", "code_information": [{"code": "84255", "type": "CPT"}, {"code": "7004255", "type": "CDM"}], "standard_charges": [{"gross_charge": 306.0, "discounted_cash": 229.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SELENIUM", "code_information": [{"code": "84255", "type": "CPT"}, {"code": "7254255", "type": "CDM"}], "standard_charges": [{"gross_charge": 306.0, "discounted_cash": 229.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SELENIUM 40MCG/ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5324090", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "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": 173.0, "discounted_cash": 129.75, "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": 173.0, "discounted_cash": 129.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SEMI-PRIVATE DETOX", "code_information": [{"code": "1990083", "type": "CDM"}, {"code": "126", "type": "RC"}], "standard_charges": [{"gross_charge": 4743.0, "discounted_cash": 3557.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SENNA 8.6MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5310755", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SENNA 8.6MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5310755", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SENSITIVITY ANTBDY AGAR", "code_information": [{"code": "87181", "type": "CPT"}, {"code": "4107181", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 101.0, "discounted_cash": 75.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SENSITIVITY ANTBDY AGAR/2", "code_information": [{"code": "87181", "type": "CPT"}, {"code": "4107198", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "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": 146.0, "discounted_cash": 109.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SENSITV 12 DISKS OR LESS", "code_information": [{"code": "87184", "type": "CPT"}, {"code": "4127184", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SENSITV 12 DISKS OR LESS", "code_information": [{"code": "87184", "type": "CPT"}, {"code": "7007184", "type": "CDM"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SEPARATOR INDIGO", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8177024", "type": "CDM"}], "standard_charges": [{"gross_charge": 12089.0, "discounted_cash": 9066.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SEROTONIN", "code_information": [{"code": "84260", "type": "CPT"}, {"code": "7004260", "type": "CDM"}], "standard_charges": [{"gross_charge": 1575.0, "discounted_cash": 1181.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SEROTONIN", "code_information": [{"code": "84260", "type": "CPT"}, {"code": "7254260", "type": "CDM"}], "standard_charges": [{"gross_charge": 1575.0, "discounted_cash": 1181.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SERTRALINE", "code_information": [{"code": "80332", "type": "CPT"}, {"code": "7258224", "type": "CDM"}], "standard_charges": [{"gross_charge": 505.0, "discounted_cash": 378.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SERTRALINE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310761", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SERTRALINE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310761", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "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": 69.0, "discounted_cash": 51.75, "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": 69.0, "discounted_cash": 51.75, "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": 70.0, "discounted_cash": 52.5, "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": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SEVELAMER 0.8GM PW LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316317", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SEVELAMER 0.8GM PW LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316317", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SEVELAMER 400MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310763", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SEVELAMER 400MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310763", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "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": 59.0, "discounted_cash": 44.25, "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": 59.0, "discounted_cash": 44.25, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SEX HORMONE BIND GLOBULN", "code_information": [{"code": "84270", "type": "CPT"}, {"code": "7004270", "type": "CDM"}], "standard_charges": [{"gross_charge": 174.0, "discounted_cash": 130.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SEX HORMONE BIND GLOBULN", "code_information": [{"code": "84270", "type": "CPT"}, {"code": "7254270", "type": "CDM"}], "standard_charges": [{"gross_charge": 174.0, "discounted_cash": 130.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SHEATH GUIDE", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8177118", "type": "CDM"}], "standard_charges": [{"gross_charge": 1083.0, "discounted_cash": 812.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SHEATH STEERABLE TOURGUIDE", "code_information": [{"code": "C1766", "type": "HCPCS"}, {"code": "8177128", "type": "CDM"}], "standard_charges": [{"gross_charge": 2928.0, "discounted_cash": 2196.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SHEATH URETERAL ACCESS", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8041028", "type": "CDM"}], "standard_charges": [{"gross_charge": 942.0, "discounted_cash": 706.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SHNT", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8145000", "type": "CDM"}], "standard_charges": [{"gross_charge": 34664.0, "discounted_cash": 25998.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SHNT CAROTID", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8145010", "type": "CDM"}], "standard_charges": [{"gross_charge": 663.0, "discounted_cash": 497.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SHNT CONN NEURO", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8145070", "type": "CDM"}], "standard_charges": [{"gross_charge": 1858.0, "discounted_cash": 1393.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SHNT CORONARY", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8145086", "type": "CDM"}], "standard_charges": [{"gross_charge": 1398.0, "discounted_cash": 1048.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SHNT VALVE FL", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8145135", "type": "CDM"}], "standard_charges": [{"gross_charge": 9180.0, "discounted_cash": 6885.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SHOE PLASTAZOTE CUSTM", "code_information": [{"code": "L3253", "type": "HCPCS"}, {"code": "8136315", "type": "CDM"}], "standard_charges": [{"gross_charge": 1182.0, "discounted_cash": 886.5, "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": 1770.0, "discounted_cash": 1327.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SHOULDER 2 VWS MINIMUM", "code_information": [{"code": "73030", "type": "CPT"}, {"code": "5013030", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1424.0, "discounted_cash": 1068.0, "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": 1770.0, "discounted_cash": 1327.5, "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": 4587.0, "discounted_cash": 3440.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SHOULDER ARTHROGRAPHY", "code_information": [{"code": "73040", "type": "CPT"}, {"code": "5013040", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 5360.0, "discounted_cash": 4020.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SHOULDER ARTHROGRAPHY", "code_information": [{"code": "73040", "type": "CPT"}, {"code": "5113040", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 5826.0, "discounted_cash": 4369.5, "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": 784.0, "discounted_cash": 588.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SHRINKER ABOVE KNEE", "code_information": [{"code": "L8460", "type": "HCPCS"}, {"code": "8130068", "type": "CDM"}], "standard_charges": [{"gross_charge": 1590.0, "discounted_cash": 1192.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SHRINKER BELOW KNEE", "code_information": [{"code": "L8440", "type": "HCPCS"}, {"code": "8130071", "type": "CDM"}], "standard_charges": [{"gross_charge": 1590.0, "discounted_cash": 1192.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SHTH CHANNEL STEERABLE", "code_information": [{"code": "C1766", "type": "HCPCS"}, {"code": "8243090", "type": "CDM"}], "standard_charges": [{"gross_charge": 6302.0, "discounted_cash": 4726.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SHTH GUID FLEXOR SHUTTLE", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8073261", "type": "CDM"}], "standard_charges": [{"gross_charge": 954.0, "discounted_cash": 715.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SHTH GUIDE BI-DIRECTNL VIZIGO", "code_information": [{"code": "C1766", "type": "HCPCS"}, {"code": "8073526", "type": "CDM"}], "standard_charges": [{"gross_charge": 6043.0, "discounted_cash": 4532.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SHTH GUIDE DESTINATION SLENDER", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8177117", "type": "CDM"}], "standard_charges": [{"gross_charge": 318.0, "discounted_cash": 238.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SHTH GUIDE TRANSSEPTAL", "code_information": [{"code": "C1893", "type": "HCPCS"}, {"code": "8073264", "type": "CDM"}], "standard_charges": [{"gross_charge": 808.0, "discounted_cash": 606.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SHTH GUIDING DESTINATION", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8178597", "type": "CDM"}], "standard_charges": [{"gross_charge": 659.0, "discounted_cash": 494.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SHTH GUIDING FLEXR RAABE", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8073259", "type": "CDM"}], "standard_charges": [{"gross_charge": 688.0, "discounted_cash": 516.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SHTH INTRO DRYSEAL FLEX", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8177114", "type": "CDM"}], "standard_charges": [{"gross_charge": 2130.0, "discounted_cash": 1597.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SHTH INTRO SLENDER KIT", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8177133", "type": "CDM"}], "standard_charges": [{"gross_charge": 1246.0, "discounted_cash": 934.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SHTH INTRODUCER DRYSEAL", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8177108", "type": "CDM"}], "standard_charges": [{"gross_charge": 2130.0, "discounted_cash": 1597.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SHTH INTRODUCER MICRA", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8177115", "type": "CDM"}], "standard_charges": [{"gross_charge": 2517.0, "discounted_cash": 1887.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SHTH INTRODUCER SENTRANT", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8177106", "type": "CDM"}], "standard_charges": [{"gross_charge": 1143.0, "discounted_cash": 857.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SHTH PRELUDE ROADSTER", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8177033", "type": "CDM"}], "standard_charges": [{"gross_charge": 388.0, "discounted_cash": 291.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SHTH STEERBL INTRAVASCLR", "code_information": [{"code": "C1766", "type": "HCPCS"}, {"code": "8177126", "type": "CDM"}], "standard_charges": [{"gross_charge": 7726.0, "discounted_cash": 5794.5, "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": 1101.0, "discounted_cash": 825.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SHUNTOGRAM PREV NONVASC", "code_information": [{"code": "75809", "type": "CPT"}, {"code": "4915809", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1101.0, "discounted_cash": 825.75, "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": 1695.0, "discounted_cash": 1271.25, "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": 138.0, "discounted_cash": 103.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SICKLING OF RBC", "code_information": [{"code": "85660", "type": "CPT"}, {"code": "4123052", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SICKLING OF RBC", "code_information": [{"code": "85660", "type": "CPT"}, {"code": "4153052", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 120.0, "discounted_cash": 90.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SICKLING OF RBC", "code_information": [{"code": "85660", "type": "CPT"}, {"code": "7255660", "type": "CDM"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SIGNAL AVERAGED EKG", "code_information": [{"code": "93278", "type": "CPT"}, {"code": "4600400", "type": "CDM"}, {"code": "730", "type": "RC"}], "standard_charges": [{"gross_charge": 3163.0, "discounted_cash": 2372.25, "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": 152.0, "discounted_cash": 114.0, "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": 152.0, "discounted_cash": 114.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SILDENAFIL 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310773", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 192.0, "discounted_cash": 144.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SILDENAFIL 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310773", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 192.0, "discounted_cash": 144.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SILDENAFIL 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310774", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 192.0, "discounted_cash": 144.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SILDENAFIL 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310774", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 192.0, "discounted_cash": 144.0, "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": 3.0, "discounted_cash": 2.25, "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": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SILVER SULFADIA 1%20GMCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337279", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 168.0, "discounted_cash": 126.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SILVER SULFADIA 1%20GMCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337279", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 168.0, "discounted_cash": 126.0, "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": 175.0, "discounted_cash": 131.25, "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": 175.0, "discounted_cash": 131.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SILVER SULFADIA1%25GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337266", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SILVER SULFADIA1%25GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337266", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 425.0, "discounted_cash": 318.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 425.0, "discounted_cash": 318.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SIMETHICON DRPS 1DOSE LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316332", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SIMETHICON DRPS 1DOSE LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316332", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SIMETHICONE 125MG CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5310784", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SIMETHICONE 125MG CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5310784", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SIMETHICONE 180MG CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5310785", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SIMETHICONE 180MG CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5310785", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SIMETHICONE 40/.6 1ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316329", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SIMETHICONE 40/.6 1ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316329", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "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": 211.0, "discounted_cash": 158.25, "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": 211.0, "discounted_cash": 158.25, "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": 76.0, "discounted_cash": 57.0, "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": 76.0, "discounted_cash": 57.0, "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": 117.0, "discounted_cash": 87.75, "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": 117.0, "discounted_cash": 87.75, "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": 124.0, "discounted_cash": 93.0, "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": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SIMVASTATIN 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310790", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SIMVASTATIN 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310790", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SIMVASTATIN 80MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310794", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 129.0, "discounted_cash": 96.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SIMVASTATIN 80MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310794", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 129.0, "discounted_cash": 96.75, "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": 652.0, "discounted_cash": 489.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SINUSES 2VW MAX", "code_information": [{"code": "70210", "type": "CPT"}, {"code": "5010210", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 652.0, "discounted_cash": 489.0, "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": 662.0, "discounted_cash": 496.5, "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": 2445.0, "discounted_cash": 1833.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SINUSES 3VW MIN", "code_information": [{"code": "70220", "type": "CPT"}, {"code": "5010220", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2445.0, "discounted_cash": 1833.75, "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": 2910.0, "discounted_cash": 2182.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SIROLIMUS", "code_information": [{"code": "80195", "type": "CPT"}, {"code": "7000254", "type": "CDM"}], "standard_charges": [{"gross_charge": 211.0, "discounted_cash": 158.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SIROLIMUS", "code_information": [{"code": "80195", "type": "CPT"}, {"code": "7250254", "type": "CDM"}], "standard_charges": [{"gross_charge": 211.0, "discounted_cash": 158.25, "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": 133.0, "discounted_cash": 99.75, "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": 133.0, "discounted_cash": 99.75, "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": 89.0, "discounted_cash": 66.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 89.0, "discounted_cash": 66.75, "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": 89.0, "discounted_cash": 66.75, "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": 89.0, "discounted_cash": 66.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SKIN CLEAN MED 480ML TS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336386", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SKIN CLEAN MED 480ML TS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336386", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "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": 2196.0, "discounted_cash": 1647.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SKULL 4VW MIN", "code_information": [{"code": "70260", "type": "CPT"}, {"code": "5010260", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2506.0, "discounted_cash": 1879.5, "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": 2655.0, "discounted_cash": 1991.25, "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": 1546.0, "discounted_cash": 1159.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SKULL < 4 VIEWS", "code_information": [{"code": "70250", "type": "CPT"}, {"code": "5010250", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1705.0, "discounted_cash": 1278.75, "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": 1965.0, "discounted_cash": 1473.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SLING CRADLE/PED", "code_information": [{"code": "A4565", "type": "HCPCS"}, {"code": "8034058", "type": "CDM"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SLNG ARM STRAP A/S", "code_information": [{"code": "A4565", "type": "HCPCS"}, {"code": "8104996", "type": "CDM"}], "standard_charges": [{"gross_charge": 189.0, "discounted_cash": 141.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SLNG SGL INCISION ADJUST", "code_information": [{"code": "C1771", "type": "HCPCS"}, {"code": "4024690", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11573.0, "discounted_cash": 8679.75, "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": 2807.0, "discounted_cash": 2105.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SM BOWEL SNGL CM STDY", "code_information": [{"code": "74250", "type": "CPT"}, {"code": "5014250", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2807.0, "discounted_cash": 2105.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SM BOWEL SNGL CM STDY", "code_information": [{"code": "74250", "type": "CPT"}, {"code": "5114250", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 3301.0, "discounted_cash": 2475.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SM153 LEXIDRONAM 150 MCI", "code_information": [{"code": "A9604", "type": "HCPCS"}, {"code": "5196201", "type": "CDM"}, {"code": "344", "type": "RC"}], "standard_charges": [{"gross_charge": 59183.0, "discounted_cash": 44387.25, "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": 519.0, "discounted_cash": 389.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SMEAR FLUORESCENT/AFS", "code_information": [{"code": "87206", "type": "CPT"}, {"code": "4127201", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SMEAR FLUORESCENT/AFS", "code_information": [{"code": "87206", "type": "CPT"}, {"code": "4157201", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 232.0, "discounted_cash": 174.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SMEAR FLUORESCENT/AFS", "code_information": [{"code": "87206", "type": "CPT"}, {"code": "7257198", "type": "CDM"}], "standard_charges": [{"gross_charge": 354.0, "discounted_cash": 265.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SMEAR FLUORESCENT/AFS/2", "code_information": [{"code": "87206", "type": "CPT"}, {"code": "7077201", "type": "CDM"}], "standard_charges": [{"gross_charge": 138.0, "discounted_cash": 103.5, "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": 505.0, "discounted_cash": 378.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SMEAR FLUORESCENT/AFS/4", "code_information": [{"code": "87206", "type": "CPT"}, {"code": "7257211", "type": "CDM"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "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": 582.0, "discounted_cash": 436.5, "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": 647.0, "discounted_cash": 485.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SMKE/TOBAC CNSL 3-10MIN", "code_information": [{"code": "99406", "type": "CPT"}, {"code": "5500375", "type": "CDM"}, {"code": "942", "type": "RC"}], "standard_charges": [{"gross_charge": 444.0, "discounted_cash": 333.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SMKE/TOBAC CNSL >10 MIN", "code_information": [{"code": "99407", "type": "CPT"}, {"code": "5500376", "type": "CDM"}, {"code": "942", "type": "RC"}], "standard_charges": [{"gross_charge": 382.0, "discounted_cash": 286.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SMOOTH MUSCLE AB", "code_information": [{"code": "86015", "type": "CPT"}, {"code": "7006379", "type": "CDM"}], "standard_charges": [{"gross_charge": 825.0, "discounted_cash": 618.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "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": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SMX-TMP 200-40/5 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316403", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SMX-TMP 200-40/5 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316403", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SMX-TMP 400/80MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311091", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SMX-TMP 400/80MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311091", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "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": 39.0, "discounted_cash": 29.25, "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": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SNARE MICRO LOOP", "code_information": [{"code": "C1773", "type": "HCPCS"}, {"code": "8084925", "type": "CDM"}], "standard_charges": [{"gross_charge": 1091.0, "discounted_cash": 818.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SOD ZIRCONIUM CYCLO 5GM PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316366", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 156.0, "discounted_cash": 117.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SOD ZIRCONIUM CYCLO 5GM PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316366", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 156.0, "discounted_cash": 117.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 156.0, "discounted_cash": 117.0, "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": 156.0, "discounted_cash": 117.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SOD/POT/PHOS 278/250/ TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310863", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SOD/POT/PHOS 278/250/ TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310863", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "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": 207.0, "discounted_cash": 155.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SODIUM", "code_information": [{"code": "84295", "type": "CPT"}, {"code": "4124295", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SODIUM", "code_information": [{"code": "84295", "type": "CPT"}, {"code": "4154295", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "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": 206.0, "discounted_cash": 154.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SODIUM OTHER SOURCE/3", "code_information": [{"code": "84302", "type": "CPT"}, {"code": "7254302", "type": "CDM"}], "standard_charges": [{"gross_charge": 107.0, "discounted_cash": 80.25, "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": 488.0, "discounted_cash": 366.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SODIUM URINE", "code_information": [{"code": "84300", "type": "CPT"}, {"code": "4124296", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "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": 667.0, "discounted_cash": 500.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SODIUM URINE/2", "code_information": [{"code": "84300", "type": "CPT"}, {"code": "4124300", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SODIUM URINE/2", "code_information": [{"code": "84300", "type": "CPT"}, {"code": "4154300", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 276.0, "discounted_cash": 207.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SOFT INTERFC BLW KNEE SE", "code_information": [{"code": "L2820", "type": "HCPCS"}, {"code": "8130050", "type": "CDM"}], "standard_charges": [{"gross_charge": 1242.0, "discounted_cash": 931.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SOLIFENACIN 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310869", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SOLIFENACIN 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310869", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SOLIFENACIN 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310867", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SOLIFENACIN 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310867", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SOMATOMEDIN", "code_information": [{"code": "84305", "type": "CPT"}, {"code": "7253543", "type": "CDM"}], "standard_charges": [{"gross_charge": 1156.0, "discounted_cash": 867.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SOMATOMEDIN/2", "code_information": [{"code": "84305", "type": "CPT"}, {"code": "7004300", "type": "CDM"}], "standard_charges": [{"gross_charge": 1156.0, "discounted_cash": 867.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SOMATOSEN STDY UPPR/LWER", "code_information": [{"code": "95938", "type": "CPT"}, {"code": "3215938", "type": "CDM"}, {"code": "922", "type": "RC"}], "standard_charges": [{"gross_charge": 6640.0, "discounted_cash": 4980.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SOMATOSENS STDY UPR LIMB", "code_information": [{"code": "95925", "type": "CPT"}, {"code": "4705925", "type": "CDM"}, {"code": "922", "type": "RC"}], "standard_charges": [{"gross_charge": 3529.0, "discounted_cash": 2646.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SOMATOSENSORY EP L/LIMB", "code_information": [{"code": "95926", "type": "CPT"}, {"code": "3215926", "type": "CDM"}, {"code": "922", "type": "RC"}], "standard_charges": [{"gross_charge": 4324.0, "discounted_cash": 3243.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SOMATOSENSORY EP U/LIMB", "code_information": [{"code": "95925", "type": "CPT"}, {"code": "3215925", "type": "CDM"}, {"code": "922", "type": "RC"}], "standard_charges": [{"gross_charge": 3953.0, "discounted_cash": 2964.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SOMATOSTATIN", "code_information": [{"code": "84307", "type": "CPT"}, {"code": "7254307", "type": "CDM"}], "standard_charges": [{"gross_charge": 558.0, "discounted_cash": 418.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SORAFENIB 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8999", "type": "HCPCS"}, {"code": "5310859", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 585.0, "discounted_cash": 438.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SORAFENIB 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8999", "type": "HCPCS"}, {"code": "5310859", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 585.0, "discounted_cash": 438.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SORBITOL 3% 1500ML IRR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5414220", "type": "CDM"}, {"code": "270", "type": "RC"}], "standard_charges": [{"gross_charge": 445.0, "discounted_cash": 333.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SORBITOL 70% 120ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316375", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 101.0, "discounted_cash": 75.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SORBITOL 70% 120ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316375", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 101.0, "discounted_cash": 75.75, "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": 12.0, "discounted_cash": 9.0, "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": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SOTALOL 120MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300869", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SOTALOL 120MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300869", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SOTALOL 160MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310871", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SOTALOL 160MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310871", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SOTALOL 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300873", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SOTALOL 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300873", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "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": 68.0, "discounted_cash": 51.0, "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": 68.0, "discounted_cash": 51.0, "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": 13459.0, "discounted_cash": 10094.25, "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": 13796.0, "discounted_cash": 10347.0, "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": 13710.0, "discounted_cash": 10282.5, "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": 16640.0, "discounted_cash": 12480.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SP ANTERIOR LUMBAR PLT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011247", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 29251.0, "discounted_cash": 21938.25, "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": 2911.0, "discounted_cash": 2183.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SP ARTIFICIAL DISC CERV", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "4011245", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 46229.0, "discounted_cash": 34671.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SP BN GRAFT ALLOGRAFT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011205", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9790.0, "discounted_cash": 7342.5, "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": 8878.0, "discounted_cash": 6658.5, "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": 8878.0, "discounted_cash": 6658.5, "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": 12164.0, "discounted_cash": 9123.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SP CERV STANDLNE INT DEV", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011234", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 27246.0, "discounted_cash": 20434.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SP CERV STNLN INT DV SCR", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011235", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 567.0, "discounted_cash": 425.25, "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": 30686.0, "discounted_cash": 23014.5, "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": 21452.0, "discounted_cash": 16089.0, "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": 315.0, "discounted_cash": 236.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP COG FUNC ACTIVITY ADDL 15M", "code_information": [{"code": "97130", "type": "CPT"}, {"code": "6057136", "type": "CDM"}, {"code": "440", "type": "RC"}], "standard_charges": [{"gross_charge": 315.0, "discounted_cash": 236.25, "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": 315.0, "discounted_cash": 236.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP COG FUNC ACTIVITY INIT 15M", "code_information": [{"code": "97129", "type": "CPT"}, {"code": "6057134", "type": "CDM"}, {"code": "440", "type": "RC"}], "standard_charges": [{"gross_charge": 315.0, "discounted_cash": 236.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP COMP SCRW WASHER", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011249", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 15638.0, "discounted_cash": 11728.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SP CROSSLINK ASSEMBLY", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011219", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12812.0, "discounted_cash": 9609.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SP DYNC STABILZ SET SCRW", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011258", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3891.0, "discounted_cash": 2918.25, "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": 501.0, "discounted_cash": 375.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP EVAL BEH QUAL A V/RS BASIC", "code_information": [{"code": "92524", "type": "CPT"}, {"code": "6052813", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 535.0, "discounted_cash": 401.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP EVAL BEH QUAL A V/RS CMPLX", "code_information": [{"code": "92524", "type": "CPT"}, {"code": "6050821", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 511.0, "discounted_cash": 383.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP EVAL BEH QUAL A V/RS EXTNSV", "code_information": [{"code": "92524", "type": "CPT"}, {"code": "6050822", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 511.0, "discounted_cash": 383.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP EVAL BEH QUAL A V/RS INTERM", "code_information": [{"code": "92524", "type": "CPT"}, {"code": "6050820", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 511.0, "discounted_cash": 383.25, "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": 2142.0, "discounted_cash": 1606.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP EVAL CINE VIDEO BASIC", "code_information": [{"code": "92611", "type": "CPT"}, {"code": "6042611", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 1942.0, "discounted_cash": 1456.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP EVAL CINE VIDEO CMPLX", "code_information": [{"code": "92611", "type": "CPT"}, {"code": "5902635", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 2163.0, "discounted_cash": 1622.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP EVAL CINE VIDEO COMPLEX", "code_information": [{"code": "92611", "type": "CPT"}, {"code": "6040612", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 2059.0, "discounted_cash": 1544.25, "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": 1372.0, "discounted_cash": 1029.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP EVAL CINE VIDEO INTERM", "code_information": [{"code": "92611", "type": "CPT"}, {"code": "5902633", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 2163.0, "discounted_cash": 1622.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP EVAL CINE VIDEO INTERM", "code_information": [{"code": "92611", "type": "CPT"}, {"code": "6040611", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 1894.0, "discounted_cash": 1420.5, "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": 505.0, "discounted_cash": 378.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP EVAL FLUENCY BASIC", "code_information": [{"code": "92521", "type": "CPT"}, {"code": "6052810", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 511.0, "discounted_cash": 383.25, "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": 511.0, "discounted_cash": 383.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP EVAL FLUENCY COMPLEX", "code_information": [{"code": "92521", "type": "CPT"}, {"code": "6050812", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 511.0, "discounted_cash": 383.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP EVAL FLUENCY EXTENSIVE", "code_information": [{"code": "92521", "type": "CPT"}, {"code": "6050813", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 511.0, "discounted_cash": 383.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP EVAL FLUENCY INTERM", "code_information": [{"code": "92521", "type": "CPT"}, {"code": "6050811", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 511.0, "discounted_cash": 383.25, "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": 683.0, "discounted_cash": 512.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP EVAL LNG COM W/EXP BASIC", "code_information": [{"code": "92523", "type": "CPT"}, {"code": "6042523", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 495.0, "discounted_cash": 371.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP EVAL LNG COM W/EXP BASIC", "code_information": [{"code": "92523", "type": "CPT"}, {"code": "6052812", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 501.0, "discounted_cash": 375.75, "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": 510.0, "discounted_cash": 382.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP EVAL LNG COM W/EXP COMPLEX", "code_information": [{"code": "92523", "type": "CPT"}, {"code": "6040525", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 510.0, "discounted_cash": 382.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP EVAL LNG COM W/EXP COMPLEX", "code_information": [{"code": "92523", "type": "CPT"}, {"code": "6050818", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 511.0, "discounted_cash": 383.25, "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": 510.0, "discounted_cash": 382.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP EVAL LNG COM W/EXP EXTNSV", "code_information": [{"code": "92523", "type": "CPT"}, {"code": "6040526", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 511.0, "discounted_cash": 383.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP EVAL LNG COM W/EXP EXTNSV", "code_information": [{"code": "92523", "type": "CPT"}, {"code": "6050819", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 511.0, "discounted_cash": 383.25, "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": 510.0, "discounted_cash": 382.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP EVAL LNG COM W/EXP INTERM", "code_information": [{"code": "92523", "type": "CPT"}, {"code": "6040524", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 510.0, "discounted_cash": 382.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP EVAL LNG COM W/EXP INTERM", "code_information": [{"code": "92523", "type": "CPT"}, {"code": "6050817", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 511.0, "discounted_cash": 383.25, "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": 495.0, "discounted_cash": 371.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP EVAL SOUND PROD BASIC", "code_information": [{"code": "92522", "type": "CPT"}, {"code": "6052811", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 501.0, "discounted_cash": 375.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP EVAL SOUND PRODUCTION BASIC", "code_information": [{"code": "92522", "type": "CPT"}, {"code": "6042522", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 505.0, "discounted_cash": 378.75, "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": 872.0, "discounted_cash": 654.0, "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": 12107.0, "discounted_cash": 9080.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SP FLEX ENDO VIDEO BASIC", "code_information": [{"code": "92612", "type": "CPT"}, {"code": "5902612", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 1001.0, "discounted_cash": 750.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP FLEX ENDO VIDEO CMPLX", "code_information": [{"code": "92612", "type": "CPT"}, {"code": "5900615", "type": "CDM"}, {"code": "440", "type": "RC"}], "standard_charges": [{"gross_charge": 1001.0, "discounted_cash": 750.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP FLEX ENDO VIDEO EXTNSV", "code_information": [{"code": "92612", "type": "CPT"}, {"code": "5900616", "type": "CDM"}, {"code": "440", "type": "RC"}], "standard_charges": [{"gross_charge": 1001.0, "discounted_cash": 750.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP FLEX ENDO VIDEO INTERM", "code_information": [{"code": "92612", "type": "CPT"}, {"code": "5900614", "type": "CDM"}, {"code": "440", "type": "RC"}], "standard_charges": [{"gross_charge": 1001.0, "discounted_cash": 750.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP GUIDEWR FOR MIS PRO", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "4011221", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 824.0, "discounted_cash": 618.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SP IBF BN ALLOGRAFT CERV", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011222", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10504.0, "discounted_cash": 7878.0, "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": 19809.0, "discounted_cash": 14856.75, "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": 27759.0, "discounted_cash": 20819.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SP INTBODY DEV NANOTEC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4018110", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 56892.78, "discounted_cash": 42669.59, "setting": "both", "billing_class": "facility"}]}, {"description": "SP INTRSPN PROC DCMP DVC", "code_information": [{"code": "C1821", "type": "HCPCS"}, {"code": "4011241", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 33523.0, "discounted_cash": 25142.25, "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": 3483.0, "discounted_cash": 2612.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SP LAMINOPLASTY PLATE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011262", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5810.0, "discounted_cash": 4357.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SP LUM INTBDY DV LAT OTR", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011240", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 43300.0, "discounted_cash": 32475.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SP LUMB INTBODY DEV ALIF", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011225", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 34045.0, "discounted_cash": 25533.75, "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": 43879.0, "discounted_cash": 32909.25, "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": 30237.0, "discounted_cash": 22677.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SP LUMB SCRW ALIF DEV", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011264", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 15851.0, "discounted_cash": 11888.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SP LUMB STANDLNE INT DEV", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011228", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 65525.0, "discounted_cash": 49143.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SP LUMB STNLN INT DV SCR", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011236", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4573.0, "discounted_cash": 3429.75, "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": 2054.0, "discounted_cash": 1540.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SP LUMBAR MIN 6 VWS", "code_information": [{"code": "72114", "type": "CPT"}, {"code": "5012114", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2479.0, "discounted_cash": 1859.25, "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": 2607.0, "discounted_cash": 1955.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SP MAGNIFUSE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011284", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8530.0, "discounted_cash": 6397.5, "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": 2417.0, "discounted_cash": 1812.75, "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": 13428.0, "discounted_cash": 10071.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SP OTHER PLATE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011265", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6904.0, "discounted_cash": 5178.0, "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": 17912.0, "discounted_cash": 13434.0, "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": 10430.0, "discounted_cash": 7822.5, "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": 7476.0, "discounted_cash": 5607.0, "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": 3479.0, "discounted_cash": 2609.25, "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": 2530.0, "discounted_cash": 1897.5, "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": 67048.0, "discounted_cash": 50286.0, "setting": "both", "billing_class": "facility"}]}, {"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": 1207.0, "discounted_cash": 905.25, "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": 1109.0, "discounted_cash": 831.75, "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": 1305.0, "discounted_cash": 978.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP SWAL EVAL ORL PHARYN EXTNSV", "code_information": [{"code": "92610", "type": "CPT"}, {"code": "6042619", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 1095.0, "discounted_cash": 821.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP SWAL EVAL ORL PHARYN EXTNSV", "code_information": [{"code": "92610", "type": "CPT"}, {"code": "6050827", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 1207.0, "discounted_cash": 905.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP SWAL EVAL PHARYN BASIC", "code_information": [{"code": "92610", "type": "CPT"}, {"code": "6042610", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 1033.0, "discounted_cash": 774.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP SWAL EVAL PHARYN BASIC", "code_information": [{"code": "92610", "type": "CPT"}, {"code": "6052610", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 1207.0, "discounted_cash": 905.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP SWAL EVAL PHARYN COMPLEX", "code_information": [{"code": "92610", "type": "CPT"}, {"code": "6042618", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 1085.0, "discounted_cash": 813.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP SWAL EVAL PHARYN COMPLEX", "code_information": [{"code": "92610", "type": "CPT"}, {"code": "6052618", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 1207.0, "discounted_cash": 905.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP SWAL EVAL PHARYN INTERM", "code_information": [{"code": "92610", "type": "CPT"}, {"code": "6042617", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 1085.0, "discounted_cash": 813.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP SWAL EVAL PHARYN INTERM", "code_information": [{"code": "92610", "type": "CPT"}, {"code": "6052617", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 1207.0, "discounted_cash": 905.25, "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": 435.0, "discounted_cash": 326.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP SWAL/ORAL TX BASIC", "code_information": [{"code": "92526", "type": "CPT"}, {"code": "6041090", "type": "CDM"}, {"code": "440", "type": "RC"}], "standard_charges": [{"gross_charge": 343.0, "discounted_cash": 257.25, "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": 417.0, "discounted_cash": 312.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP SWAL/ORAL TX COMPLX", "code_information": [{"code": "92526", "type": "CPT"}, {"code": "6041094", "type": "CDM"}, {"code": "440", "type": "RC"}], "standard_charges": [{"gross_charge": 401.0, "discounted_cash": 300.75, "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": 417.0, "discounted_cash": 312.75, "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": 435.0, "discounted_cash": 326.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP SWAL/ORAL TX INTERM", "code_information": [{"code": "92526", "type": "CPT"}, {"code": "6041092", "type": "CDM"}, {"code": "440", "type": "RC"}], "standard_charges": [{"gross_charge": 403.0, "discounted_cash": 302.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP SWAL/ORAL TX INTERMEDIATE", "code_information": [{"code": "92526", "type": "CPT"}, {"code": "6052527", "type": "CDM"}, {"code": "440", "type": "RC"}], "standard_charges": [{"gross_charge": 452.0, "discounted_cash": 339.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP THORCOLUMB SP PLT SCR", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011232", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1851.0, "discounted_cash": 1388.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SP TRANSVERSE BAR", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011268", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2956.0, "discounted_cash": 2217.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SP-GR EXCEPT URINE", "code_information": [{"code": "84315", "type": "CPT"}, {"code": "4104315", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SPACER HUM OR TRAY ZIMMER CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012938", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 14615.0, "discounted_cash": 10961.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPACER HUMERAL TRAY EXACT CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012842", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16369.0, "discounted_cash": 12276.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SPACER MIS INDEPENDENCE GLOBUS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011288", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 21366.0, "discounted_cash": 16024.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SPACER SPINAL IDENTITI", "code_information": [{"code": "C1821", "type": "HCPCS"}, {"code": "8137901", "type": "CDM"}], "standard_charges": [{"gross_charge": 18957.0, "discounted_cash": 14217.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SPACER SPINL INTBDY EXP PROLFT", "code_information": [{"code": "C1821", "type": "HCPCS"}, {"code": "8137896", "type": "CDM"}], "standard_charges": [{"gross_charge": 33964.0, "discounted_cash": 25473.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SPCL TX PROCEDURE", "code_information": [{"code": "77470", "type": "CPT"}, {"code": "5107470", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 4710.0, "discounted_cash": 3532.5, "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": 232.0, "discounted_cash": 174.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SPEC STAIN TRICH OVA/PARA", "code_information": [{"code": "87209", "type": "CPT"}, {"code": "7078313", "type": "CDM"}], "standard_charges": [{"gross_charge": 157.0, "discounted_cash": 117.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SPEC STAIN TRICH OVA/PARA", "code_information": [{"code": "87209", "type": "CPT"}, {"code": "7258313", "type": "CDM"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "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": 531.0, "discounted_cash": 398.25, "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": 403.0, "discounted_cash": 302.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPEC STAINS GROUP II", "code_information": [{"code": "88313", "type": "CPT"}, {"code": "7008333", "type": "CDM"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPEC STAINS GROUP II", "code_information": [{"code": "88313", "type": "CPT"}, {"code": "7058333", "type": "CDM"}], "standard_charges": [{"gross_charge": 339.0, "discounted_cash": 254.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPEC TELETHER PORT PLAN", "code_information": [{"code": "77321", "type": "CPT"}, {"code": "5107321", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 2544.0, "discounted_cash": 1908.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SPECIAL DOSIMETRY", "code_information": [{"code": "77331", "type": "CPT"}, {"code": "5107331", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 267.0, "discounted_cash": 200.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPECIAL STAIN SMEAR", "code_information": [{"code": "87207", "type": "CPT"}, {"code": "4107207", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 238.0, "discounted_cash": 178.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SPECIAL STAIN SMEAR", "code_information": [{"code": "87207", "type": "CPT"}, {"code": "7257207", "type": "CDM"}], "standard_charges": [{"gross_charge": 145.0, "discounted_cash": 108.75, "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": 967.0, "discounted_cash": 725.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPECIAL STAIN SMEAR/2", "code_information": [{"code": "87207", "type": "CPT"}, {"code": "7257208", "type": "CDM"}], "standard_charges": [{"gross_charge": 304.0, "discounted_cash": 228.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SPECIAL STAIN SMEAR/3", "code_information": [{"code": "87207", "type": "CPT"}, {"code": "7258720", "type": "CDM"}], "standard_charges": [{"gross_charge": 145.0, "discounted_cash": 108.75, "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": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SPECTROPHOTOMETRY NES/2", "code_information": [{"code": "84311", "type": "CPT"}, {"code": "7004314", "type": "CDM"}], "standard_charges": [{"gross_charge": 760.0, "discounted_cash": 570.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SPECTROPHOTOMETRY NES/2", "code_information": [{"code": "84311", "type": "CPT"}, {"code": "7254312", "type": "CDM"}], "standard_charges": [{"gross_charge": 760.0, "discounted_cash": 570.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SPECTROPHOTOMETRY NES/3", "code_information": [{"code": "84311", "type": "CPT"}, {"code": "7254317", "type": "CDM"}], "standard_charges": [{"gross_charge": 760.0, "discounted_cash": 570.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SPEECH/LANG COMMUNICATE INDIV", "code_information": [{"code": "92507", "type": "CPT"}, {"code": "6041008", "type": "CDM"}, {"code": "440", "type": "RC"}], "standard_charges": [{"gross_charge": 314.0, "discounted_cash": 235.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SPEECH/LANG TX BASIC", "code_information": [{"code": "92507", "type": "CPT"}, {"code": "5901007", "type": "CDM"}, {"code": "440", "type": "RC"}], "standard_charges": [{"gross_charge": 314.0, "discounted_cash": 235.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SPEECH/LANG TX BASIC", "code_information": [{"code": "92507", "type": "CPT"}, {"code": "6041007", "type": "CDM"}, {"code": "440", "type": "RC"}], "standard_charges": [{"gross_charge": 314.0, "discounted_cash": 235.5, "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": 408.0, "discounted_cash": 306.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SPEECH/LANG TX CMPLX", "code_information": [{"code": "92507", "type": "CPT"}, {"code": "6041009", "type": "CDM"}, {"code": "440", "type": "RC"}], "standard_charges": [{"gross_charge": 300.0, "discounted_cash": 225.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SPEECH/LANG TX COMPLEX", "code_information": [{"code": "92507", "type": "CPT"}, {"code": "6052522", "type": "CDM"}, {"code": "440", "type": "RC"}], "standard_charges": [{"gross_charge": 301.0, "discounted_cash": 225.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SPEECH/LANG TX EXTENSIVE", "code_information": [{"code": "92507", "type": "CPT"}, {"code": "6052523", "type": "CDM"}, {"code": "440", "type": "RC"}], "standard_charges": [{"gross_charge": 319.0, "discounted_cash": 239.25, "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": 315.0, "discounted_cash": 236.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SPEECH/LANG TX EXTNSV", "code_information": [{"code": "92507", "type": "CPT"}, {"code": "6041010", "type": "CDM"}, {"code": "440", "type": "RC"}], "standard_charges": [{"gross_charge": 293.0, "discounted_cash": 219.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SPEECH/LANG TX GRP BASIC", "code_information": [{"code": "92508", "type": "CPT"}, {"code": "6042508", "type": "CDM"}, {"code": "440", "type": "RC"}], "standard_charges": [{"gross_charge": 585.0, "discounted_cash": 438.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SPEECH/LANG TX GRP COMPLEX", "code_information": [{"code": "92508", "type": "CPT"}, {"code": "6042510", "type": "CDM"}, {"code": "440", "type": "RC"}], "standard_charges": [{"gross_charge": 554.0, "discounted_cash": 415.5, "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": 314.0, "discounted_cash": 235.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SPEECH/LANG TX INTERMEDIATE", "code_information": [{"code": "92507", "type": "CPT"}, {"code": "6052521", "type": "CDM"}, {"code": "440", "type": "RC"}], "standard_charges": [{"gross_charge": 314.0, "discounted_cash": 235.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SPHINCTERTOME DREAMTOME RX", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8035222", "type": "CDM"}], "standard_charges": [{"gross_charge": 1910.0, "discounted_cash": 1432.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINAL BOLT MODULUS ALIF", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136521", "type": "CDM"}], "standard_charges": [{"gross_charge": 5093.0, "discounted_cash": 3819.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINAL CAGE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136504", "type": "CDM"}], "standard_charges": [{"gross_charge": 63043.0, "discounted_cash": 47282.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINAL CAGE CORPECTOMY", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136524", "type": "CDM"}], "standard_charges": [{"gross_charge": 53315.0, "discounted_cash": 39986.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINAL CROSS CONNECTOR RELINE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136509", "type": "CDM"}], "standard_charges": [{"gross_charge": 3949.0, "discounted_cash": 2961.75, "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": 4217.0, "discounted_cash": 3162.75, "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": 4217.0, "discounted_cash": 3162.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINAL PUNCTR LUMB DIAG", "code_information": [{"code": "4908900", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1880.0, "discounted_cash": 1410.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINAL PUNCTR LUMB DIAG", "code_information": [{"code": "4918900", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1797.0, "discounted_cash": 1347.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINAL PUNCTURE THERAPTC", "code_information": [{"code": "4902135", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2851.0, "discounted_cash": 2138.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINAL PUNCTURE THERAPTC", "code_information": [{"code": "4912272", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2601.0, "discounted_cash": 1950.75, "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": 1515.0, "discounted_cash": 1136.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE ANY LEVEL SNGL VW", "code_information": [{"code": "72020", "type": "CPT"}, {"code": "5012020", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1298.0, "discounted_cash": 973.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE ANY LEVEL SNGL VW", "code_information": [{"code": "72020", "type": "CPT"}, {"code": "5112020", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1515.0, "discounted_cash": 1136.25, "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": 1637.0, "discounted_cash": 1227.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE CERV 6 > VWS", "code_information": [{"code": "72052", "type": "CPT"}, {"code": "5012052", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1886.0, "discounted_cash": 1414.5, "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": 2083.0, "discounted_cash": 1562.25, "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": 1616.0, "discounted_cash": 1212.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE CERVICAL 2 VIEWS", "code_information": [{"code": "72040", "type": "CPT"}, {"code": "5012040", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1616.0, "discounted_cash": 1212.0, "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": 1616.0, "discounted_cash": 1212.0, "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": 2143.0, "discounted_cash": 1607.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE CERVICAL 4 OR 5 VW", "code_information": [{"code": "72050", "type": "CPT"}, {"code": "5012050", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1825.0, "discounted_cash": 1368.75, "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": 2143.0, "discounted_cash": 1607.25, "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": 1879.0, "discounted_cash": 1409.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE LUMBAR 2 VIEWS", "code_information": [{"code": "72100", "type": "CPT"}, {"code": "5012100", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1879.0, "discounted_cash": 1409.25, "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": 2195.0, "discounted_cash": 1646.25, "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": 2183.0, "discounted_cash": 1637.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE LUMBAR 3 VIEWS", "code_information": [{"code": "72100", "type": "CPT"}, {"code": "5012101", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1972.0, "discounted_cash": 1479.0, "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": 2183.0, "discounted_cash": 1637.25, "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": 2681.0, "discounted_cash": 2010.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE LUMBAR MIN 4VWS", "code_information": [{"code": "72110", "type": "CPT"}, {"code": "5012110", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2479.0, "discounted_cash": 1859.25, "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": 2681.0, "discounted_cash": 2010.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE PUNC DRN CSF W/FLUOR/CT", "code_information": [{"code": "4912329", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4936.0, "discounted_cash": 3702.0, "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": 2315.0, "discounted_cash": 1736.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE THORACIC 2 VIEWS", "code_information": [{"code": "72070", "type": "CPT"}, {"code": "5012070", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1857.0, "discounted_cash": 1392.75, "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": 2049.0, "discounted_cash": 1536.75, "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": 907.0, "discounted_cash": 680.25, "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": 2245.0, "discounted_cash": 1683.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE THORACIC 4VW MIN", "code_information": [{"code": "72074", "type": "CPT"}, {"code": "5012072", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1970.0, "discounted_cash": 1477.5, "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": 2499.0, "discounted_cash": 1874.25, "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": 547.0, "discounted_cash": 410.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPIROMETRY", "code_information": [{"code": "94010", "type": "CPT"}, {"code": "4401200", "type": "CDM"}, {"code": "460", "type": "RC"}], "standard_charges": [{"gross_charge": 597.0, "discounted_cash": 447.75, "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": 1219.0, "discounted_cash": 914.25, "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": 55.0, "discounted_cash": 41.25, "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": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPIRONOLACTONE 12.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310901", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SPIRONOLACTONE 12.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310901", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPIRONOLACTONE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310914", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPIRONOLACTONE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310914", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPLIT CALIPER STRUP PLT", "code_information": [{"code": "L2230", "type": "HCPCS"}, {"code": "8130156", "type": "CDM"}], "standard_charges": [{"gross_charge": 1055.0, "discounted_cash": 791.25, "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": 323.0, "discounted_cash": 242.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SR89 1MCI", "code_information": [{"code": "A9600", "type": "HCPCS"}, {"code": "5196225", "type": "CDM"}, {"code": "344", "type": "RC"}], "standard_charges": [{"gross_charge": 9167.0, "discounted_cash": 6875.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SRS TX BODY LIN ACCL", "code_information": [{"code": "77373", "type": "CPT"}, {"code": "5107373", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 33150.0, "discounted_cash": 24862.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SRS TX CRANL LIN ACCL", "code_information": [{"code": "77372", "type": "CPT"}, {"code": "5107374", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 54268.0, "discounted_cash": 40701.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ST ACCESS LIVER TRNSJUG", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8034187", "type": "CDM"}], "standard_charges": [{"gross_charge": 2814.0, "discounted_cash": 2110.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ST CATH EVD BACTISEAL", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8082681", "type": "CDM"}], "standard_charges": [{"gross_charge": 12935.0, "discounted_cash": 9701.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ST CATH URET ILLUMINAT", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8041321", "type": "CDM"}], "standard_charges": [{"gross_charge": 1386.0, "discounted_cash": 1039.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ST CHEST TUBE THAL-QUICK", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8082684", "type": "CDM"}], "standard_charges": [{"gross_charge": 2032.0, "discounted_cash": 1524.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ST COLON DECOMPRESS W GW", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8082686", "type": "CDM"}], "standard_charges": [{"gross_charge": 1042.0, "discounted_cash": 781.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ST COMMON BIL DUCT EXPLR", "code_information": [{"code": "C1726", "type": "HCPCS"}, {"code": "8177211", "type": "CDM"}], "standard_charges": [{"gross_charge": 11833.0, "discounted_cash": 8874.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ST CYLINDR/PUMP SCROTAL", "code_information": [{"code": "C1813", "type": "HCPCS"}, {"code": "8156021", "type": "CDM"}], "standard_charges": [{"gross_charge": 52681.0, "discounted_cash": 39510.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ST DIL RENAL AMPLATZ", "code_information": [{"code": "C1726", "type": "HCPCS"}, {"code": "8243050", "type": "CDM"}], "standard_charges": [{"gross_charge": 1684.0, "discounted_cash": 1263.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ST EVACUATED DRAINAGE BOTTLE", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8082695", "type": "CDM"}], "standard_charges": [{"gross_charge": 153.0, "discounted_cash": 114.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ST INTRO PEELAWAY W GW", "code_information": [{"code": "C1892", "type": "HCPCS"}, {"code": "8248551", "type": "CDM"}], "standard_charges": [{"gross_charge": 491.0, "discounted_cash": 368.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ST INTROD PERFORMER W/GW", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8185303", "type": "CDM"}], "standard_charges": [{"gross_charge": 487.0, "discounted_cash": 365.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ST PERCUTANEOUS INTROD", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8034169", "type": "CDM"}], "standard_charges": [{"gross_charge": 1749.0, "discounted_cash": 1311.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ST PUMP IMPELLA CP CATH", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8145166", "type": "CDM"}], "standard_charges": [{"gross_charge": 330149.0, "discounted_cash": 247611.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ST THROMB ZELANTE DVT", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8058500", "type": "CDM"}], "standard_charges": [{"gross_charge": 18805.0, "discounted_cash": 14103.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ST THROMBECT SOLENT OMNI", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8084942", "type": "CDM"}], "standard_charges": [{"gross_charge": 10168.0, "discounted_cash": 7626.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ST VENA CAVA FLTR RETRVL", "code_information": [{"code": "C1773", "type": "HCPCS"}, {"code": "8177274", "type": "CDM"}], "standard_charges": [{"gross_charge": 2727.0, "discounted_cash": 2045.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STAPLE BN NITINOL DYN W INST", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137810", "type": "CDM"}], "standard_charges": [{"gross_charge": 26216.0, "discounted_cash": 19662.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STAPLE COMPRESSION", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136624", "type": "CDM"}], "standard_charges": [{"gross_charge": 3597.0, "discounted_cash": 2697.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STARCH 51% SU", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5338204", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STARCH 51% SU", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5338204", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STATIC AFO", "code_information": [{"code": "L4396", "type": "HCPCS"}, {"code": "8130069", "type": "CDM"}], "standard_charges": [{"gross_charge": 1651.0, "discounted_cash": 1238.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STAVUDINE 15MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310952", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STAVUDINE 15MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310952", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STAVUDINE 20MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310951", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 120.0, "discounted_cash": 90.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STAVUDINE 20MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310951", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 120.0, "discounted_cash": 90.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STAVUDINE 30MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310949", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 134.0, "discounted_cash": 100.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STAVUDINE 30MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310949", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 134.0, "discounted_cash": 100.5, "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": 141.0, "discounted_cash": 105.75, "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": 141.0, "discounted_cash": 105.75, "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": 31522.0, "discounted_cash": 23641.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM EXTENSION ELEOS", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8136593", "type": "CDM"}], "standard_charges": [{"gross_charge": 16920.0, "discounted_cash": 12690.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM FEM COATED HA ZIMMER CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012971", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 23192.0, "discounted_cash": 17394.0, "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": 17336.0, "discounted_cash": 13002.0, "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": 22127.0, "discounted_cash": 16595.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM FEM FRACTURE STM ZIMM CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012974", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11355.0, "discounted_cash": 8516.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM FEMORAL COATED SN CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012896", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 21638.0, "discounted_cash": 16228.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM FEMORAL COATED STRYKR CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013055", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 22127.0, "discounted_cash": 16595.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM FEMORAL UNCOATED SN CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012901", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 15942.0, "discounted_cash": 11956.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM FEMORL UNCOATD STRYKR CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013059", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 17343.0, "discounted_cash": 13007.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM HIP MODULAR REV ZIM CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012949", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 21972.0, "discounted_cash": 16479.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM HIP REVISION SN CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012880", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 34165.0, "discounted_cash": 25623.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM HUM CTD UNCEM STRYKR CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013027", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 30739.0, "discounted_cash": 23054.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM HUM CTD UNCEM ZIMMER CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012939", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 31566.0, "discounted_cash": 23674.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM HUM FRACT REVS TORNIER CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013513", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 36511.0, "discounted_cash": 27383.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM HUMERL FRAC REV EXACT CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012844", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 24551.0, "discounted_cash": 18413.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM HUMRL COATD TORNIER CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013511", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 30064.0, "discounted_cash": 22548.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM KNE FEM REM OSTEOREMED CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013364", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 14929.0, "discounted_cash": 11196.75, "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": 5979.0, "discounted_cash": 4484.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM KNEE EXTENS CONFORMIS CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013326", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5254.0, "discounted_cash": 3940.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM KNEE EXTENSION SN CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012881", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10248.0, "discounted_cash": 7686.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM SEGMENTAL CANAL ELEOS", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8136594", "type": "CDM"}], "standard_charges": [{"gross_charge": 54924.0, "discounted_cash": 41193.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM TALAR ANKLE", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8136596", "type": "CDM"}], "standard_charges": [{"gross_charge": 12796.0, "discounted_cash": 9597.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM TIBIAL BASE PLASMA", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8136587", "type": "CDM"}], "standard_charges": [{"gross_charge": 6688.0, "discounted_cash": 5016.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM TIBIAL MID PLASMA", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8136598", "type": "CDM"}], "standard_charges": [{"gross_charge": 6688.0, "discounted_cash": 5016.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM TIBIAL TOP PLASMA", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8136599", "type": "CDM"}], "standard_charges": [{"gross_charge": 6688.0, "discounted_cash": 5016.0, "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": 606.0, "discounted_cash": 454.5, "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": 1506.0, "discounted_cash": 1129.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STERNUM 2VW MIN", "code_information": [{"code": "71120", "type": "CPT"}, {"code": "5011120", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1584.0, "discounted_cash": 1188.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STERNUM 2VW MIN", "code_information": [{"code": "71120", "type": "CPT"}, {"code": "5111120", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1913.0, "discounted_cash": 1434.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STM EXT MOD KNEE OSTEOREMED CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013361", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6824.0, "discounted_cash": 5118.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STM HIP REM SPCT OSTEOREMED CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013359", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 17061.0, "discounted_cash": 12795.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT B ABSOLTE OTW S-EXP", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8243156", "type": "CDM"}], "standard_charges": [{"gross_charge": 7383.0, "discounted_cash": 5537.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT B ASSURANT BRIDGE", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "4024798", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9680.0, "discounted_cash": 7260.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT B COMPLETE SE", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8062059", "type": "CDM"}], "standard_charges": [{"gross_charge": 8985.0, "discounted_cash": 6738.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT B EXPRESS LD", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8243136", "type": "CDM"}], "standard_charges": [{"gross_charge": 10855.0, "discounted_cash": 8141.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT B LUMINEX", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8243138", "type": "CDM"}], "standard_charges": [{"gross_charge": 7151.0, "discounted_cash": 5363.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT B OMNILINK", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8243159", "type": "CDM"}], "standard_charges": [{"gross_charge": 10152.0, "discounted_cash": 7614.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT B PALMAZ XL", "code_information": [{"code": "C1877", "type": "HCPCS"}, {"code": "8248618", "type": "CDM"}], "standard_charges": [{"gross_charge": 6484.0, "discounted_cash": 4863.0, "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": 10667.0, "discounted_cash": 8000.25, "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": 7567.0, "discounted_cash": 5675.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT B PROTEGE W DEL", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "4024805", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5289.0, "discounted_cash": 3966.75, "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": 2727.0, "discounted_cash": 2045.25, "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": 10711.0, "discounted_cash": 8033.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT B SMART CORDS NITNL", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8243150", "type": "CDM"}], "standard_charges": [{"gross_charge": 13200.0, "discounted_cash": 9900.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT B SUPERA VERITAS", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8062062", "type": "CDM"}], "standard_charges": [{"gross_charge": 13155.0, "discounted_cash": 9866.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT B TRANSHEPT UNCVR", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8062217", "type": "CDM"}], "standard_charges": [{"gross_charge": 16020.0, "discounted_cash": 12015.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT B VAS E-LIMINEXX", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "4024816", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 7083.0, "discounted_cash": 5312.25, "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": 8001.0, "discounted_cash": 6000.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT B WALLFLEX RX CVR", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "8062056", "type": "CDM"}], "standard_charges": [{"gross_charge": 29465.0, "discounted_cash": 22098.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT B WALLFLX RX UNCVR", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "4024818", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 20473.0, "discounted_cash": 15354.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT BLLN EXPANDABLE VIABAHN", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "4025007", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 26146.0, "discounted_cash": 19609.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT C ACS MULTILNK ULT", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8243184", "type": "CDM"}], "standard_charges": [{"gross_charge": 3255.0, "discounted_cash": 2441.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT C CYPHER W DEL SYS", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "4024820", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 18040.0, "discounted_cash": 13530.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT C GRAFTMASTER RX", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "8062082", "type": "CDM"}], "standard_charges": [{"gross_charge": 31627.0, "discounted_cash": 23720.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT C INTEGRITY BMS RX", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8062067", "type": "CDM"}], "standard_charges": [{"gross_charge": 3974.0, "discounted_cash": 2980.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT C PROMUS PREMIER", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "8062073", "type": "CDM"}], "standard_charges": [{"gross_charge": 889.0, "discounted_cash": 666.75, "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": 14668.0, "discounted_cash": 11001.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT C REBEL MR BMS", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8062081", "type": "CDM"}], "standard_charges": [{"gross_charge": 5410.0, "discounted_cash": 4057.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT C RESOLUT INTEG DES", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "8062069", "type": "CDM"}], "standard_charges": [{"gross_charge": 12152.0, "discounted_cash": 9114.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT C TAXUS EXPRESS", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "4025002", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 22221.0, "discounted_cash": 16665.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT C XIENC XPED EVR RX", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "8062078", "type": "CDM"}], "standard_charges": [{"gross_charge": 7947.0, "discounted_cash": 5960.25, "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": 11944.0, "discounted_cash": 8958.0, "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": 12572.0, "discounted_cash": 9429.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT C/CV SYNERGY MR US LRG", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "8062087", "type": "CDM"}], "standard_charges": [{"gross_charge": 7574.0, "discounted_cash": 5680.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT CAROTID PRECISE PRO", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "4025012", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 17479.0, "discounted_cash": 13109.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT CAROTID RX ACCULINK", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8062063", "type": "CDM"}], "standard_charges": [{"gross_charge": 15550.0, "discounted_cash": 11662.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT CAROTID RX XACT", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8062079", "type": "CDM"}], "standard_charges": [{"gross_charge": 17243.0, "discounted_cash": 12932.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT COAT/COV W DEL SYS7", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "4025018", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 20791.0, "discounted_cash": 15593.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT COR FRONTIER ONYX DES RX", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "8062088", "type": "CDM"}], "standard_charges": [{"gross_charge": 3412.0, "discounted_cash": 2559.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT COR XIENCE SIERRA EE RX", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "8062205", "type": "CDM"}], "standard_charges": [{"gross_charge": 9375.0, "discounted_cash": 7031.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT DUODENAL WALLFLEX", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8248675", "type": "CDM"}], "standard_charges": [{"gross_charge": 23221.0, "discounted_cash": 17415.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT ENDEAVOR SPRINT", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "4025102", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 14206.0, "discounted_cash": 10654.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT ENDOPROSTH FEM ART", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "8062215", "type": "CDM"}], "standard_charges": [{"gross_charge": 23193.0, "discounted_cash": 17394.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT ENDOPYLOTOMY", "code_information": [{"code": "C2625", "type": "HCPCS"}, {"code": "8062101", "type": "CDM"}], "standard_charges": [{"gross_charge": 2237.0, "discounted_cash": 1677.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT ESOPH ENDOMAXX FCVR", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "8062219", "type": "CDM"}], "standard_charges": [{"gross_charge": 17914.0, "discounted_cash": 13435.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT ESOPH ULTRAFLEX SYS", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8243260", "type": "CDM"}], "standard_charges": [{"gross_charge": 16553.0, "discounted_cash": 12414.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT ESOPHAGEAL AGILE", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "8062224", "type": "CDM"}], "standard_charges": [{"gross_charge": 30471.0, "discounted_cash": 22853.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT ILIAC ASSURNT COBLT", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8062230", "type": "CDM"}], "standard_charges": [{"gross_charge": 8381.0, "discounted_cash": 6285.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT MULTLINK VISION RX", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "4025205", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3225.0, "discounted_cash": 2418.75, "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": 3225.0, "discounted_cash": 2418.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT NEUROFORM ATLAS", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8062267", "type": "CDM"}], "standard_charges": [{"gross_charge": 88133.0, "discounted_cash": 66099.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT PERIPH PTX DRG ELUT", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "8062271", "type": "CDM"}], "standard_charges": [{"gross_charge": 13026.0, "discounted_cash": 9769.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT PERIPH RX SLF-EXPD MISAGO", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8062275", "type": "CDM"}], "standard_charges": [{"gross_charge": 9196.0, "discounted_cash": 6897.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT PERIPH SE MISAGO", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "8062273", "type": "CDM"}], "standard_charges": [{"gross_charge": 10846.0, "discounted_cash": 8134.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT PERIPHERAL SUPERA", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8062272", "type": "CDM"}], "standard_charges": [{"gross_charge": 11714.0, "discounted_cash": 8785.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT SILICONE", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8062125", "type": "CDM"}], "standard_charges": [{"gross_charge": 469.0, "discounted_cash": 351.75, "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": 25012.0, "discounted_cash": 18759.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT TBRONCH ICAST", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "4025401", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 26531.0, "discounted_cash": 19898.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT TRABCULR MICRO-BYPS", "code_information": [{"code": "C1783", "type": "HCPCS"}, {"code": "8062134", "type": "CDM"}], "standard_charges": [{"gross_charge": 12334.0, "discounted_cash": 9250.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT U DP COOK UROLOGICL", "code_information": [{"code": "C2617", "type": "HCPCS"}, {"code": "8248758", "type": "CDM"}], "standard_charges": [{"gross_charge": 1106.0, "discounted_cash": 829.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT U METAL RESONANCE", "code_information": [{"code": "C2625", "type": "HCPCS"}, {"code": "4025501", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12503.0, "discounted_cash": 9377.25, "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": 784.0, "discounted_cash": 588.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT ULTRAFLX ESOPH", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "8062143", "type": "CDM"}], "standard_charges": [{"gross_charge": 32290.0, "discounted_cash": 24217.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT URETERAL CONTOUR", "code_information": [{"code": "C2617", "type": "HCPCS"}, {"code": "8062157", "type": "CDM"}], "standard_charges": [{"gross_charge": 1499.0, "discounted_cash": 1124.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT URETHRAL", "code_information": [{"code": "C2625", "type": "HCPCS"}, {"code": "8062156", "type": "CDM"}], "standard_charges": [{"gross_charge": 427.0, "discounted_cash": 320.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT VAS ABSOLUTE PRO SE", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8062177", "type": "CDM"}], "standard_charges": [{"gross_charge": 9329.0, "discounted_cash": 6996.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT VAS DRUG ELUT ELUVIA", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "8067799", "type": "CDM"}], "standard_charges": [{"gross_charge": 29683.0, "discounted_cash": 22262.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT VAS ZILVR 518 RX SE", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8062188", "type": "CDM"}], "standard_charges": [{"gross_charge": 11692.0, "discounted_cash": 8769.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT VASC BLN EXPND OTW", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8062192", "type": "CDM"}], "standard_charges": [{"gross_charge": 8985.0, "discounted_cash": 6738.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT VASC COVERED LIFESTREAM", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "8062194", "type": "CDM"}], "standard_charges": [{"gross_charge": 31034.0, "discounted_cash": 23275.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT VASC EPIC SLF EXPND", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8062178", "type": "CDM"}], "standard_charges": [{"gross_charge": 6184.0, "discounted_cash": 4638.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT VASC LIFESTENT", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8062184", "type": "CDM"}], "standard_charges": [{"gross_charge": 8985.0, "discounted_cash": 6738.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT VASC LIFESTENT SOLO", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8062182", "type": "CDM"}], "standard_charges": [{"gross_charge": 18660.0, "discounted_cash": 13995.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT VASCULAR CAROTID", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8062179", "type": "CDM"}], "standard_charges": [{"gross_charge": 19011.0, "discounted_cash": 14258.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT VASCULAR SE INNOVA", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8062181", "type": "CDM"}], "standard_charges": [{"gross_charge": 858.0, "discounted_cash": 643.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT VENOUS VICI", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8067803", "type": "CDM"}], "standard_charges": [{"gross_charge": 17053.0, "discounted_cash": 12789.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STPL LINE REINFORCEMENT", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8185138", "type": "CDM"}], "standard_charges": [{"gross_charge": 2504.0, "discounted_cash": 1878.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STRAPPING OF PASTE BOOT", "code_information": [{"code": "6900092", "type": "CDM"}], "standard_charges": [{"gross_charge": 1122.0, "discounted_cash": 841.5, "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": 336.0, "discounted_cash": 252.0, "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": 336.0, "discounted_cash": 252.0, "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": 935.0, "discounted_cash": 701.25, "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": 935.0, "discounted_cash": 701.25, "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": 976.0, "discounted_cash": 732.0, "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": 976.0, "discounted_cash": 732.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STRAVIX PL 3CMX6CM PER SQ CM", "code_information": [{"code": "Q4133", "type": "HCPCS"}, {"code": "4028749", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 673.0, "discounted_cash": 504.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STRAVIX PL 3CMX6CM PER SQ CM", "code_information": [{"code": "Q4133", "type": "HCPCS"}, {"code": "4028749", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 673.0, "discounted_cash": 504.75, "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": 230.0, "discounted_cash": 172.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STREPTOCOCCUS A DIR OPT", "code_information": [{"code": "87880", "type": "CPT"}, {"code": "4126410", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "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": 350.0, "discounted_cash": 262.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STREPTOCOCCUS B DIR OPT", "code_information": [{"code": "87802", "type": "CPT"}, {"code": "4107802", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 282.0, "discounted_cash": 211.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STREPTOMYCIN LEVEL", "code_information": [{"code": "80375", "type": "CPT"}, {"code": "7258281", "type": "CDM"}], "standard_charges": [{"gross_charge": 262.0, "discounted_cash": 196.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STREPTOMYCIN UPTO 1GM IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3000", "type": "HCPCS"}, {"code": "5324363", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 368.0, "discounted_cash": 276.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STREPTOMYCIN UPTO 1GM IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3000", "type": "HCPCS"}, {"code": "5324363", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 368.0, "discounted_cash": 276.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STRIATED AB SCR", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "7251260", "type": "CDM"}], "standard_charges": [{"gross_charge": 956.0, "discounted_cash": 717.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STRP PERI", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8034258", "type": "CDM"}], "standard_charges": [{"gross_charge": 5091.0, "discounted_cash": 3818.25, "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": 28.0, "discounted_cash": 21.0, "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": 28.0, "discounted_cash": 21.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "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": 83.0, "discounted_cash": 62.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SUFENT/ROPIV EPI 1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5324414", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "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": 388.0, "discounted_cash": 291.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SUFENTANIL 50UG/ML2ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5327993", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 646.0, "discounted_cash": 484.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SUFENTANIL 50UG/ML5ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5327995", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 980.0, "discounted_cash": 735.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SUGAMMADEX 200MG PFS IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5324394", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 521.3, "discounted_cash": 390.98, "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": 730.0, "discounted_cash": 547.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SUGAMMADEX 500MG/5ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5324401", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1489.0, "discounted_cash": 1116.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SUGARS CHROMOGRPH/2", "code_information": [{"code": "84375", "type": "CPT"}, {"code": "7004375", "type": "CDM"}], "standard_charges": [{"gross_charge": 535.0, "discounted_cash": 401.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SUGARS MULT QUAL EA SPEC", "code_information": [{"code": "84377", "type": "CPT"}, {"code": "7251008", "type": "CDM"}], "standard_charges": [{"gross_charge": 147.0, "discounted_cash": 110.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SULFACET/PRED .2% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332514", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 438.0, "discounted_cash": 328.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SULFACET/PRED .2% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332514", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 438.0, "discounted_cash": 328.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SULFACET/PRED .5% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332518", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 280.0, "discounted_cash": 210.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SULFACET/PRED .5% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332518", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 280.0, "discounted_cash": 210.0, "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": 226.0, "discounted_cash": 169.5, "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": 226.0, "discounted_cash": 169.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SULFACETAMD NA10%3.5GMOO", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332473", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 295.0, "discounted_cash": 221.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SULFACETAMD NA10%3.5GMOO", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332473", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 295.0, "discounted_cash": 221.25, "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": 39.0, "discounted_cash": 29.25, "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": 39.0, "discounted_cash": 29.25, "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": 0.51, "discounted_cash": 0.38, "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": 0.51, "discounted_cash": 0.38, "setting": "both", "billing_class": "facility"}]}, {"description": "SULFASALAZIN 500MG EC TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311111", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SULFASALAZIN 500MG EC TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311111", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SULFATE GLUCURONYL ABB", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "7258375", "type": "CDM"}], "standard_charges": [{"gross_charge": 177.0, "discounted_cash": 132.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SULFUR HEXAFLUOR SF6 GAS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5353150", "type": "CDM"}, {"code": "255", "type": "RC"}], "standard_charges": [{"gross_charge": 3229.0, "discounted_cash": 2421.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SUMATRIPTAN 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311192", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 213.0, "discounted_cash": 159.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SUMATRIPTAN 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311192", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 213.0, "discounted_cash": 159.75, "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": 317.0, "discounted_cash": 237.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 317.0, "discounted_cash": 237.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SUMATRIPTAN 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311191", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 317.0, "discounted_cash": 237.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SUMATRIPTAN 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311191", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 317.0, "discounted_cash": 237.75, "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": 857.0, "discounted_cash": 642.75, "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": 857.0, "discounted_cash": 642.75, "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": 13052.0, "discounted_cash": 9789.0, "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": 197.0, "discounted_cash": 147.75, "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": 4936.0, "discounted_cash": 3702.0, "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": 12064.0, "discounted_cash": 9048.0, "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": 5760.0, "discounted_cash": 4320.0, "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": 14219.0, "discounted_cash": 10664.25, "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": 6583.0, "discounted_cash": 4937.25, "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": 16375.0, "discounted_cash": 12281.25, "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": 7052.0, "discounted_cash": 5289.0, "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": 16845.0, "discounted_cash": 12633.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG PROC EA ADD 15 MIN", "code_information": [{"code": "3110276", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 507.0, "discounted_cash": 380.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG PROC I", "code_information": [{"code": "6296000", "type": "CDM"}], "standard_charges": [{"gross_charge": 1178.0, "discounted_cash": 883.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG PROC II", "code_information": [{"code": "6296001", "type": "CDM"}], "standard_charges": [{"gross_charge": 3097.0, "discounted_cash": 2322.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG PROC III", "code_information": [{"code": "6296002", "type": "CDM"}], "standard_charges": [{"gross_charge": 4248.0, "discounted_cash": 3186.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG PROC INIT 30 MIN", "code_information": [{"code": "3110275", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1015.0, "discounted_cash": 761.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG PROC LEVEL I", "code_information": [{"code": "3913000", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 1336.0, "discounted_cash": 1002.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG PROC LEVEL I", "code_information": [{"code": "3913000", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1336.0, "discounted_cash": 1002.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG PROC LEVEL I", "code_information": [{"code": "6100400", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1610.0, "discounted_cash": 1207.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG PROC LEVEL I", "code_information": [{"code": "6110010", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1472.0, "discounted_cash": 1104.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG PROC LEVEL I", "code_information": [{"code": "6110400", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1472.0, "discounted_cash": 1104.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG PROC LEVEL I", "code_information": [{"code": "6126050", "type": "CDM"}, {"code": "516", "type": "RC"}], "standard_charges": [{"gross_charge": 1336.0, "discounted_cash": 1002.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG PROC LEVEL I", "code_information": [{"code": "6166000", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1371.0, "discounted_cash": 1028.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG PROC LEVEL I", "code_information": [{"code": "6216011", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 1328.0, "discounted_cash": 996.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG PROC LEVEL I", "code_information": [{"code": "6216011", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1328.0, "discounted_cash": 996.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG PROC LEVEL I", "code_information": [{"code": "6920401", "type": "CDM"}], "standard_charges": [{"gross_charge": 1336.0, "discounted_cash": 1002.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG PROC LEVEL II", "code_information": [{"code": "6100402", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 2842.0, "discounted_cash": 2131.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG PROC LEVEL II", "code_information": [{"code": "6110011", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 2938.0, "discounted_cash": 2203.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG PROC LEVEL II", "code_information": [{"code": "6110402", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 2938.0, "discounted_cash": 2203.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG PROC LEVEL II", "code_information": [{"code": "6126000", "type": "CDM"}, {"code": "516", "type": "RC"}], "standard_charges": [{"gross_charge": 2669.0, "discounted_cash": 2001.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG PROC LEVEL II", "code_information": [{"code": "6166001", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 2984.0, "discounted_cash": 2238.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG PROC LEVEL II", "code_information": [{"code": "6920402", "type": "CDM"}], "standard_charges": [{"gross_charge": 2669.0, "discounted_cash": 2001.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG PROC LEVEL III", "code_information": [{"code": "6100404", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 5683.0, "discounted_cash": 4262.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG PROC LEVEL III", "code_information": [{"code": "6110012", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 5876.0, "discounted_cash": 4407.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG PROC LEVEL III", "code_information": [{"code": "6110404", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 5876.0, "discounted_cash": 4407.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG PROC LEVEL III", "code_information": [{"code": "6126004", "type": "CDM"}, {"code": "516", "type": "RC"}], "standard_charges": [{"gross_charge": 5341.0, "discounted_cash": 4005.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG PROC LEVEL III", "code_information": [{"code": "6166002", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 5327.0, "discounted_cash": 3995.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG PROC LEVEL III", "code_information": [{"code": "6920404", "type": "CDM"}], "standard_charges": [{"gross_charge": 5341.0, "discounted_cash": 4005.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG PROC NICU 1ST 30MN", "code_information": [{"code": "3110278", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1015.0, "discounted_cash": 761.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG PROC NICU EA ADD MN", "code_information": [{"code": "3110284", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SURGICAL ADHESIVE 30MLTS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5335065", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 411.0, "discounted_cash": 308.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SURGICAL ADHESIVE.67MLTS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334046", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SURGICAL ADHESIVE.67MLTS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334046", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "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": 175.0, "discounted_cash": 131.25, "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": 349.0, "discounted_cash": 261.75, "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": 379.0, "discounted_cash": 284.25, "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": 523.0, "discounted_cash": 392.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SURGICAL PATH LEVEL IV", "code_information": [{"code": "88305", "type": "CPT"}, {"code": "7058404", "type": "CDM"}], "standard_charges": [{"gross_charge": 534.0, "discounted_cash": 400.5, "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": 1099.0, "discounted_cash": 824.25, "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": 1527.0, "discounted_cash": 1145.25, "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": 1472.0, "discounted_cash": 1104.0, "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": 1521.0, "discounted_cash": 1140.75, "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": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SUSCEPTBILTY STDY ENZYME", "code_information": [{"code": "87185", "type": "CPT"}, {"code": "4127036", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 58.0, "discounted_cash": 43.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SUSCEPTIBLTY MACROBROTH", "code_information": [{"code": "87188", "type": "CPT"}, {"code": "4107188", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 724.0, "discounted_cash": 543.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SUSCEPTIBLTY MACROBROTH/3", "code_information": [{"code": "87188", "type": "CPT"}, {"code": "7007188", "type": "CDM"}], "standard_charges": [{"gross_charge": 1322.0, "discounted_cash": 991.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SUSCEPTIBLTY STUDY MIC/2", "code_information": [{"code": "87186", "type": "CPT"}, {"code": "4157186", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 269.0, "discounted_cash": 201.75, "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": 900.0, "discounted_cash": 675.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SUSCEPTIBLTY STUDY MIC/3", "code_information": [{"code": "87186", "type": "CPT"}, {"code": "4127186", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SUSCEPTIBLTY STUDY MIC/5", "code_information": [{"code": "87186", "type": "CPT"}, {"code": "7077186", "type": "CDM"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "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": 1706.0, "discounted_cash": 1279.5, "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": 438.0, "discounted_cash": 328.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SYPHILIS NONTREP QUAL", "code_information": [{"code": "86592", "type": "CPT"}, {"code": "4126592", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SYPHILIS NONTREP QUAL", "code_information": [{"code": "86592", "type": "CPT"}, {"code": "4156592", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 122.0, "discounted_cash": 91.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SYPHILIS NONTREP QUAL", "code_information": [{"code": "86592", "type": "CPT"}, {"code": "7256592", "type": "CDM"}], "standard_charges": [{"gross_charge": 427.0, "discounted_cash": 320.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SYPHILIS NONTREP QUAL/2", "code_information": [{"code": "86592", "type": "CPT"}, {"code": "7006594", "type": "CDM"}], "standard_charges": [{"gross_charge": 427.0, "discounted_cash": 320.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SYPHILIS NONTREP QUAL/2", "code_information": [{"code": "86592", "type": "CPT"}, {"code": "7256594", "type": "CDM"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "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": 573.0, "discounted_cash": 429.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SYPHILIS NONTREP QUAN", "code_information": [{"code": "86593", "type": "CPT"}, {"code": "4126593", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "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": 11.0, "discounted_cash": 8.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 11.0, "discounted_cash": 8.25, "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": 12648.0, "discounted_cash": 9486.0, "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": 7513.0, "discounted_cash": 5634.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS ACL TIGHTROPE BTB", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136678", "type": "CDM"}], "standard_charges": [{"gross_charge": 3597.0, "discounted_cash": 2697.75, "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": 2094.0, "discounted_cash": 1570.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS ANKL LAT RECON IMPL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4018071", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12094.0, "discounted_cash": 9070.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS ASPIRATION CVAC CALYXO", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8086970", "type": "CDM"}], "standard_charges": [{"gross_charge": 41680.0, "discounted_cash": 31260.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS ATHER EXCSN ROTAT ROTAREX", "code_information": [{"code": "C1724", "type": "HCPCS"}, {"code": "8057018", "type": "CDM"}], "standard_charges": [{"gross_charge": 30828.0, "discounted_cash": 23121.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS ATHERCT JETSTREAM XC", "code_information": [{"code": "C1724", "type": "HCPCS"}, {"code": "8058501", "type": "CDM"}], "standard_charges": [{"gross_charge": 23557.0, "discounted_cash": 17667.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS ATHERECTOMY PHOENIX", "code_information": [{"code": "C1724", "type": "HCPCS"}, {"code": "8058502", "type": "CDM"}], "standard_charges": [{"gross_charge": 18506.0, "discounted_cash": 13879.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS BICEP BIRMINGHAM IMPLANT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4018083", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10508.0, "discounted_cash": 7881.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS BICEP RPR DSTL BIOCMP DEL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4018079", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9853.0, "discounted_cash": 7389.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS CATH FLASH OSTIAL", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056995", "type": "CDM"}], "standard_charges": [{"gross_charge": 8405.0, "discounted_cash": 6303.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS CBL ACCORD TROCH GRP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136681", "type": "CDM"}], "standard_charges": [{"gross_charge": 34703.0, "discounted_cash": 26027.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS CEREBRAL PROTECTION", "code_information": [{"code": "C1884", "type": "HCPCS"}, {"code": "8177447", "type": "CDM"}], "standard_charges": [{"gross_charge": 36970.0, "discounted_cash": 27727.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS COIL DETACH INZONE", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8173728", "type": "CDM"}], "standard_charges": [{"gross_charge": 2486.0, "discounted_cash": 1864.5, "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": 6893.0, "discounted_cash": 5169.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS COR ROTLNK CATH/BURR", "code_information": [{"code": "C1724", "type": "HCPCS"}, {"code": "8240374", "type": "CDM"}], "standard_charges": [{"gross_charge": 7802.0, "discounted_cash": 5851.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS DEL LFT HEART", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056997", "type": "CDM"}], "standard_charges": [{"gross_charge": 1172.0, "discounted_cash": 879.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS DELIVERY CPS LOCATOR 3D", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056612", "type": "CDM"}], "standard_charges": [{"gross_charge": 1083.0, "discounted_cash": 812.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS DILATAT MULTI-SINUS", "code_information": [{"code": "C1726", "type": "HCPCS"}, {"code": "8178697", "type": "CDM"}], "standard_charges": [{"gross_charge": 9713.0, "discounted_cash": 7284.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS EMB PROT FLTRWIRE", "code_information": [{"code": "C1884", "type": "HCPCS"}, {"code": "4036801", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10351.0, "discounted_cash": 7763.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS EMB PROT FLTRWIRE", "code_information": [{"code": "C1884", "type": "HCPCS"}, {"code": "8073272", "type": "CDM"}], "standard_charges": [{"gross_charge": 9592.0, "discounted_cash": 7194.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS EMBOLIC LIQUID", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8034559", "type": "CDM"}], "standard_charges": [{"gross_charge": 23040.0, "discounted_cash": 17280.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS EMBOLIC LIQUID ONYX", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8178705", "type": "CDM"}], "standard_charges": [{"gross_charge": 32340.0, "discounted_cash": 24255.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS EMBOLIZATION ANEURYSM WEB", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8177466", "type": "CDM"}], "standard_charges": [{"gross_charge": 145619.0, "discounted_cash": 109214.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS EMBOLIZATN PROTECT", "code_information": [{"code": "C1884", "type": "HCPCS"}, {"code": "8243530", "type": "CDM"}], "standard_charges": [{"gross_charge": 11589.0, "discounted_cash": 8691.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS FIBERTAK BICEPS IMPLANT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8086989", "type": "CDM"}], "standard_charges": [{"gross_charge": 6567.0, "discounted_cash": 4925.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS FIXATION SM BN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8243532", "type": "CDM"}], "standard_charges": [{"gross_charge": 18944.0, "discounted_cash": 14208.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS FLEXOR DIGITORIUM LONGUS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011783", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 17829.0, "discounted_cash": 13371.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS FRONTAL SINUS BLN", "code_information": [{"code": "C1726", "type": "HCPCS"}, {"code": "8177456", "type": "CDM"}], "standard_charges": [{"gross_charge": 6030.0, "discounted_cash": 4522.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS GASTRIC BANDING", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8185628", "type": "CDM"}], "standard_charges": [{"gross_charge": 32477.0, "discounted_cash": 24357.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS ILLUM SINUS", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8178703", "type": "CDM"}], "standard_charges": [{"gross_charge": 4270.0, "discounted_cash": 3202.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS IMPELLA CP PLS CMPN SHEATH", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8145179", "type": "CDM"}], "standard_charges": [{"gross_charge": 213261.0, "discounted_cash": 159945.75, "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": 12624.0, "discounted_cash": 9468.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS INFUSION CV CATH", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8145170", "type": "CDM"}], "standard_charges": [{"gross_charge": 1212.0, "discounted_cash": 909.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS INTROD LV WORLEY TEL", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8073605", "type": "CDM"}], "standard_charges": [{"gross_charge": 2314.0, "discounted_cash": 1735.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS LIGAMENT AUGMNT REPR PLUS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4018090", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 18222.0, "discounted_cash": 13666.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS MAXILLARY SINUS BLN", "code_information": [{"code": "C1726", "type": "HCPCS"}, {"code": "8177464", "type": "CDM"}], "standard_charges": [{"gross_charge": 3597.0, "discounted_cash": 2697.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS MCATH PROGREAT COAX", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "4036806", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6072.0, "discounted_cash": 4554.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS MENISCL FAST-FIX CRV", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4018064", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6054.0, "discounted_cash": 4540.5, "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": 81601.0, "discounted_cash": 61200.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS MESH VAGINAL SUPPORT", "code_information": [{"code": "C1763", "type": "HCPCS"}, {"code": "4028806", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 15456.0, "discounted_cash": 11592.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS NSTIM CHARGING AXONICS", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "4008547", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 7841.0, "discounted_cash": 5880.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS PERIPH INFUS TRELLIS", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8178723", "type": "CDM"}], "standard_charges": [{"gross_charge": 18235.0, "discounted_cash": 13676.25, "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": 11394.0, "discounted_cash": 8545.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS RETRV TREVO XP PROVU", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8177474", "type": "CDM"}], "standard_charges": [{"gross_charge": 88200.0, "discounted_cash": 66150.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS SACRAL NEUROMODULATION", "code_information": [{"code": "C1820", "type": "HCPCS"}, {"code": "8178737", "type": "CDM"}], "standard_charges": [{"gross_charge": 115828.0, "discounted_cash": 86871.0, "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": 23134.0, "discounted_cash": 17350.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS SACROILC JOINT FUSN 3D", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "4011784", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 34584.0, "discounted_cash": 25938.0, "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": 5096.0, "discounted_cash": 3822.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS SLING ADVANCE MALE AMS", "code_information": [{"code": "C1771", "type": "HCPCS"}, {"code": "4025539", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 77794.0, "discounted_cash": 58345.5, "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": 8057.0, "discounted_cash": 6042.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS SLNG FIX M ADVNC W/S", "code_information": [{"code": "C1771", "type": "HCPCS"}, {"code": "4025521", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 36992.0, "discounted_cash": 27744.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS SLNG MDURET TRN HALO", "code_information": [{"code": "C1771", "type": "HCPCS"}, {"code": "4028814", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6868.0, "discounted_cash": 5151.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS SLNG MIDURETH TRNOBT", "code_information": [{"code": "C1771", "type": "HCPCS"}, {"code": "4028811", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8001.0, "discounted_cash": 6000.75, "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": 18261.0, "discounted_cash": 13695.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS SNARE ENDOVASCULAR", "code_information": [{"code": "C1773", "type": "HCPCS"}, {"code": "8082988", "type": "CDM"}], "standard_charges": [{"gross_charge": 4250.0, "discounted_cash": 3187.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS SPACEOAR", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8178741", "type": "CDM"}], "standard_charges": [{"gross_charge": 34993.0, "discounted_cash": 26244.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS SPINL CMNT DEL ZAVATION", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8086978", "type": "CDM"}], "standard_charges": [{"gross_charge": 20089.0, "discounted_cash": 15066.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS STNT AXIOS ELCTR DEL", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "8062198", "type": "CDM"}], "standard_charges": [{"gross_charge": 46232.0, "discounted_cash": 34674.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS STNT TRANSCAROTID", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8062203", "type": "CDM"}], "standard_charges": [{"gross_charge": 25743.0, "discounted_cash": 19307.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS STNT VENOUS SLF EXP ABRE", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8067503", "type": "CDM"}], "standard_charges": [{"gross_charge": 15760.0, "discounted_cash": 11820.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS SYNDESMOSIS TGHTRP XP SS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4018082", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 17829.0, "discounted_cash": 13371.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS TACK ENDOVASCULAR", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8067504", "type": "CDM"}], "standard_charges": [{"gross_charge": 7634.0, "discounted_cash": 5725.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS THROMB SOLENT DISTA", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8178747", "type": "CDM"}], "standard_charges": [{"gross_charge": 20836.0, "discounted_cash": 15627.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS THROMB SOLENT PROXI", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8178746", "type": "CDM"}], "standard_charges": [{"gross_charge": 16450.0, "discounted_cash": 12337.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS TIBIAL ANKLE INFINITY", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4018087", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 63140.0, "discounted_cash": 47355.0, "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": 99474.0, "discounted_cash": 74605.5, "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": 95967.0, "discounted_cash": 71975.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS TRANSCATH PACE MICRA2 AV", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4005003", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 43955.0, "discounted_cash": 32966.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS TRANSCATH PACE MICRA2 VR", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4005004", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 74170.0, "discounted_cash": 55627.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS TRNSCAR NEUROPROTECT", "code_information": [{"code": "C1884", "type": "HCPCS"}, {"code": "8178744", "type": "CDM"}], "standard_charges": [{"gross_charge": 26444.0, "discounted_cash": 19833.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS VASC ACCES PRECISION", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8185650", "type": "CDM"}], "standard_charges": [{"gross_charge": 264.0, "discounted_cash": 198.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS VASCULR CLSR VASCADE", "code_information": [{"code": "C1760", "type": "HCPCS"}, {"code": "8178760", "type": "CDM"}], "standard_charges": [{"gross_charge": 1425.0, "discounted_cash": 1068.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS W/BONE ANCHOR ADV DEL SN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136674", "type": "CDM"}], "standard_charges": [{"gross_charge": 23830.0, "discounted_cash": 17872.5, "setting": "both", "billing_class": "facility"}]}, {"description": "T CELLS T4/T8 INC RATIO", "code_information": [{"code": "86360", "type": "CPT"}, {"code": "7056360", "type": "CDM"}], "standard_charges": [{"gross_charge": 283.0, "discounted_cash": 212.25, "setting": "both", "billing_class": "facility"}]}, {"description": "T CELLS T4/T8 INC RATIO", "code_information": [{"code": "86360", "type": "CPT"}, {"code": "7256360", "type": "CDM"}], "standard_charges": [{"gross_charge": 128.0, "discounted_cash": 96.0, "setting": "both", "billing_class": "facility"}]}, {"description": "T CELLS TOTAL COUNT", "code_information": [{"code": "86359", "type": "CPT"}, {"code": "7256359", "type": "CDM"}], "standard_charges": [{"gross_charge": 128.0, "discounted_cash": 96.0, "setting": "both", "billing_class": "facility"}]}, {"description": "T-CELLS ABSOLUTE CD4 CNT", "code_information": [{"code": "86361", "type": "CPT"}, {"code": "7006361", "type": "CDM"}], "standard_charges": [{"gross_charge": 558.0, "discounted_cash": 418.5, "setting": "both", "billing_class": "facility"}]}, {"description": "T-CELLS ABSOLUTE CD4 CNT", "code_information": [{"code": "86361", "type": "CPT"}, {"code": "7076361", "type": "CDM"}], "standard_charges": [{"gross_charge": 328.0, "discounted_cash": 246.0, "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": 1206.0, "discounted_cash": 904.5, "setting": "both", "billing_class": "facility"}]}, {"description": "T3 FREE", "code_information": [{"code": "84481", "type": "CPT"}, {"code": "4123554", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "T3 FREE", "code_information": [{"code": "84481", "type": "CPT"}, {"code": "7003554", "type": "CDM"}], "standard_charges": [{"gross_charge": 927.0, "discounted_cash": 695.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TACROLIMUS", "code_information": [{"code": "80197", "type": "CPT"}, {"code": "7070348", "type": "CDM"}], "standard_charges": [{"gross_charge": 590.0, "discounted_cash": 442.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TACROLIMUS", "code_information": [{"code": "80197", "type": "CPT"}, {"code": "7090348", "type": "CDM"}], "standard_charges": [{"gross_charge": 756.0, "discounted_cash": 567.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "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": 86.0, "discounted_cash": 64.5, "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": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TACROLIMUS PER 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7525", "type": "HCPCS"}, {"code": "5324423", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2507.0, "discounted_cash": 1880.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TACROLIMUS PER 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7525", "type": "HCPCS"}, {"code": "5324423", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 2507.0, "discounted_cash": 1880.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TACROLIMUS/2", "code_information": [{"code": "80197", "type": "CPT"}, {"code": "7250348", "type": "CDM"}], "standard_charges": [{"gross_charge": 756.0, "discounted_cash": 567.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TADALAFIL 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311208", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 374.0, "discounted_cash": 280.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TADALAFIL 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311208", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 374.0, "discounted_cash": 280.5, "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": 1125.0, "discounted_cash": 843.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TALC STERILE 5GM PW SP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337414", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1182.0, "discounted_cash": 886.5, "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": 59.0, "discounted_cash": 44.25, "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": 59.0, "discounted_cash": 44.25, "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": 60.0, "discounted_cash": 45.0, "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": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TAPENTADOL 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327998", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TAPENTADOL 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327998", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TARGT SEQ ANLYS 5-50", "code_information": [{"code": "81450", "type": "CPT"}, {"code": "7050032", "type": "CDM"}], "standard_charges": [{"gross_charge": 5014.0, "discounted_cash": 3760.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TAVR PERC FEM", "code_information": [{"code": "4613361", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 44636.0, "discounted_cash": 33477.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TAVR TRANSCAROTID APPROACH", "code_information": [{"code": "4614003", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 26489.0, "discounted_cash": 19866.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TB EYE DUCT", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8177525", "type": "CDM"}], "standard_charges": [{"gross_charge": 635.0, "discounted_cash": 476.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TB TEST CELL AG RESPONSE", "code_information": [{"code": "86480", "type": "CPT"}, {"code": "7258648", "type": "CDM"}], "standard_charges": [{"gross_charge": 179.0, "discounted_cash": 134.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TB TRACH CUFF", "code_information": [{"code": "A7521", "type": "HCPCS"}, {"code": "8207304", "type": "CDM"}], "standard_charges": [{"gross_charge": 189.0, "discounted_cash": 141.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TBG-THYROXINE BND GLOBLN", "code_information": [{"code": "84442", "type": "CPT"}, {"code": "7004442", "type": "CDM"}], "standard_charges": [{"gross_charge": 872.0, "discounted_cash": 654.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TBG-THYROXINE BND GLOBLN", "code_information": [{"code": "84442", "type": "CPT"}, {"code": "7254442", "type": "CDM"}], "standard_charges": [{"gross_charge": 872.0, "discounted_cash": 654.0, "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": 11.0, "discounted_cash": 8.25, "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": 11.0, "discounted_cash": 8.25, "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": 196.0, "discounted_cash": 147.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TC99 APCITIDE VIAL", "code_information": [{"code": "A9504", "type": "HCPCS"}, {"code": "5194000", "type": "CDM"}, {"code": "343", "type": "RC"}], "standard_charges": [{"gross_charge": 6056.0, "discounted_cash": 4542.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TC99 EXAMETAZME WBC DOSE", "code_information": [{"code": "A9569", "type": "HCPCS"}, {"code": "5199569", "type": "CDM"}, {"code": "343", "type": "RC"}], "standard_charges": [{"gross_charge": 21831.0, "discounted_cash": 16373.25, "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": 467.0, "discounted_cash": 350.25, "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": 216.0, "discounted_cash": 162.0, "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": 888.0, "discounted_cash": 666.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TC99 OXIDRONATE DOSE", "code_information": [{"code": "A9561", "type": "HCPCS"}, {"code": "5199561", "type": "CDM"}, {"code": "343", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "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": 306.0, "discounted_cash": 229.5, "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": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TC99 PYROPHOSPHATE DOSE", "code_information": [{"code": "A9538", "type": "HCPCS"}, {"code": "5199538", "type": "CDM"}, {"code": "343", "type": "RC"}], "standard_charges": [{"gross_charge": 484.0, "discounted_cash": 363.0, "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": 583.0, "discounted_cash": 437.25, "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": 1472.0, "discounted_cash": 1104.0, "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": 639.0, "discounted_cash": 479.25, "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": 8238.0, "discounted_cash": 6178.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TCATH TX A/V NONCOR SUBS", "code_information": [{"code": "4917213", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 10077.0, "discounted_cash": 7557.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TCATH TX CESSATION", "code_information": [{"code": "4617214", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1212.0, "discounted_cash": 909.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TCATH TX CESSATION", "code_information": [{"code": "4917214", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 13193.0, "discounted_cash": 9894.75, "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": 4413.0, "discounted_cash": 3309.75, "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": 8432.0, "discounted_cash": 6324.0, "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": 8125.0, "discounted_cash": 6093.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TCATH TX INIT NONCOR VEN", "code_information": [{"code": "4917212", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7665.0, "discounted_cash": 5748.75, "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": 526.0, "discounted_cash": 394.5, "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": 526.0, "discounted_cash": 394.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TEBENTAFUSP-TEBN PER 1MCG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9274", "type": "HCPCS"}, {"code": "5324443", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1068.0, "discounted_cash": 801.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TEBENTAFUSP-TEBN PER 1MCG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9274", "type": "HCPCS"}, {"code": "5324443", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1068.0, "discounted_cash": 801.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TEDIZOLID 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311214", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2644.0, "discounted_cash": 1983.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TEDIZOLID 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311214", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2644.0, "discounted_cash": 1983.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TEDIZOLID PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3090", "type": "HCPCS"}, {"code": "5324438", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TEDIZOLID PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3090", "type": "HCPCS"}, {"code": "5324438", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TEE CONT/ASSESS/FUNC", "code_information": [{"code": "93318", "type": "CPT"}, {"code": "4603319", "type": "CDM"}, {"code": "483", "type": "RC"}], "standard_charges": [{"gross_charge": 3004.0, "discounted_cash": 2253.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TEE W OR WO CM+PROBE PLCMT+RPT", "code_information": [{"code": "C8925", "type": "HCPCS"}, {"code": "4608925", "type": "CDM"}, {"code": "483", "type": "RC"}], "standard_charges": [{"gross_charge": 3004.0, "discounted_cash": 2253.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TEE W/INTRACARD THERAPY", "code_information": [{"code": "93355", "type": "CPT"}, {"code": "4613355", "type": "CDM"}, {"code": "483", "type": "RC"}], "standard_charges": [{"gross_charge": 7051.0, "discounted_cash": 5288.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TEE W/INTRCARD THERAPY", "code_information": [{"code": "93355", "type": "CPT"}, {"code": "4603354", "type": "CDM"}, {"code": "483", "type": "RC"}], "standard_charges": [{"gross_charge": 7051.0, "discounted_cash": 5288.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TELAVANCIN PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3095", "type": "HCPCS"}, {"code": "5324435", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TELAVANCIN PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3095", "type": "HCPCS"}, {"code": "5324435", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TELETHER ISODOSE CMPLEX", "code_information": [{"code": "77307", "type": "CPT"}, {"code": "5107315", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 2071.0, "discounted_cash": 1553.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TELETHER ISODOSE SIMPLE", "code_information": [{"code": "77306", "type": "CPT"}, {"code": "5107305", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 980.0, "discounted_cash": 735.0, "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": 39.0, "discounted_cash": 29.25, "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": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TEMAZEPAM 30MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311237", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TEMAZEPAM 30MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311237", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TEMAZEPAM 7.5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311234", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TEMAZEPAM 7.5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311234", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TEMOZOLOMIDE 5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8700", "type": "HCPCS"}, {"code": "5311240", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 210.0, "discounted_cash": 157.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TEMOZOLOMIDE 5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8700", "type": "HCPCS"}, {"code": "5311240", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 210.0, "discounted_cash": 157.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TEMSIROLIMUS PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9330", "type": "HCPCS"}, {"code": "5324429", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 574.0, "discounted_cash": 430.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TEMSIROLIMUS PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9330", "type": "HCPCS"}, {"code": "5324429", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 574.0, "discounted_cash": 430.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TENDON ALLOGRF PRESUTURD", "code_information": [{"code": "C1762", "type": "HCPCS"}, {"code": "4028820", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16691.0, "discounted_cash": 12518.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TENDON ANKLE PRESUTURED", "code_information": [{"code": "C1762", "type": "HCPCS"}, {"code": "4028822", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16483.0, "discounted_cash": 12362.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TENDON PATELL PRESHPE ALLOGRFT", "code_information": [{"code": "C1762", "type": "HCPCS"}, {"code": "4028823", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 35370.0, "discounted_cash": 26527.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 839.0, "discounted_cash": 629.25, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 839.0, "discounted_cash": 629.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 284.0, "discounted_cash": 213.0, "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": 284.0, "discounted_cash": 213.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TENOFOVIR ALAFEN 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311246", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 266.0, "discounted_cash": 199.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TENOFOVIR ALAFEN 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311246", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 266.0, "discounted_cash": 199.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TERBINAFINE 1% 12GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337426", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 179.0, "discounted_cash": 134.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TERBINAFINE 1% 12GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337426", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 179.0, "discounted_cash": 134.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TERBINAFINE 1% 30GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337427", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TERBINAFINE 1% 30GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337427", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "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": 194.0, "discounted_cash": 145.5, "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": 194.0, "discounted_cash": 145.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "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": 48.0, "discounted_cash": 36.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 192.0, "discounted_cash": 144.0, "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": 192.0, "discounted_cash": 144.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TESTICULAR VASC FLOW", "code_information": [{"code": "78761", "type": "CPT"}, {"code": "5208762", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 6057.0, "discounted_cash": 4542.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TESTOSTERN2.5MG/24HRXRTD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5337434", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TESTOSTERN2.5MG/24HRXRTD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5337434", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TESTOSTERONE 1%2.5GMPKGL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5337438", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 158.0, "discounted_cash": 118.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TESTOSTERONE 1%2.5GMPKGL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5337438", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 158.0, "discounted_cash": 118.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TESTOSTERONE CYP 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1071", "type": "HCPCS"}, {"code": "5324458", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TESTOSTERONE CYP 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1071", "type": "HCPCS"}, {"code": "5324458", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TESTOSTERONE FREE", "code_information": [{"code": "84402", "type": "CPT"}, {"code": "7004407", "type": "CDM"}], "standard_charges": [{"gross_charge": 1875.0, "discounted_cash": 1406.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TESTOSTERONE FREE", "code_information": [{"code": "84402", "type": "CPT"}, {"code": "7254407", "type": "CDM"}], "standard_charges": [{"gross_charge": 936.0, "discounted_cash": 702.0, "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": 1970.0, "discounted_cash": 1477.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TESTOSTERONE TOTAL", "code_information": [{"code": "84403", "type": "CPT"}, {"code": "4154403", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 512.0, "discounted_cash": 384.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TESTOSTERONE TOTAL", "code_information": [{"code": "84403", "type": "CPT"}, {"code": "7254403", "type": "CDM"}], "standard_charges": [{"gross_charge": 605.0, "discounted_cash": 453.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TESTOSTERONE2MG/24HRXRTD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5337451", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TESTOSTERONE2MG/24HRXRTD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5337451", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TESTOSTERONE4MG/24HRXRTD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5337452", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 168.0, "discounted_cash": 126.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TESTOSTERONE4MG/24HRXRTD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5337452", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 168.0, "discounted_cash": 126.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TESTOSTERONE5MG/24HRXRTD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5337437", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 126.0, "discounted_cash": 94.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TESTOSTERONE5MG/24HRXRTD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5337437", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 126.0, "discounted_cash": 94.5, "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": 761.0, "discounted_cash": 570.75, "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": 761.0, "discounted_cash": 570.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TETRACAINE .5% 15ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332593", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 320.0, "discounted_cash": 240.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TETRACAINE .5% 1ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332589", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "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": 112.0, "discounted_cash": 84.0, "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": 98.0, "discounted_cash": 73.5, "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": 206.0, "discounted_cash": 154.5, "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": 99.0, "discounted_cash": 74.25, "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": 216.0, "discounted_cash": 162.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TETRACYCLINE 250MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311310", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TETRACYCLINE 250MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311310", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TETRACYCLINE 500MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311314", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TETRACYCLINE 500MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311314", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TETRAHYDRAZOL .1%15ML OS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5332669", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TETRAHYDRAZOL .1%15ML OS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5332669", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "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": 118.0, "discounted_cash": 88.5, "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": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TETRAHYDROZ NS.05%15MLIS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332661", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 414.0, "discounted_cash": 310.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TETRAHYDROZ NS.05%15MLIS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332661", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 414.0, "discounted_cash": 310.5, "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": 292.0, "discounted_cash": 219.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THEOPHYLLINE", "code_information": [{"code": "80198", "type": "CPT"}, {"code": "4122137", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THEOPHYLLINE", "code_information": [{"code": "80198", "type": "CPT"}, {"code": "4152137", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "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": 39.0, "discounted_cash": 29.25, "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": 39.0, "discounted_cash": 29.25, "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": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "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": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "THEOPHYLLINE 450MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311397", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "THEOPHYLLINE 450MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311397", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "THEOPHYLLINE100MG XR24CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311408", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "THEOPHYLLINE100MG XR24CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311408", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "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": 14.0, "discounted_cash": 10.5, "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": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "THEOPHYLLINE80/15 30MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316435", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "THEOPHYLLINE80/15 30MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316435", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "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": 28.0, "discounted_cash": 21.0, "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": 28.0, "discounted_cash": 21.0, "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": 36.0, "discounted_cash": 27.0, "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": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THIAMINE 50MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5311467", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "THIAMINE 50MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5311467", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "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": 165.0, "discounted_cash": 123.75, "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": 165.0, "discounted_cash": 123.75, "setting": "both", "billing_class": "facility"}]}, {"description": "THIAMINE(VITAMIN B1)", "code_information": [{"code": "84425", "type": "CPT"}, {"code": "7004425", "type": "CDM"}], "standard_charges": [{"gross_charge": 840.0, "discounted_cash": 630.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THIAMINE(VITAMIN B1)", "code_information": [{"code": "84425", "type": "CPT"}, {"code": "7254423", "type": "CDM"}], "standard_charges": [{"gross_charge": 840.0, "discounted_cash": 630.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THIAMINE(VITAMIN B1)/2", "code_information": [{"code": "84425", "type": "CPT"}, {"code": "7254429", "type": "CDM"}], "standard_charges": [{"gross_charge": 840.0, "discounted_cash": 630.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THIOCYANATE", "code_information": [{"code": "84430", "type": "CPT"}, {"code": "7004430", "type": "CDM"}], "standard_charges": [{"gross_charge": 349.0, "discounted_cash": 261.75, "setting": "both", "billing_class": "facility"}]}, {"description": "THIOGUANINE 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311517", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "THIOGUANINE 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311517", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "THIOPENTAL 500MG SG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5328067", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 227.0, "discounted_cash": 170.25, "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": 47.0, "discounted_cash": 35.25, "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": 47.0, "discounted_cash": 35.25, "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": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "THIORIDAZINE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311552", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "THIORIDAZINE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311552", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "THIOTEPA NOS PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9342", "type": "HCPCS"}, {"code": "5324680", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 244.0, "discounted_cash": 183.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THIOTEPA NOS PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9342", "type": "HCPCS"}, {"code": "5324680", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 244.0, "discounted_cash": 183.0, "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": 52.0, "discounted_cash": 39.0, "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": 52.0, "discounted_cash": 39.0, "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": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "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": 49.0, "discounted_cash": 36.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "THORACENTSIS W/IMAGING", "code_information": [{"code": "4912555", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 9624.0, "discounted_cash": 7218.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THORACENTSIS W/IMAGING", "code_information": [{"code": "5012555", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3849.0, "discounted_cash": 2886.75, "setting": "both", "billing_class": "facility"}]}, {"description": "THORACENTSIS W/IMAGING", "code_information": [{"code": "5052555", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 8512.0, "discounted_cash": 6384.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THORACENTSIS W/IMAGING", "code_information": [{"code": "5062555", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4865.0, "discounted_cash": 3648.75, "setting": "both", "billing_class": "facility"}]}, {"description": "THORACIC MYELO LUMB INJ", "code_information": [{"code": "4902302", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 8996.0, "discounted_cash": 6747.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THORACIC W/SERL COMPLT", "code_information": [{"code": "75605", "type": "CPT"}, {"code": "4615605", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 5091.0, "discounted_cash": 3818.25, "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": 3899.0, "discounted_cash": 2924.25, "setting": "both", "billing_class": "facility"}]}, {"description": "THROMB NONCOR ADD VESSLS", "code_information": [{"code": "4617185", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 14147.0, "discounted_cash": 10610.25, "setting": "both", "billing_class": "facility"}]}, {"description": "THROMB NONCOR ADD VESSLS", "code_information": [{"code": "4914101", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 14147.0, "discounted_cash": 10610.25, "setting": "both", "billing_class": "facility"}]}, {"description": "THROMB NONCOR INITL VSL", "code_information": [{"code": "4617184", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 33616.0, "discounted_cash": 25212.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THROMB NONCOR INITL VSL", "code_information": [{"code": "4914100", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 33616.0, "discounted_cash": 25212.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THROMB NONCOR SECONDARY", "code_information": [{"code": "4914102", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 10391.0, "discounted_cash": 7793.25, "setting": "both", "billing_class": "facility"}]}, {"description": "THROMBECTOMY VENOUS", "code_information": [{"code": "4614451", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 15029.0, "discounted_cash": 11271.75, "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": 3198.0, "discounted_cash": 2398.5, "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": 2469.0, "discounted_cash": 1851.75, "setting": "both", "billing_class": "facility"}]}, {"description": "THROMBIN 20000U SP KT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5337463", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3709.0, "discounted_cash": 2781.75, "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": 840.0, "discounted_cash": 630.0, "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": 888.0, "discounted_cash": 666.0, "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": 489.0, "discounted_cash": 366.75, "setting": "both", "billing_class": "facility"}]}, {"description": "THROMBIN EPISTX 5000U PW", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5337457", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 959.0, "discounted_cash": 719.25, "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": 327.0, "discounted_cash": 245.25, "setting": "both", "billing_class": "facility"}]}, {"description": "THROMBIN TIME PLASMA", "code_information": [{"code": "85670", "type": "CPT"}, {"code": "4125670", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "THROMBIN TIME PLASMA/3", "code_information": [{"code": "85670", "type": "CPT"}, {"code": "7255670", "type": "CDM"}], "standard_charges": [{"gross_charge": 129.0, "discounted_cash": 96.75, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROGLOBULIN", "code_information": [{"code": "84432", "type": "CPT"}, {"code": "7004432", "type": "CDM"}], "standard_charges": [{"gross_charge": 349.0, "discounted_cash": 261.75, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROGLOBULIN", "code_information": [{"code": "84432", "type": "CPT"}, {"code": "7254432", "type": "CDM"}], "standard_charges": [{"gross_charge": 349.0, "discounted_cash": 261.75, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROGLOBULIN AB", "code_information": [{"code": "86800", "type": "CPT"}, {"code": "7006175", "type": "CDM"}], "standard_charges": [{"gross_charge": 673.0, "discounted_cash": 504.75, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROGLOBULIN AB", "code_information": [{"code": "86800", "type": "CPT"}, {"code": "7256175", "type": "CDM"}], "standard_charges": [{"gross_charge": 673.0, "discounted_cash": 504.75, "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": 2226.0, "discounted_cash": 1669.5, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROID DESICTD 120MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311672", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROID DESICTD 120MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311672", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROID DESICTD 15MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311641", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROID DESICTD 15MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311641", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROID DESICTD 180MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311676", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROID DESICTD 180MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311676", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "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": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROID DESICTED 60MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311649", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROID DESICTED 60MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311649", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROID DESICTED 90MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311650", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROID DESICTED 90MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311650", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "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": 1507.0, "discounted_cash": 1130.25, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROID STIM IMMUNGLBN", "code_information": [{"code": "84445", "type": "CPT"}, {"code": "7004444", "type": "CDM"}], "standard_charges": [{"gross_charge": 1934.0, "discounted_cash": 1450.5, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROID STIM IMMUNGLBN", "code_information": [{"code": "84445", "type": "CPT"}, {"code": "7254444", "type": "CDM"}], "standard_charges": [{"gross_charge": 1934.0, "discounted_cash": 1450.5, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROTROPIN RECEPTOR AB", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7253528", "type": "CDM"}], "standard_charges": [{"gross_charge": 1056.0, "discounted_cash": 792.0, "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": 1039.0, "discounted_cash": 779.25, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROXINE FREE", "code_information": [{"code": "84439", "type": "CPT"}, {"code": "4123531", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 23.0, "discounted_cash": 17.25, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROXINE FREE", "code_information": [{"code": "84439", "type": "CPT"}, {"code": "7253534", "type": "CDM"}], "standard_charges": [{"gross_charge": 1159.0, "discounted_cash": 869.25, "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": 1044.0, "discounted_cash": 783.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROXINE TOTAL", "code_information": [{"code": "84436", "type": "CPT"}, {"code": "4124436", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROXINE TOTAL", "code_information": [{"code": "84436", "type": "CPT"}, {"code": "4154436", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 178.0, "discounted_cash": 133.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TIAGABINE 4MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311630", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TIAGABINE 4MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311630", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "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": 1610.0, "discounted_cash": 1207.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TIBIA/FIBULA 2 VIEWS", "code_information": [{"code": "73590", "type": "CPT"}, {"code": "5013590", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1333.0, "discounted_cash": 999.75, "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": 1595.0, "discounted_cash": 1196.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TIBIAL KNEE TRY REVISION SN CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012888", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 27047.0, "discounted_cash": 20285.25, "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": 50.0, "discounted_cash": 37.5, "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": 50.0, "discounted_cash": 37.5, "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": 53.0, "discounted_cash": 39.75, "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": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TICAR/CLAV PER 3.1GM IJ", "code_information": [{"code": "S0040", "type": "HCPCS"}, {"code": "5324735", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 323.0, "discounted_cash": 242.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TICAR/CLAV PER3.1GMPMXIJ", "code_information": [{"code": "S0040", "type": "HCPCS"}, {"code": "5324736", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 617.0, "discounted_cash": 462.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TIGHTROPE ABS W/BUTTON", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4018080", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1643.0, "discounted_cash": 1232.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TIGHTROPE RT W/FLIPCUTR II/III", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4018081", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 13211.0, "discounted_cash": 9908.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TIGHTRPE ACL RT DBL LD PAS SUT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4018084", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3856.0, "discounted_cash": 2892.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TILT TABLE EVAL", "code_information": [{"code": "93660", "type": "CPT"}, {"code": "4611132", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 8009.0, "discounted_cash": 6006.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TIMOLOL .25% .45ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332704", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 301.0, "discounted_cash": 225.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TIMOLOL .25% .45ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332704", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 301.0, "discounted_cash": 225.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TIMOLOL .25% 10ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332696", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 425.0, "discounted_cash": 318.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TIMOLOL .25% 10ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332696", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 425.0, "discounted_cash": 318.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TIMOLOL .25% 5ML GL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332699", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 395.0, "discounted_cash": 296.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TIMOLOL .25% 5ML GL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332699", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 395.0, "discounted_cash": 296.25, "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": 206.0, "discounted_cash": 154.5, "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": 206.0, "discounted_cash": 154.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TIMOLOL .5% 2.5ML GL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332701", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 289.0, "discounted_cash": 216.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TIMOLOL .5% 2.5ML GL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332701", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 289.0, "discounted_cash": 216.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TIMOLOL .5% 5ML GL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332702", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 417.0, "discounted_cash": 312.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TIMOLOL .5% 5ML GL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332702", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 417.0, "discounted_cash": 312.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 175.0, "discounted_cash": 131.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 175.0, "discounted_cash": 131.25, "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": 64.0, "discounted_cash": 48.0, "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": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TIOTROPIUM CP18MCG5DS IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5332714", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 630.0, "discounted_cash": 472.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TIOTROPIUM CP18MCG5DS IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5332714", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 630.0, "discounted_cash": 472.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 146.0, "discounted_cash": 109.5, "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": 146.0, "discounted_cash": 109.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TISS CONNECTIVE HUMAN", "code_information": [{"code": "C1762", "type": "HCPCS"}, {"code": "8240407", "type": "CDM"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TISS CONNECTIVE N-HUMAN", "code_information": [{"code": "C1763", "type": "HCPCS"}, {"code": "8240409", "type": "CDM"}], "standard_charges": [{"gross_charge": 794.0, "discounted_cash": 595.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TISS CULT ADD STUDIES", "code_information": [{"code": "87253", "type": "CPT"}, {"code": "7009357", "type": "CDM"}], "standard_charges": [{"gross_charge": 1322.0, "discounted_cash": 991.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TISS CULT INOC/OBSERV", "code_information": [{"code": "87252", "type": "CPT"}, {"code": "7257227", "type": "CDM"}], "standard_charges": [{"gross_charge": 1239.0, "discounted_cash": 929.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TISS CULT INOC/OBSERV/2", "code_information": [{"code": "87252", "type": "CPT"}, {"code": "7007084", "type": "CDM"}], "standard_charges": [{"gross_charge": 1239.0, "discounted_cash": 929.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TISS CULT INOC/OBSERV/4", "code_information": [{"code": "87252", "type": "CPT"}, {"code": "7009361", "type": "CDM"}], "standard_charges": [{"gross_charge": 1239.0, "discounted_cash": 929.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TISS CULT INOC/OBSERV/5", "code_information": [{"code": "87252", "type": "CPT"}, {"code": "7257252", "type": "CDM"}], "standard_charges": [{"gross_charge": 1201.0, "discounted_cash": 900.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TISS CULT SOLID TUMOR", "code_information": [{"code": "88239", "type": "CPT"}, {"code": "7058239", "type": "CDM"}], "standard_charges": [{"gross_charge": 1690.0, "discounted_cash": 1267.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TISS MATRIX ACELL DERM", "code_information": [{"code": "Q4100", "type": "HCPCS"}, {"code": "8243792", "type": "CDM"}], "standard_charges": [{"gross_charge": 13310.55, "discounted_cash": 9982.91, "setting": "both", "billing_class": "facility"}]}, {"description": "TISS TRANSGLUTAMINASE AB/2", "code_information": [{"code": "86364", "type": "CPT"}, {"code": "7253562", "type": "CDM"}], "standard_charges": [{"gross_charge": 368.0, "discounted_cash": 276.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TISS TRANSGLUTAMINASE AB/5", "code_information": [{"code": "86364", "type": "CPT"}, {"code": "7253979", "type": "CDM"}], "standard_charges": [{"gross_charge": 368.0, "discounted_cash": 276.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TISSUE ACQUISITN CORNEAL", "code_information": [{"code": "V2785", "type": "HCPCS"}, {"code": "3412785", "type": "CDM"}, {"code": "810", "type": "RC"}], "standard_charges": [{"gross_charge": 22214.0, "discounted_cash": 16660.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TISSUE ACQUISITN CORNEAL", "code_information": [{"code": "V2785", "type": "HCPCS"}, {"code": "3412785", "type": "CDM"}, {"code": "812", "type": "RC"}], "standard_charges": [{"gross_charge": 22214.0, "discounted_cash": 16660.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TISSUE CULT BONE MARROW", "code_information": [{"code": "88237", "type": "CPT"}, {"code": "7008236", "type": "CDM"}], "standard_charges": [{"gross_charge": 627.0, "discounted_cash": 470.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TISSUE CULT BONE MARROW", "code_information": [{"code": "88237", "type": "CPT"}, {"code": "7058236", "type": "CDM"}], "standard_charges": [{"gross_charge": 821.0, "discounted_cash": 615.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TISSUE CULT BONE MARROW/2", "code_information": [{"code": "88237", "type": "CPT"}, {"code": "7038236", "type": "CDM"}], "standard_charges": [{"gross_charge": 2083.0, "discounted_cash": 1562.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TISSUE CULTURE LYMPHOCYTE", "code_information": [{"code": "88230", "type": "CPT"}, {"code": "7038230", "type": "CDM"}], "standard_charges": [{"gross_charge": 2083.0, "discounted_cash": 1562.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TISSUE CULTURE LYMPHOCYTE/4", "code_information": [{"code": "88230", "type": "CPT"}, {"code": "7258229", "type": "CDM"}], "standard_charges": [{"gross_charge": 386.0, "discounted_cash": 289.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TISSUE EXPANDER", "code_information": [{"code": "C1789", "type": "HCPCS"}, {"code": "8177585", "type": "CDM"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "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": 17.0, "discounted_cash": 12.75, "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": 17.0, "discounted_cash": 12.75, "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": 1592.0, "discounted_cash": 1194.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TLSO TRPLNR MOD PREFB", "code_information": [{"code": "L0460", "type": "HCPCS"}, {"code": "8130983", "type": "CDM"}], "standard_charges": [{"gross_charge": 9655.0, "discounted_cash": 7241.25, "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": 530.0, "discounted_cash": 397.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TM JOINTS BILATERAL", "code_information": [{"code": "70330", "type": "CPT"}, {"code": "5010330", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 643.0, "discounted_cash": 482.25, "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": 643.0, "discounted_cash": 482.25, "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": 526.0, "discounted_cash": 394.5, "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": 368.0, "discounted_cash": 276.0, "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": 368.0, "discounted_cash": 276.0, "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": 725.0, "discounted_cash": 543.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 725.0, "discounted_cash": 543.75, "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": 439.0, "discounted_cash": 329.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TOBRAMYCIN", "code_information": [{"code": "80200", "type": "CPT"}, {"code": "4124468", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TOBRAMYCIN", "code_information": [{"code": "80200", "type": "CPT"}, {"code": "4154468", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TOBRAMYCIN", "code_information": [{"code": "80200", "type": "CPT"}, {"code": "7254465", "type": "CDM"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "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": 193.0, "discounted_cash": 144.75, "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": 193.0, "discounted_cash": 144.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 227.0, "discounted_cash": 170.25, "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": 227.0, "discounted_cash": 170.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TOBRAMYCIN .3%5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332728", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1032.0, "discounted_cash": 774.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TOBRAMYCIN .3%5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332728", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1032.0, "discounted_cash": 774.0, "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": 3226.0, "discounted_cash": 2419.5, "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": 695.0, "discounted_cash": 521.25, "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": 695.0, "discounted_cash": 521.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TOBRAMYCIN CMPD OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5332724", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1080.0, "discounted_cash": 810.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TOBRAMYCIN CMPD OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5332724", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1080.0, "discounted_cash": 810.0, "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": 314.0, "discounted_cash": 235.5, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 314.0, "discounted_cash": 235.5, "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": 227.0, "discounted_cash": 170.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TOBRAMYCIN/2", "code_information": [{"code": "80200", "type": "CPT"}, {"code": "4124469", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TOBRAMYCIN/2", "code_information": [{"code": "80200", "type": "CPT"}, {"code": "7254466", "type": "CDM"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "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": 227.0, "discounted_cash": 170.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TOBRAMYCIN/3", "code_information": [{"code": "80200", "type": "CPT"}, {"code": "4124471", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "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": 52.0, "discounted_cash": 39.0, "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": 52.0, "discounted_cash": 39.0, "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": 52.0, "discounted_cash": 39.0, "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": 565.0, "discounted_cash": 423.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 94.0, "discounted_cash": 70.5, "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": 94.0, "discounted_cash": 70.5, "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": 98.0, "discounted_cash": 73.5, "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": 98.0, "discounted_cash": 73.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TOLVAPTAN 15MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311730", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2499.0, "discounted_cash": 1874.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TOLVAPTAN 15MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311730", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2499.0, "discounted_cash": 1874.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TOLVAPTAN 30MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311731", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2358.0, "discounted_cash": 1768.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TOLVAPTAN 30MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311731", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2358.0, "discounted_cash": 1768.5, "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": 3198.0, "discounted_cash": 2398.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TOMOGRAPHY SNGL PLANE", "code_information": [{"code": "76100", "type": "CPT"}, {"code": "5016100", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 3872.0, "discounted_cash": 2904.0, "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": 86.0, "discounted_cash": 64.5, "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": 86.0, "discounted_cash": 64.5, "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": 59.0, "discounted_cash": 44.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 59.0, "discounted_cash": 44.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TOPIRAMATE LVL", "code_information": [{"code": "80201", "type": "CPT"}, {"code": "7004470", "type": "CDM"}], "standard_charges": [{"gross_charge": 409.0, "discounted_cash": 306.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TOPIRAMATE LVL", "code_information": [{"code": "80201", "type": "CPT"}, {"code": "7254470", "type": "CDM"}], "standard_charges": [{"gross_charge": 409.0, "discounted_cash": 306.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TOPOTECAN PER 0.1 MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9351", "type": "HCPCS"}, {"code": "5324796", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1209.0, "discounted_cash": 906.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TOPOTECAN PER 0.1 MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9351", "type": "HCPCS"}, {"code": "5324796", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1209.0, "discounted_cash": 906.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TORSEMIDE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311763", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TORSEMIDE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311763", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TORSEMIDE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311761", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TORSEMIDE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311761", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "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": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TORSEMIDE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311760", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TORSEMIDE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311760", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TOXOPLASMA AB IGM", "code_information": [{"code": "86778", "type": "CPT"}, {"code": "7256923", "type": "CDM"}], "standard_charges": [{"gross_charge": 948.0, "discounted_cash": 711.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TOXOPLASMA AB IGM/4", "code_information": [{"code": "86778", "type": "CPT"}, {"code": "7006909", "type": "CDM"}], "standard_charges": [{"gross_charge": 948.0, "discounted_cash": 711.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TOXOPLASMA AB/4", "code_information": [{"code": "86777", "type": "CPT"}, {"code": "7006922", "type": "CDM"}], "standard_charges": [{"gross_charge": 927.0, "discounted_cash": 695.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TOXOPLASMA AB/5", "code_information": [{"code": "86777", "type": "CPT"}, {"code": "7256922", "type": "CDM"}], "standard_charges": [{"gross_charge": 927.0, "discounted_cash": 695.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TP53 FULL GENE SEQUENCE", "code_information": [{"code": "81351", "type": "CPT"}, {"code": "7050039", "type": "CDM"}], "standard_charges": [{"gross_charge": 1864.74, "discounted_cash": 1398.56, "setting": "both", "billing_class": "facility"}]}, {"description": "TRACE METAL 10ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5324849", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "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": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRACE METAL 1ML PFS IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5324839", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "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": 47.0, "discounted_cash": 35.25, "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": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRACE METAL PED 3ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5324847", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRAMADOL 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311773", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRAMADOL 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311773", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "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": 47.0, "discounted_cash": 35.25, "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": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRANEXAMIC ACID 650MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311805", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRANEXAMIC ACID 650MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311805", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "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": 0.1, "discounted_cash": 0.08, "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": 0.1, "discounted_cash": 0.08, "setting": "both", "billing_class": "facility"}]}, {"description": "TRANS CATH PLCMNT RMV CEPD", "code_information": [{"code": "4613337", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 14520.0, "discounted_cash": 10890.0, "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": 75251.0, "discounted_cash": 56438.25, "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": 630.0, "discounted_cash": 472.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRANSAMINASE-SGPT (ALT)", "code_information": [{"code": "84460", "type": "CPT"}, {"code": "4124460", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRANSAMINASE-SGPT (ALT)", "code_information": [{"code": "84460", "type": "CPT"}, {"code": "4154460", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 172.0, "discounted_cash": 129.0, "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": 111950.0, "discounted_cash": 83962.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRANSCRANIAL DOPP COMP", "code_information": [{"code": "93886", "type": "CPT"}, {"code": "4637020", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 2056.0, "discounted_cash": 1542.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRANSCRANIAL DOPP COMP", "code_information": [{"code": "93886", "type": "CPT"}, {"code": "5063886", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 2253.0, "discounted_cash": 1689.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRANSCRANIAL DOPP LTD", "code_information": [{"code": "93888", "type": "CPT"}, {"code": "4637040", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 893.0, "discounted_cash": 669.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRANSCRANIAL DOPP LTD", "code_information": [{"code": "93888", "type": "CPT"}, {"code": "5063888", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 1437.0, "discounted_cash": 1077.75, "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": 908.0, "discounted_cash": 681.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRANSCUTANEOUS PACING", "code_information": [{"code": "92953", "type": "CPT"}, {"code": "6110610", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1036.0, "discounted_cash": 777.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRANSESOPHAGEAL ECHO", "code_information": [{"code": "93312", "type": "CPT"}, {"code": "3303312", "type": "CDM"}, {"code": "483", "type": "RC"}], "standard_charges": [{"gross_charge": 3156.0, "discounted_cash": 2367.0, "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": 5872.0, "discounted_cash": 4404.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRANSESOPHAGEAL ECHO", "code_information": [{"code": "93312", "type": "CPT"}, {"code": "4633400", "type": "CDM"}, {"code": "483", "type": "RC"}], "standard_charges": [{"gross_charge": 3372.0, "discounted_cash": 2529.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRANSFERIN RECEPTOR", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7254467", "type": "CDM"}], "standard_charges": [{"gross_charge": 716.0, "discounted_cash": 537.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRANSFERRIN", "code_information": [{"code": "84466", "type": "CPT"}, {"code": "7004462", "type": "CDM"}], "standard_charges": [{"gross_charge": 549.0, "discounted_cash": 411.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRANSFERRIN", "code_information": [{"code": "84466", "type": "CPT"}, {"code": "7254462", "type": "CDM"}], "standard_charges": [{"gross_charge": 549.0, "discounted_cash": 411.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRANSFUSN REACTN W RPT", "code_information": [{"code": "86078", "type": "CPT"}, {"code": "4106648", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 415.0, "discounted_cash": 311.25, "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": 573.0, "discounted_cash": 429.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRANSTERASE AST(SGOT)", "code_information": [{"code": "84450", "type": "CPT"}, {"code": "4124450", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRANSTERASE AST(SGOT)", "code_information": [{"code": "84450", "type": "CPT"}, {"code": "4154450", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 138.0, "discounted_cash": 103.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRANYLCYPROMINE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311768", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRANYLCYPROMINE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311768", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRASTUZUMAB PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9355", "type": "HCPCS"}, {"code": "5324855", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1141.0, "discounted_cash": 855.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRASTUZUMAB PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9355", "type": "HCPCS"}, {"code": "5324855", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1141.0, "discounted_cash": 855.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRASTUZUMAB-ANNS PER 10MG IJ", "code_information": [{"code": "Q5117", "type": "HCPCS"}, {"code": "5324862", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 623.0, "discounted_cash": 467.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRASTUZUMAB-ANNS PER 10MG IJ", "code_information": [{"code": "Q5117", "type": "HCPCS"}, {"code": "5324862", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 623.0, "discounted_cash": 467.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRASTUZUMAB-QYYP PER 10MG IJ", "code_information": [{"code": "Q5116", "type": "HCPCS"}, {"code": "5324875", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 425.0, "discounted_cash": 318.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRASTUZUMAB-QYYP PER 10MG IJ", "code_information": [{"code": "Q5116", "type": "HCPCS"}, {"code": "5324875", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 425.0, "discounted_cash": 318.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1156.0, "discounted_cash": 867.0, "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": 1156.0, "discounted_cash": 867.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRAZADONE", "code_information": [{"code": "80338", "type": "CPT"}, {"code": "7250301", "type": "CDM"}], "standard_charges": [{"gross_charge": 520.0, "discounted_cash": 390.0, "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": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "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": 47.0, "discounted_cash": 35.25, "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": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRAZODONE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311790", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRAZODONE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311790", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRAZODONE 300MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311794", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 123.0, "discounted_cash": 92.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRAZODONE 300MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311794", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 123.0, "discounted_cash": 92.25, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TREPONEMA PALLIDUM AB", "code_information": [{"code": "86780", "type": "CPT"}, {"code": "7256650", "type": "CDM"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "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": 192.0, "discounted_cash": 144.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TREPONEMA PALLIDUM AB/4", "code_information": [{"code": "86780", "type": "CPT"}, {"code": "7256781", "type": "CDM"}], "standard_charges": [{"gross_charge": 349.0, "discounted_cash": 261.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TREPONEMA PALLIDUM AB/6", "code_information": [{"code": "86780", "type": "CPT"}, {"code": "7258659", "type": "CDM"}], "standard_charges": [{"gross_charge": 340.0, "discounted_cash": 255.0, "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": 304.0, "discounted_cash": 228.0, "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": 304.0, "discounted_cash": 228.0, "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": 145.0, "discounted_cash": 108.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 145.0, "discounted_cash": 108.75, "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": 48.0, "discounted_cash": 36.0, "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": 48.0, "discounted_cash": 36.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMCIN.147MG/GM63GM SP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337625", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 673.0, "discounted_cash": 504.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMCIN.147MG/GM63GM SP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337625", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 673.0, "discounted_cash": 504.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "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": 65.0, "discounted_cash": 48.75, "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": 58.0, "discounted_cash": 43.5, "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": 58.0, "discounted_cash": 43.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMCINOLONE .1%15GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337570", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 75.0, "discounted_cash": 56.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMCINOLONE .1%15GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337570", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 75.0, "discounted_cash": 56.25, "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": 254.0, "discounted_cash": 190.5, "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": 254.0, "discounted_cash": 190.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 130.0, "discounted_cash": 97.5, "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": 130.0, "discounted_cash": 97.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMCINOLONE 10GM IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332736", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 735.0, "discounted_cash": 551.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMCINOLONE 10GM IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332736", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 735.0, "discounted_cash": 551.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMCINOLONE 20GM IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332735", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1000.0, "discounted_cash": 750.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMCINOLONE 20GM IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332735", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1000.0, "discounted_cash": 750.0, "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": 86.0, "discounted_cash": 64.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMTER-HCTZ 75/50 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311864", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMTER-HCTZ 75/50 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311864", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMTR-HCTZ18.75/12.5TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311866", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMTR-HCTZ18.75/12.5TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311866", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRICHINELLA AB", "code_information": [{"code": "86784", "type": "CPT"}, {"code": "7016183", "type": "CDM"}], "standard_charges": [{"gross_charge": 932.0, "discounted_cash": 699.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRICHINELLA AB", "code_information": [{"code": "86784", "type": "CPT"}, {"code": "7256183", "type": "CDM"}], "standard_charges": [{"gross_charge": 932.0, "discounted_cash": 699.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRICHOMONAS AMP PROBE", "code_information": [{"code": "87661", "type": "CPT"}, {"code": "7257661", "type": "CDM"}], "standard_charges": [{"gross_charge": 160.0, "discounted_cash": 120.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIETHANOLAMINE 6ML OT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332741", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 374.0, "discounted_cash": 280.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIETHANOLAMINE 6ML OT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332741", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 374.0, "discounted_cash": 280.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIFLUOPERAZINE 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311915", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIFLUOPERAZINE 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311915", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIFLUOPERAZINE 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311917", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIFLUOPERAZINE 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311917", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIFLUOPERAZINE 5MGTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311919", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIFLUOPERAZINE 5MGTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311919", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIFLURIDINE 1% 7.5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332753", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1039.0, "discounted_cash": 779.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIFLURIDINE 1% 7.5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332753", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1039.0, "discounted_cash": 779.25, "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": 755.0, "discounted_cash": 566.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIGLYCERIDES", "code_information": [{"code": "84478", "type": "CPT"}, {"code": "4124475", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIGLYCERIDES", "code_information": [{"code": "84478", "type": "CPT"}, {"code": "4154475", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "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": 99.0, "discounted_cash": 74.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIGLYCERIDES/2", "code_information": [{"code": "84478", "type": "CPT"}, {"code": "4124478", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIGLYCERIDES/4", "code_information": [{"code": "84478", "type": "CPT"}, {"code": "7258447", "type": "CDM"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIHEXYPHENIDYL 1MGTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311943", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIHEXYPHENIDYL 1MGTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311943", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIHEXYPHENIDYL 5MGTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311946", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIHEXYPHENIDYL 5MGTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311946", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "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": 807.0, "discounted_cash": 605.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIIODTHYRN (T3/T4) UPTAKE", "code_information": [{"code": "84479", "type": "CPT"}, {"code": "4124250", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIIODTHYRN (T3/T4) UPTAKE", "code_information": [{"code": "84479", "type": "CPT"}, {"code": "4154250", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 160.0, "discounted_cash": 120.0, "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": 848.0, "discounted_cash": 636.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIIODTHYRNINE TOTAL T3", "code_information": [{"code": "84480", "type": "CPT"}, {"code": "4123538", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIIODTHYRNINE TOTAL T3", "code_information": [{"code": "84480", "type": "CPT"}, {"code": "4153538", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 186.0, "discounted_cash": 139.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIM NAILS ANY NUMBER", "code_information": [{"code": "6900035", "type": "CDM"}], "standard_charges": [{"gross_charge": 471.0, "discounted_cash": 353.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIM SKIN LESION 2-4", "code_information": [{"code": "6900071", "type": "CDM"}], "standard_charges": [{"gross_charge": 1425.0, "discounted_cash": 1068.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIM SKIN LESION >4", "code_information": [{"code": "6900072", "type": "CDM"}], "standard_charges": [{"gross_charge": 1425.0, "discounted_cash": 1068.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIM SKIN LESION SINGLE", "code_information": [{"code": "6900070", "type": "CDM"}], "standard_charges": [{"gross_charge": 1425.0, "discounted_cash": 1068.75, "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": 191.0, "discounted_cash": 143.25, "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": 191.0, "discounted_cash": 143.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIMETHOBENZAMIDE300MGCP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312028", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIMETHOBENZAMIDE300MGCP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312028", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "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": 353.0, "discounted_cash": 264.75, "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": 353.0, "discounted_cash": 264.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIPROLIDN/PSE 2.5/60 TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312142", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIPROLIDN/PSE 2.5/60 TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312142", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIPTORELIN XR 3.75MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3316", "type": "HCPCS"}, {"code": "5324963", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 4957.0, "discounted_cash": 3717.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIPTORELIN XR 3.75MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3316", "type": "HCPCS"}, {"code": "5324963", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 4957.0, "discounted_cash": 3717.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRNSCTH BIOPSY", "code_information": [{"code": "4918005", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 13822.0, "discounted_cash": 10366.5, "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": 3296.0, "discounted_cash": 2472.0, "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": 5526.0, "discounted_cash": 4144.5, "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": 4726.0, "discounted_cash": 3544.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRNSTHOR 2D ECHO CMPLETE", "code_information": [{"code": "93307", "type": "CPT"}, {"code": "4633301", "type": "CDM"}, {"code": "483", "type": "RC"}], "standard_charges": [{"gross_charge": 5669.0, "discounted_cash": 4251.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRNSVN INTRHEP PORT SHNT", "code_information": [{"code": "4917182", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 30391.0, "discounted_cash": 22793.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TROLAMINE SALIC10%60GMCR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337651", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 106.0, "discounted_cash": 79.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TROLAMINE SALIC10%60GMCR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337651", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 106.0, "discounted_cash": 79.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TROLAMINE SALIC10%90GMCR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337652", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TROLAMINE SALIC10%90GMCR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337652", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TROMETHAMINE18GM/500MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5324965", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3792.0, "discounted_cash": 2844.0, "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": 402.0, "discounted_cash": 301.5, "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": 497.0, "discounted_cash": 372.75, "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": 93.0, "discounted_cash": 69.75, "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": 141.0, "discounted_cash": 105.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TROPONIN QUAN", "code_information": [{"code": "84484", "type": "CPT"}, {"code": "4157235", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 455.0, "discounted_cash": 341.25, "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": 1183.0, "discounted_cash": 887.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TROPONIN QUAN/2", "code_information": [{"code": "84484", "type": "CPT"}, {"code": "4127235", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TROSPIUM 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312155", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TROSPIUM 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312155", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TROSPIUM 60MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312156", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TROSPIUM 60MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312156", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRY CATH CV PWRLIN DL MCROINTD", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8057030", "type": "CDM"}], "standard_charges": [{"gross_charge": 3221.0, "discounted_cash": 2415.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRY CATH PICC SGL MAXBAR", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8057021", "type": "CDM"}], "standard_charges": [{"gross_charge": 1312.0, "discounted_cash": 984.0, "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": 19273.0, "discounted_cash": 14454.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRY TIBIAL INBONE RTLT ALL SZS", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8083652", "type": "CDM"}], "standard_charges": [{"gross_charge": 24474.0, "discounted_cash": 18355.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRY TIBIAL STEM OSTEOREMEDS CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013365", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 14929.0, "discounted_cash": 11196.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRYPAN BLUE .06% .5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332790", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 484.0, "discounted_cash": 363.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRYPS/BAL/CASTOIL113MLSP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337657", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 750.0, "discounted_cash": 562.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRYPS/BAL/CASTOIL113MLSP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337657", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 750.0, "discounted_cash": 562.5, "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": 936.0, "discounted_cash": 702.0, "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": 936.0, "discounted_cash": 702.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRYPTASE LEVEL", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7253529", "type": "CDM"}], "standard_charges": [{"gross_charge": 520.0, "discounted_cash": 390.0, "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": 1093.0, "discounted_cash": 819.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TSH", "code_information": [{"code": "84443", "type": "CPT"}, {"code": "4124443", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TSH", "code_information": [{"code": "84443", "type": "CPT"}, {"code": "4154443", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 323.0, "discounted_cash": 242.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TSH RECEPTOR AB/2", "code_information": [{"code": "84235", "type": "CPT"}, {"code": "7004240", "type": "CDM"}], "standard_charges": [{"gross_charge": 716.0, "discounted_cash": 537.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TUBERCULIN PPD 1TU IJ", "code_information": [{"code": "86580", "type": "CPT"}, {"code": "5324979", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "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": 65.0, "discounted_cash": 48.75, "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": 513.0, "discounted_cash": 384.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TUMOR IMM PER SPEC MAN", "code_information": [{"code": "88360", "type": "CPT"}, {"code": "7050083", "type": "CDM"}], "standard_charges": [{"gross_charge": 452.0, "discounted_cash": 339.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TUMOR IMM PER SPEC MAN", "code_information": [{"code": "88360", "type": "CPT"}, {"code": "7088360", "type": "CDM"}], "standard_charges": [{"gross_charge": 419.0, "discounted_cash": 314.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TUMOR LOC 2D WHOLE BDY 2+DAYS", "code_information": [{"code": "78804", "type": "CPT"}, {"code": "5018804", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 10936.0, "discounted_cash": 8202.0, "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": 8611.0, "discounted_cash": 6458.25, "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": 7949.0, "discounted_cash": 5961.75, "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": 9042.0, "discounted_cash": 6781.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TUMR LOC SPECT SGL AREA SGL DY", "code_information": [{"code": "78803", "type": "CPT"}, {"code": "5018803", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 8088.0, "discounted_cash": 6066.0, "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": 7020.0, "discounted_cash": 5265.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TX DVC DESIGN CMPLX", "code_information": [{"code": "77334", "type": "CPT"}, {"code": "5107334", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 5038.0, "discounted_cash": 3778.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TX DVC DESIGN INT", "code_information": [{"code": "77333", "type": "CPT"}, {"code": "5107333", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 3017.0, "discounted_cash": 2262.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TX DVC DESIGN SMPL", "code_information": [{"code": "77332", "type": "CPT"}, {"code": "5107332", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 2119.0, "discounted_cash": 1589.25, "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": 38.0, "discounted_cash": 28.5, "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": 171.0, "discounted_cash": 128.25, "setting": "both", "billing_class": "facility"}]}, {"description": "UA AUTO W/MICRO", "code_information": [{"code": "81001", "type": "CPT"}, {"code": "4121001", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "UA AUTO W/MICRO", "code_information": [{"code": "81001", "type": "CPT"}, {"code": "4151001", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "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": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "UA AUTO W/O MICRO/2", "code_information": [{"code": "81003", "type": "CPT"}, {"code": "4121004", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "UA AUTO W/O MICRO/2", "code_information": [{"code": "81003", "type": "CPT"}, {"code": "4151004", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 75.0, "discounted_cash": 56.25, "setting": "both", "billing_class": "facility"}]}, {"description": "UA NON-AUTO W/O MICRO/2", "code_information": [{"code": "81002", "type": "CPT"}, {"code": "4101007", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "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": 291.0, "discounted_cash": 218.25, "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": 29.0, "discounted_cash": 21.75, "setting": "both", "billing_class": "facility"}]}, {"description": "UA QUAL/SEMIQUANT", "code_information": [{"code": "81005", "type": "CPT"}, {"code": "4121005", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "UE ART IMAGING COMP BILAT", "code_information": [{"code": "93930", "type": "CPT"}, {"code": "4636010", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 1655.0, "discounted_cash": 1241.25, "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": 2352.0, "discounted_cash": 1764.0, "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": 2003.0, "discounted_cash": 1502.25, "setting": "both", "billing_class": "facility"}]}, {"description": "UE ART IMAGING UNI/LTD", "code_information": [{"code": "93931", "type": "CPT"}, {"code": "4636048", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 1359.0, "discounted_cash": 1019.25, "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": 1606.0, "discounted_cash": 1204.5, "setting": "both", "billing_class": "facility"}]}, {"description": "UE ART IMAGING UNI/LTD", "code_information": [{"code": "93931", "type": "CPT"}, {"code": "5117203", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 1210.0, "discounted_cash": 907.5, "setting": "both", "billing_class": "facility"}]}, {"description": "UE/LE ART STUD COMP 3+LVL", "code_information": [{"code": "93923", "type": "CPT"}, {"code": "4630085", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 3780.0, "discounted_cash": 2835.0, "setting": "both", "billing_class": "facility"}]}, {"description": "UE/LE ART STUD COMP 3+LVL", "code_information": [{"code": "93923", "type": "CPT"}, {"code": "5067198", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 1796.0, "discounted_cash": 1347.0, "setting": "both", "billing_class": "facility"}]}, {"description": "UE/LE ART STUD COMP 3+LVL", "code_information": [{"code": "93923", "type": "CPT"}, {"code": "6903923", "type": "CDM"}], "standard_charges": [{"gross_charge": 3780.0, "discounted_cash": 2835.0, "setting": "both", "billing_class": "facility"}]}, {"description": "UE/LE ART STUD LTD 1-2LV", "code_information": [{"code": "93922", "type": "CPT"}, {"code": "4630081", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 1909.0, "discounted_cash": 1431.75, "setting": "both", "billing_class": "facility"}]}, {"description": "UE/LE ART STUD LTD 1-2LV", "code_information": [{"code": "93922", "type": "CPT"}, {"code": "5067196", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 1153.0, "discounted_cash": 864.75, "setting": "both", "billing_class": "facility"}]}, {"description": "UE/LE ART STUD LTD 1-2LV", "code_information": [{"code": "93922", "type": "CPT"}, {"code": "6903925", "type": "CDM"}], "standard_charges": [{"gross_charge": 1909.0, "discounted_cash": 1431.75, "setting": "both", "billing_class": "facility"}]}, {"description": "UE/LE IMG VEINS COMP BILAT", "code_information": [{"code": "93970", "type": "CPT"}, {"code": "4636000", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 6722.0, "discounted_cash": 5041.5, "setting": "both", "billing_class": "facility"}]}, {"description": "UE/LE IMG VEINS COMP BILAT", "code_information": [{"code": "93970", "type": "CPT"}, {"code": "5016520", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 6096.0, "discounted_cash": 4572.0, "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": 6722.0, "discounted_cash": 5041.5, "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": 6096.0, "discounted_cash": 4572.0, "setting": "both", "billing_class": "facility"}]}, {"description": "UE/LE IMG VEINS UNI/LTD", "code_information": [{"code": "93971", "type": "CPT"}, {"code": "4637012", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 3049.0, "discounted_cash": 2286.75, "setting": "both", "billing_class": "facility"}]}, {"description": "UE/LE IMG VEINS UNI/LTD", "code_information": [{"code": "93971", "type": "CPT"}, {"code": "5016525", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 2903.0, "discounted_cash": 2177.25, "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": 2903.0, "discounted_cash": 2177.25, "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": 2903.0, "discounted_cash": 2177.25, "setting": "both", "billing_class": "facility"}]}, {"description": "UMBILICAL ART LINE NB", "code_information": [{"code": "3112120", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 339.0, "discounted_cash": 254.25, "setting": "both", "billing_class": "facility"}]}, {"description": "UMBILICAL ART LINE NB", "code_information": [{"code": "3112120", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 339.0, "discounted_cash": 254.25, "setting": "both", "billing_class": "facility"}]}, {"description": "UMBILICAL VEIN LINE NB", "code_information": [{"code": "3112130", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 330.0, "discounted_cash": 247.5, "setting": "both", "billing_class": "facility"}]}, {"description": "UMBILICAL VEIN LINE NB", "code_information": [{"code": "3112130", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 330.0, "discounted_cash": 247.5, "setting": "both", "billing_class": "facility"}]}, {"description": "UMECLID/VILANT 7DS IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5332810", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 720.0, "discounted_cash": 540.0, "setting": "both", "billing_class": "facility"}]}, {"description": "UMECLID/VILANT 7DS IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5332810", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 720.0, "discounted_cash": 540.0, "setting": "both", "billing_class": "facility"}]}, {"description": "UMECLIDINIUM BROM 7DS IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5332808", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 525.0, "discounted_cash": 393.75, "setting": "both", "billing_class": "facility"}]}, {"description": "UMECLIDINIUM BROM 7DS IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5332808", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 525.0, "discounted_cash": 393.75, "setting": "both", "billing_class": "facility"}]}, {"description": "UNLISTED MOLEC PROC/21", "code_information": [{"code": "81479", "type": "CPT"}, {"code": "7071479", "type": "CDM"}], "standard_charges": [{"gross_charge": 1845.0, "discounted_cash": 1383.75, "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": 2569.0, "discounted_cash": 1926.75, "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": 2569.0, "discounted_cash": 1926.75, "setting": "both", "billing_class": "facility"}]}, {"description": "UPGRADE TO DUAL CHAMBER", "code_information": [{"code": "4613214", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 20616.0, "discounted_cash": 15462.0, "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": 3285.0, "discounted_cash": 2463.75, "setting": "both", "billing_class": "facility"}]}, {"description": "UPPER GI DOUBLE CM STDY", "code_information": [{"code": "74246", "type": "CPT"}, {"code": "5014244", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 3400.0, "discounted_cash": 2550.0, "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": 2807.0, "discounted_cash": 2105.25, "setting": "both", "billing_class": "facility"}]}, {"description": "UPPER GI SM INT F-THRU STD", "code_information": [{"code": "74248", "type": "CPT"}, {"code": "5014248", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2807.0, "discounted_cash": 2105.25, "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": 1783.0, "discounted_cash": 1337.25, "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": 180.0, "discounted_cash": 135.0, "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": 180.0, "discounted_cash": 135.0, "setting": "both", "billing_class": "facility"}]}, {"description": "UREA 15GM PW", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337695", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 25.0, "discounted_cash": 18.75, "setting": "both", "billing_class": "facility"}]}, {"description": "UREA 40% 30GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337685", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 206.0, "discounted_cash": 154.5, "setting": "both", "billing_class": "facility"}]}, {"description": "UREA 40% 30GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337685", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 206.0, "discounted_cash": 154.5, "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": 856.0, "discounted_cash": 642.0, "setting": "both", "billing_class": "facility"}]}, {"description": "UREA NITROGEN URINE", "code_information": [{"code": "84540", "type": "CPT"}, {"code": "4124540", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "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": 60.0, "discounted_cash": 45.0, "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": 1395.0, "discounted_cash": 1046.25, "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": 1054.0, "discounted_cash": 790.5, "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": 1880.0, "discounted_cash": 1410.0, "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": 416.0, "discounted_cash": 312.0, "setting": "both", "billing_class": "facility"}]}, {"description": "URIC ACID BLOOD", "code_information": [{"code": "84550", "type": "CPT"}, {"code": "4124550", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "URIC ACID BLOOD", "code_information": [{"code": "84550", "type": "CPT"}, {"code": "4154550", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 315.0, "discounted_cash": 236.25, "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": 2051.0, "discounted_cash": 1538.25, "setting": "both", "billing_class": "facility"}]}, {"description": "URIC ACID OTHR SOURCE/3", "code_information": [{"code": "84560", "type": "CPT"}, {"code": "4124560", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "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": 385.0, "discounted_cash": 288.75, "setting": "both", "billing_class": "facility"}]}, {"description": "URINE PREG TEST QUAL", "code_information": [{"code": "81025", "type": "CPT"}, {"code": "4151026", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 234.0, "discounted_cash": 175.5, "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": 2418.0, "discounted_cash": 1813.5, "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": 3323.0, "discounted_cash": 2492.25, "setting": "both", "billing_class": "facility"}]}, {"description": "UROGRAPHY EXCRETORY(IVP)", "code_information": [{"code": "74400", "type": "CPT"}, {"code": "5014400", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 3983.0, "discounted_cash": 2987.25, "setting": "both", "billing_class": "facility"}]}, {"description": "UROGRAPHY EXCRETORY(IVP)", "code_information": [{"code": "74400", "type": "CPT"}, {"code": "5114400", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 3983.0, "discounted_cash": 2987.25, "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": 76.0, "discounted_cash": 57.0, "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": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "URSODIOL 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312242", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "URSODIOL 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312242", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "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": 2875.0, "discounted_cash": 2156.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US ABDOMEN COMPLETE", "code_information": [{"code": "76700", "type": "CPT"}, {"code": "5016690", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 3018.0, "discounted_cash": 2263.5, "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": 3018.0, "discounted_cash": 2263.5, "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": 2874.0, "discounted_cash": 2155.5, "setting": "both", "billing_class": "facility"}]}, {"description": "US ABDOMEN LTD/QUAD/FU", "code_information": [{"code": "76705", "type": "CPT"}, {"code": "5016705", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2585.0, "discounted_cash": 1938.75, "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": 2739.0, "discounted_cash": 2054.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US BREAST UNI COMPLETE", "code_information": [{"code": "76641", "type": "CPT"}, {"code": "5016643", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1802.0, "discounted_cash": 1351.5, "setting": "both", "billing_class": "facility"}]}, {"description": "US BREAST UNI COMPLETE", "code_information": [{"code": "76641", "type": "CPT"}, {"code": "5066645", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1620.0, "discounted_cash": 1215.0, "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": 1718.0, "discounted_cash": 1288.5, "setting": "both", "billing_class": "facility"}]}, {"description": "US BREAST UNI LTD", "code_information": [{"code": "76642", "type": "CPT"}, {"code": "5066642", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 972.0, "discounted_cash": 729.0, "setting": "both", "billing_class": "facility"}]}, {"description": "US BREAST UNI LTD", "code_information": [{"code": "76642", "type": "CPT"}, {"code": "5116642", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 900.0, "discounted_cash": 675.0, "setting": "both", "billing_class": "facility"}]}, {"description": "US BX THIGH/KNEE DEEP", "code_information": [{"code": "4917324", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 17340.0, "discounted_cash": 13005.0, "setting": "both", "billing_class": "facility"}]}, {"description": "US CHEST INCLD MEDIASTNM", "code_information": [{"code": "76604", "type": "CPT"}, {"code": "5016604", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2075.0, "discounted_cash": 1556.25, "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": 2075.0, "discounted_cash": 1556.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US CHEST INCLD MEDIASTNM", "code_information": [{"code": "76604", "type": "CPT"}, {"code": "5116604", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2190.0, "discounted_cash": 1642.5, "setting": "both", "billing_class": "facility"}]}, {"description": "US COMPRESSN REP PSEUDAN", "code_information": [{"code": "76936", "type": "CPT"}, {"code": "5066936", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 3466.0, "discounted_cash": 2599.5, "setting": "both", "billing_class": "facility"}]}, {"description": "US EXAM AAA SCREEN", "code_information": [{"code": "76706", "type": "CPT"}, {"code": "5010389", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1174.0, "discounted_cash": 880.5, "setting": "both", "billing_class": "facility"}]}, {"description": "US EXAM AAA SCREEN", "code_information": [{"code": "76706", "type": "CPT"}, {"code": "5060389", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1174.0, "discounted_cash": 880.5, "setting": "both", "billing_class": "facility"}]}, {"description": "US EXAM AAA SCREEN", "code_information": [{"code": "76706", "type": "CPT"}, {"code": "5110389", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1416.0, "discounted_cash": 1062.0, "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": 1526.0, "discounted_cash": 1144.5, "setting": "both", "billing_class": "facility"}]}, {"description": "US GUIDE NEEDLE PLACEMNT", "code_information": [{"code": "76942", "type": "CPT"}, {"code": "4636942", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 3523.0, "discounted_cash": 2642.25, "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": 3086.0, "discounted_cash": 2314.5, "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": 3523.0, "discounted_cash": 2642.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US GUIDE VASCULAR ACCESS", "code_information": [{"code": "76937", "type": "CPT"}, {"code": "4616937", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1985.0, "discounted_cash": 1488.75, "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": 2048.0, "discounted_cash": 1536.0, "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": 2148.0, "discounted_cash": 1611.0, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB COMP W FETL ANATMY", "code_information": [{"code": "76811", "type": "CPT"}, {"code": "5016811", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1274.0, "discounted_cash": 955.5, "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": 1274.0, "discounted_cash": 955.5, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB COMP W FETL ANATMY", "code_information": [{"code": "76811", "type": "CPT"}, {"code": "5116811", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1146.0, "discounted_cash": 859.5, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB COMP<14WK ADD GEST", "code_information": [{"code": "76802", "type": "CPT"}, {"code": "5016802", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 411.0, "discounted_cash": 308.25, "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": 411.0, "discounted_cash": 308.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB COMP<14WKS 1STGEST", "code_information": [{"code": "76801", "type": "CPT"}, {"code": "5016801", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 502.0, "discounted_cash": 376.5, "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": 561.0, "discounted_cash": 420.75, "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": 427.0, "discounted_cash": 320.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB COMP>14WK ADD GEST", "code_information": [{"code": "76810", "type": "CPT"}, {"code": "5016843", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1753.0, "discounted_cash": 1314.75, "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": 1671.0, "discounted_cash": 1253.25, "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": 2001.0, "discounted_cash": 1500.75, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB COMP>14WK SGL GEST", "code_information": [{"code": "76805", "type": "CPT"}, {"code": "5018230", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1419.0, "discounted_cash": 1064.25, "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": 2486.0, "discounted_cash": 1864.5, "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": 1635.0, "discounted_cash": 1226.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB FETLANAT ADDL GEST", "code_information": [{"code": "76812", "type": "CPT"}, {"code": "5016812", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 706.0, "discounted_cash": 529.5, "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": 706.0, "discounted_cash": 529.5, "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": 687.0, "discounted_cash": 515.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB LTD 1OR> FETUS", "code_information": [{"code": "76815", "type": "CPT"}, {"code": "5016810", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 609.0, "discounted_cash": 456.75, "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": 756.0, "discounted_cash": 567.0, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB LTD 1OR> FETUS", "code_information": [{"code": "76815", "type": "CPT"}, {"code": "5116815", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 621.0, "discounted_cash": 465.75, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB TRANSVAGINAL", "code_information": [{"code": "76817", "type": "CPT"}, {"code": "5016817", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 505.0, "discounted_cash": 378.75, "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": 583.0, "discounted_cash": 437.25, "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": 428.0, "discounted_cash": 321.0, "setting": "both", "billing_class": "facility"}]}, {"description": "US PELVIC COMPLETE", "code_information": [{"code": "76856", "type": "CPT"}, {"code": "5016856", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 3576.0, "discounted_cash": 2682.0, "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": 3755.0, "discounted_cash": 2816.25, "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": 3755.0, "discounted_cash": 2816.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US PELVIC LTD/FU", "code_information": [{"code": "76857", "type": "CPT"}, {"code": "5016858", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 673.0, "discounted_cash": 504.75, "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": 840.0, "discounted_cash": 630.0, "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": 775.0, "discounted_cash": 581.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US RETROPERITONEAL COMP", "code_information": [{"code": "76770", "type": "CPT"}, {"code": "5016531", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2035.0, "discounted_cash": 1526.25, "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": 2035.0, "discounted_cash": 1526.25, "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": 2035.0, "discounted_cash": 1526.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US RETROPERITONEAL LTD", "code_information": [{"code": "76775", "type": "CPT"}, {"code": "5016533", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1415.0, "discounted_cash": 1061.25, "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": 1415.0, "discounted_cash": 1061.25, "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": 1415.0, "discounted_cash": 1061.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US SCROTUM CONTENTS", "code_information": [{"code": "76870", "type": "CPT"}, {"code": "5016782", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2940.0, "discounted_cash": 2205.0, "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": 3087.0, "discounted_cash": 2315.25, "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": 2940.0, "discounted_cash": 2205.0, "setting": "both", "billing_class": "facility"}]}, {"description": "US SOFT TISSUE HEAD/NECK", "code_information": [{"code": "76536", "type": "CPT"}, {"code": "5016536", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2728.0, "discounted_cash": 2046.0, "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": 2728.0, "discounted_cash": 2046.0, "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": 2623.0, "discounted_cash": 1967.25, "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": 1024.0, "discounted_cash": 768.0, "setting": "both", "billing_class": "facility"}]}, {"description": "US TRANSRECTAL", "code_information": [{"code": "76872", "type": "CPT"}, {"code": "5016872", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 888.0, "discounted_cash": 666.0, "setting": "both", "billing_class": "facility"}]}, {"description": "US TRANSRECTAL", "code_information": [{"code": "76872", "type": "CPT"}, {"code": "5066873", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 807.0, "discounted_cash": 605.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US TRANSVAGINAL NOT OB", "code_information": [{"code": "76830", "type": "CPT"}, {"code": "5016855", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 3411.0, "discounted_cash": 2558.25, "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": 3411.0, "discounted_cash": 2558.25, "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": 3411.0, "discounted_cash": 2558.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US TRUS W MRI FUSION BIOPSY", "code_information": [{"code": "76999", "type": "CPT"}, {"code": "5060017", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 922.0, "discounted_cash": 691.5, "setting": "both", "billing_class": "facility"}]}, {"description": "US XTR JOINT COMPLETE", "code_information": [{"code": "76881", "type": "CPT"}, {"code": "5016860", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 3071.0, "discounted_cash": 2303.25, "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": 3071.0, "discounted_cash": 2303.25, "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": 3071.0, "discounted_cash": 2303.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US XTR JOINT LMTD", "code_information": [{"code": "76882", "type": "CPT"}, {"code": "5016863", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1275.0, "discounted_cash": 956.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US XTR JOINT LMTD", "code_information": [{"code": "76882", "type": "CPT"}, {"code": "5066863", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1275.0, "discounted_cash": 956.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US XTR JOINT LMTD", "code_information": [{"code": "76882", "type": "CPT"}, {"code": "5116850", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1275.0, "discounted_cash": 956.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US XTR SOFT TISSUE LMTD", "code_information": [{"code": "76882", "type": "CPT"}, {"code": "5016861", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1275.0, "discounted_cash": 956.25, "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": 1275.0, "discounted_cash": 956.25, "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": 1275.0, "discounted_cash": 956.25, "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": 6935.0, "discounted_cash": 5201.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 94.0, "discounted_cash": 70.5, "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": 94.0, "discounted_cash": 70.5, "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": 501.0, "discounted_cash": 375.75, "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": 501.0, "discounted_cash": 375.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "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": 20.0, "discounted_cash": 15.0, "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": 20.0, "discounted_cash": 15.0, "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": 355.0, "discounted_cash": 266.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VALPROATE250MG/5ML10MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316582", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 106.0, "discounted_cash": 79.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VALPROATE250MG/5ML10MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316582", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 106.0, "discounted_cash": 79.5, "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": 1285.0, "discounted_cash": 963.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VALPROIC ACID TOTAL", "code_information": [{"code": "80164", "type": "CPT"}, {"code": "4124584", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VALPROIC ACID TOTAL", "code_information": [{"code": "80164", "type": "CPT"}, {"code": "4154584", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 293.0, "discounted_cash": 219.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VALPROIC ACID TOTAL/2", "code_information": [{"code": "80164", "type": "CPT"}, {"code": "7254586", "type": "CDM"}], "standard_charges": [{"gross_charge": 996.0, "discounted_cash": 747.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VALRUBICIN PER 200MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9357", "type": "HCPCS"}, {"code": "5325067", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 4940.0, "discounted_cash": 3705.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VALRUBICIN PER 200MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9357", "type": "HCPCS"}, {"code": "5325067", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 4940.0, "discounted_cash": 3705.0, "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": 47.0, "discounted_cash": 35.25, "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": 47.0, "discounted_cash": 35.25, "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": 33.0, "discounted_cash": 24.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VALVE ADJUSTABLE STRATA MR II", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8145309", "type": "CDM"}], "standard_charges": [{"gross_charge": 56825.0, "discounted_cash": 42618.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VALVE HEART", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8143522", "type": "CDM"}], "standard_charges": [{"gross_charge": 46354.0, "discounted_cash": 34765.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VALVE STNTD TISSUE MITRAL EPIC", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8141012", "type": "CDM"}], "standard_charges": [{"gross_charge": 39624.0, "discounted_cash": 29718.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VANCOMY CMPD OPTH SOL OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5332816", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 584.0, "discounted_cash": 438.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VANCOMY CMPD OPTH SOL OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5332816", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 584.0, "discounted_cash": 438.0, "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": 798.0, "discounted_cash": 598.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VANCOMYCIN", "code_information": [{"code": "80202", "type": "CPT"}, {"code": "4120031", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VANCOMYCIN", "code_information": [{"code": "80202", "type": "CPT"}, {"code": "4150031", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 299.0, "discounted_cash": 224.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VANCOMYCIN 125MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312270", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 160.0, "discounted_cash": 120.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VANCOMYCIN 125MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312270", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 160.0, "discounted_cash": 120.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VANCOMYCIN 125MG LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316600", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VANCOMYCIN 125MG LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316600", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VANCOMYCIN 1G/20MLPWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316598", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 232.0, "discounted_cash": 174.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VANCOMYCIN 1G/20MLPWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316598", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 232.0, "discounted_cash": 174.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VANCOMYCIN 250MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312271", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 289.0, "discounted_cash": 216.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VANCOMYCIN 250MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312271", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 289.0, "discounted_cash": 216.75, "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": 21.0, "discounted_cash": 15.75, "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": 21.0, "discounted_cash": 15.75, "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": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VANCOMYCIN PER 10MG IVPB IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3373", "type": "HCPCS"}, {"code": "5325063", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VANCOMYCIN PER 10MG IVPB IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3373", "type": "HCPCS"}, {"code": "5325063", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VANCOMYCIN PER 10MG PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3373", "type": "HCPCS"}, {"code": "5325064", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VANCOMYCIN PER 10MG PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3373", "type": "HCPCS"}, {"code": "5325064", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": 267.0, "discounted_cash": 200.25, "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": 193.0, "discounted_cash": 144.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VANCOMYCIN/BSS CMPD OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5332815", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 365.0, "discounted_cash": 273.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VANCOMYCIN/BSS CMPD OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5332815", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 365.0, "discounted_cash": 273.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VARENICLINE 0.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312257", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VARENICLINE 0.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312257", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VARENICLINE 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312296", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VARENICLINE 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312296", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "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": 1113.0, "discounted_cash": 834.75, "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": 1113.0, "discounted_cash": 834.75, "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": 630.0, "discounted_cash": 472.5, "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": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VARICELLA ZOSTER AB/2", "code_information": [{"code": "86787", "type": "CPT"}, {"code": "7256273", "type": "CDM"}], "standard_charges": [{"gross_charge": 561.0, "discounted_cash": 420.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VARICELLA ZOSTER AB/3", "code_information": [{"code": "86787", "type": "CPT"}, {"code": "7256786", "type": "CDM"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VARICELLA ZOSTER DFA", "code_information": [{"code": "87290", "type": "CPT"}, {"code": "7258729", "type": "CDM"}], "standard_charges": [{"gross_charge": 62.0, "discounted_cash": 46.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VAS CLS ANGIOSEAL", "code_information": [{"code": "C1760", "type": "HCPCS"}, {"code": "8177901", "type": "CDM"}], "standard_charges": [{"gross_charge": 17317.0, "discounted_cash": 12987.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VAS CLS ANGSL 6FR 610130", "code_information": [{"code": "C1760", "type": "HCPCS"}, {"code": "8243891", "type": "CDM"}], "standard_charges": [{"gross_charge": 1874.0, "discounted_cash": 1405.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VAS CLS ART CLOSER S", "code_information": [{"code": "C1760", "type": "HCPCS"}, {"code": "8249010", "type": "CDM"}], "standard_charges": [{"gross_charge": 1827.0, "discounted_cash": 1370.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VAS CLS ART PERCLOSE", "code_information": [{"code": "C1760", "type": "HCPCS"}, {"code": "8240408", "type": "CDM"}], "standard_charges": [{"gross_charge": 2564.0, "discounted_cash": 1923.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VASC EMB/OCC ARTERY", "code_information": [{"code": "4617242", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 90838.0, "discounted_cash": 68128.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VASC EMB/OCC ARTERY", "code_information": [{"code": "4917242", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 19382.0, "discounted_cash": 14536.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VASC EMB/OCC BLEED", "code_information": [{"code": "4917244", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 21574.0, "discounted_cash": 16180.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VASC EMB/OCC ORGAN", "code_information": [{"code": "4917243", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 19382.0, "discounted_cash": 14536.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VASC EMB/OCC VENOUS", "code_information": [{"code": "4617241", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 86512.0, "discounted_cash": 64884.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VASC EMB/OCC VENOUS", "code_information": [{"code": "4917241", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 21777.0, "discounted_cash": 16332.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VASC ENDO GROWTH FACTOR/3", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7258765", "type": "CDM"}], "standard_charges": [{"gross_charge": 2372.0, "discounted_cash": 1779.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VASOACTIVE INTST POLYPEP", "code_information": [{"code": "84586", "type": "CPT"}, {"code": "7004238", "type": "CDM"}], "standard_charges": [{"gross_charge": 1012.0, "discounted_cash": 759.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VASOACTIVE INTST POLYPEP", "code_information": [{"code": "84586", "type": "CPT"}, {"code": "7254238", "type": "CDM"}], "standard_charges": [{"gross_charge": 1012.0, "discounted_cash": 759.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VASOPRESSIN (ADH)", "code_information": [{"code": "84588", "type": "CPT"}, {"code": "7004588", "type": "CDM"}], "standard_charges": [{"gross_charge": 1821.0, "discounted_cash": 1365.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VASOPRESSIN (ADH)", "code_information": [{"code": "84588", "type": "CPT"}, {"code": "7254588", "type": "CDM"}], "standard_charges": [{"gross_charge": 1821.0, "discounted_cash": 1365.75, "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": 40.0, "discounted_cash": 30.0, "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": 40.0, "discounted_cash": 30.0, "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": 774.0, "discounted_cash": 580.5, "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": 157.0, "discounted_cash": 117.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VEEG EA 12-26HR CONT MNTR", "code_information": [{"code": "95716", "type": "CPT"}, {"code": "4805712", "type": "CDM"}, {"code": "740", "type": "RC"}], "standard_charges": [{"gross_charge": 8215.0, "discounted_cash": 6161.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VENA CAVA FILT F", "code_information": [{"code": "C1880", "type": "HCPCS"}, {"code": "8145755", "type": "CDM"}], "standard_charges": [{"gross_charge": 10885.0, "discounted_cash": 8163.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VENETOCLAX 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8999", "type": "HCPCS"}, {"code": "5312449", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 702.0, "discounted_cash": 526.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VENETOCLAX 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8999", "type": "HCPCS"}, {"code": "5312449", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 702.0, "discounted_cash": 526.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VENIPUNCTURE", "code_information": [{"code": "36415", "type": "CPT"}, {"code": "6124020", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VENIPUNCTURE/3", "code_information": [{"code": "36415", "type": "CPT"}, {"code": "4209010", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VENLAFAXINE 150MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312272", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VENLAFAXINE 150MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312272", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VENLAFAXINE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312275", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VENLAFAXINE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312275", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "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": 64.0, "discounted_cash": 48.0, "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": 64.0, "discounted_cash": 48.0, "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": 76.0, "discounted_cash": 57.0, "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": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VENOGRAM BILATERAL", "code_information": [{"code": "78458", "type": "CPT"}, {"code": "5208458", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 3916.0, "discounted_cash": 2937.0, "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": 10035.0, "discounted_cash": 7526.25, "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": 7687.0, "discounted_cash": 5765.25, "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": 4528.0, "discounted_cash": 3396.0, "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": 4861.0, "discounted_cash": 3645.75, "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": 4290.0, "discounted_cash": 3217.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VENOGRAPHY RENAL BILAT", "code_information": [{"code": "75833", "type": "CPT"}, {"code": "4615834", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 7995.0, "discounted_cash": 5996.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VENOGRAPHY RENAL BILAT", "code_information": [{"code": "75833", "type": "CPT"}, {"code": "4915834", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 9149.0, "discounted_cash": 6861.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VENOGRAPHY RENAL UNILAT", "code_information": [{"code": "75831", "type": "CPT"}, {"code": "4615832", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 6972.0, "discounted_cash": 5229.0, "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": 6972.0, "discounted_cash": 5229.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VENOGRAPHY SUP SAGITTAL", "code_information": [{"code": "75870", "type": "CPT"}, {"code": "4915871", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 8664.0, "discounted_cash": 6498.0, "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": 3435.0, "discounted_cash": 2576.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VENOUS CATH SAMPLING", "code_information": [{"code": "4917991", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5430.0, "discounted_cash": 4072.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VENOUS SAMPLING VIA CATH", "code_information": [{"code": "75893", "type": "CPT"}, {"code": "4915893", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 26700.0, "discounted_cash": 20025.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VERAPAMIL 120MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312288", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VERAPAMIL 120MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312288", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "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": 43.0, "discounted_cash": 32.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "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": 53.0, "discounted_cash": 39.75, "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": 53.0, "discounted_cash": 39.75, "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": 60.0, "discounted_cash": 45.0, "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": 60.0, "discounted_cash": 45.0, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "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": 36.0, "discounted_cash": 27.0, "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": 36.0, "discounted_cash": 27.0, "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": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VERY LNG CHN FATTY ACID", "code_information": [{"code": "82726", "type": "CPT"}, {"code": "7259920", "type": "CDM"}], "standard_charges": [{"gross_charge": 505.0, "discounted_cash": 378.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VILAZODONE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312330", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VILAZODONE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312330", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VILAZODONE 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312332", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VILAZODONE 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312332", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VILAZODONE 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312331", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VILAZODONE 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312331", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VINBLASTINE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9360", "type": "HCPCS"}, {"code": "5325176", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VINBLASTINE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9360", "type": "HCPCS"}, {"code": "5325176", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VINCRISTINE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9370", "type": "HCPCS"}, {"code": "5325198", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 784.0, "discounted_cash": 588.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VINCRISTINE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9370", "type": "HCPCS"}, {"code": "5325198", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 784.0, "discounted_cash": 588.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VINORELBINE PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9390", "type": "HCPCS"}, {"code": "5325210", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1138.0, "discounted_cash": 853.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VINORELBINE PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9390", "type": "HCPCS"}, {"code": "5325210", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1138.0, "discounted_cash": 853.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VIRAL CULTURE IDENTIFY", "code_information": [{"code": "87250", "type": "CPT"}, {"code": "7027254", "type": "CDM"}], "standard_charges": [{"gross_charge": 841.0, "discounted_cash": 630.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VIRUS ANTIBODY NES", "code_information": [{"code": "86790", "type": "CPT"}, {"code": "7006184", "type": "CDM"}], "standard_charges": [{"gross_charge": 403.0, "discounted_cash": 302.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VIRUS INOC SHELL EACH/2", "code_information": [{"code": "87254", "type": "CPT"}, {"code": "7007258", "type": "CDM"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VISCOSITY", "code_information": [{"code": "85810", "type": "CPT"}, {"code": "7257192", "type": "CDM"}], "standard_charges": [{"gross_charge": 191.0, "discounted_cash": 143.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VISCOSITY/3", "code_information": [{"code": "85810", "type": "CPT"}, {"code": "4107192", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 253.0, "discounted_cash": 189.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VISUAL EVOKED POTENTIAL", "code_information": [{"code": "95930", "type": "CPT"}, {"code": "3215930", "type": "CDM"}, {"code": "922", "type": "RC"}], "standard_charges": [{"gross_charge": 4955.0, "discounted_cash": 3716.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VISUAL EVOKED POTENTIAL", "code_information": [{"code": "95930", "type": "CPT"}, {"code": "4805871", "type": "CDM"}, {"code": "922", "type": "RC"}], "standard_charges": [{"gross_charge": 5106.0, "discounted_cash": 3829.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VIT D1 25-DIHYDROXY", "code_information": [{"code": "82652", "type": "CPT"}, {"code": "7002652", "type": "CDM"}], "standard_charges": [{"gross_charge": 848.0, "discounted_cash": 636.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VIT D1 25-DIHYDROXY", "code_information": [{"code": "82652", "type": "CPT"}, {"code": "7254594", "type": "CDM"}], "standard_charges": [{"gross_charge": 848.0, "discounted_cash": 636.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VIT E 15U/.3ML 12ML DRLQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316635", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1301.0, "discounted_cash": 975.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VIT E 15U/.3ML 12ML DRLQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316635", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1301.0, "discounted_cash": 975.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN A", "code_information": [{"code": "84590", "type": "CPT"}, {"code": "7004590", "type": "CDM"}], "standard_charges": [{"gross_charge": 840.0, "discounted_cash": 630.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN A", "code_information": [{"code": "84590", "type": "CPT"}, {"code": "7254590", "type": "CDM"}], "standard_charges": [{"gross_charge": 840.0, "discounted_cash": 630.0, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN A&D 120GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337700", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN A&D 120GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337700", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "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": 76.0, "discounted_cash": 57.0, "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": 76.0, "discounted_cash": 57.0, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN B-12 500MCG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312360", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.6, "discounted_cash": 0.45, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN B-12 500MCG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312360", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 0.6, "discounted_cash": 0.45, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN B3 NIACIN", "code_information": [{"code": "80375", "type": "CPT"}, {"code": "7254591", "type": "CDM"}], "standard_charges": [{"gross_charge": 196.0, "discounted_cash": 147.0, "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": 0.35, "discounted_cash": 0.26, "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": 0.35, "discounted_cash": 0.26, "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": 383.0, "discounted_cash": 287.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN D/25 HYDROXY", "code_information": [{"code": "82306", "type": "CPT"}, {"code": "7004595", "type": "CDM"}], "standard_charges": [{"gross_charge": 810.0, "discounted_cash": 607.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN D/25 HYDROXY/2", "code_information": [{"code": "82306", "type": "CPT"}, {"code": "7254595", "type": "CDM"}], "standard_charges": [{"gross_charge": 810.0, "discounted_cash": 607.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN D3 200U TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312389", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.26, "discounted_cash": 0.2, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN D3 200U TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312389", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 0.26, "discounted_cash": 0.2, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN D3 400U CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312387", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.28, "discounted_cash": 0.21, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN D3 400U CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312387", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 0.28, "discounted_cash": 0.21, "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": 0.32, "discounted_cash": 0.24, "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": 0.32, "discounted_cash": 0.24, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN E 1000U CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312411", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN E 1000U CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312411", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN K", "code_information": [{"code": "84597", "type": "CPT"}, {"code": "7004597", "type": "CDM"}], "standard_charges": [{"gross_charge": 720.0, "discounted_cash": 540.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN K", "code_information": [{"code": "84597", "type": "CPT"}, {"code": "7254597", "type": "CDM"}], "standard_charges": [{"gross_charge": 720.0, "discounted_cash": 540.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN NOS", "code_information": [{"code": "84591", "type": "CPT"}, {"code": "7004209", "type": "CDM"}], "standard_charges": [{"gross_charge": 196.0, "discounted_cash": 147.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMN E(TOCOPHRL ALPHA)", "code_information": [{"code": "84446", "type": "CPT"}, {"code": "7004446", "type": "CDM"}], "standard_charges": [{"gross_charge": 790.0, "discounted_cash": 592.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMN E(TOCOPHRL ALPHA)", "code_information": [{"code": "84446", "type": "CPT"}, {"code": "7254446", "type": "CDM"}], "standard_charges": [{"gross_charge": 790.0, "discounted_cash": 592.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VLV AHMED GLAUCOMA", "code_information": [{"code": "C1783", "type": "HCPCS"}, {"code": "8177944", "type": "CDM"}], "standard_charges": [{"gross_charge": 8596.0, "discounted_cash": 6447.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VLV CERB SPINAL", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8177942", "type": "CDM"}], "standard_charges": [{"gross_charge": 6433.0, "discounted_cash": 4824.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VLV HAKIM PROGRAMABLE", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8145794", "type": "CDM"}], "standard_charges": [{"gross_charge": 30466.0, "discounted_cash": 22849.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VLV HYDROCEPH", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8177945", "type": "CDM"}], "standard_charges": [{"gross_charge": 31594.0, "discounted_cash": 23695.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VLV MITRAL EDWARDS MITRIS RESI", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8145307", "type": "CDM"}], "standard_charges": [{"gross_charge": 90889.0, "discounted_cash": 68166.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VLV TAVR AORTIC EVOLUTFX", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8145296", "type": "CDM"}], "standard_charges": [{"gross_charge": 22171.0, "discounted_cash": 16628.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VLV TAVR AORTIC EVPROPLUS", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8145297", "type": "CDM"}], "standard_charges": [{"gross_charge": 357768.0, "discounted_cash": 268326.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VLV TAVR AORTIC TRANSCATH", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8145302", "type": "CDM"}], "standard_charges": [{"gross_charge": 383264.0, "discounted_cash": 287448.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VLV TAVR TRANSCATH SAPIEN3", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8145308", "type": "CDM"}], "standard_charges": [{"gross_charge": 387582.0, "discounted_cash": 290686.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VMA URINE", "code_information": [{"code": "84585", "type": "CPT"}, {"code": "7004586", "type": "CDM"}], "standard_charges": [{"gross_charge": 948.0, "discounted_cash": 711.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VMA URINE", "code_information": [{"code": "84585", "type": "CPT"}, {"code": "7254585", "type": "CDM"}], "standard_charges": [{"gross_charge": 948.0, "discounted_cash": 711.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VOLATILES", "code_information": [{"code": "84600", "type": "CPT"}, {"code": "7044600", "type": "CDM"}], "standard_charges": [{"gross_charge": 289.0, "discounted_cash": 216.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VOLATILES", "code_information": [{"code": "84600", "type": "CPT"}, {"code": "7254600", "type": "CDM"}], "standard_charges": [{"gross_charge": 289.0, "discounted_cash": 216.75, "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": 2614.0, "discounted_cash": 1960.5, "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": 3687.0, "discounted_cash": 2765.25, "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": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VORICONAZOLE", "code_information": [{"code": "80299", "type": "CPT"}, {"code": "7251442", "type": "CDM"}], "standard_charges": [{"gross_charge": 505.0, "discounted_cash": 378.75, "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": 671.0, "discounted_cash": 503.25, "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": 671.0, "discounted_cash": 503.25, "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": 75.0, "discounted_cash": 56.25, "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": 75.0, "discounted_cash": 56.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VORTIOXETINE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312461", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 94.0, "discounted_cash": 70.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VORTIOXETINE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312461", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 94.0, "discounted_cash": 70.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VORTIOXETINE 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312462", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 106.0, "discounted_cash": 79.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VORTIOXETINE 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312462", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 106.0, "discounted_cash": 79.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VORTIOXETINE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312460", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 94.0, "discounted_cash": 70.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VORTIOXETINE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312460", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 94.0, "discounted_cash": 70.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VWF (VONVENDI) PER IU IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7179", "type": "HCPCS"}, {"code": "5320591", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "WARFARIN 0.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312479", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "WARFARIN 0.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312479", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "WARFARIN 1.25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312478", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "WARFARIN 1.25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312478", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "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": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "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": 39.0, "discounted_cash": 29.25, "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": 39.0, "discounted_cash": 29.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "WARFARIN 3MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312483", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "WARFARIN 3MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312483", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "WARFARIN 4MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312485", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "WARFARIN 4MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312485", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "WARFARIN 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5325245", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 598.0, "discounted_cash": 448.5, "setting": "both", "billing_class": "facility"}]}, {"description": "WARFARIN 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5325245", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 598.0, "discounted_cash": 448.5, "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": 17.0, "discounted_cash": 12.75, "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": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "WARFARIN 6MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312489", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "WARFARIN 6MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312489", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "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": 19.0, "discounted_cash": 14.25, "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": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "WARFARIN/2", "code_information": [{"code": "80375", "type": "CPT"}, {"code": "7250296", "type": "CDM"}], "standard_charges": [{"gross_charge": 520.0, "discounted_cash": 390.0, "setting": "both", "billing_class": "facility"}]}, {"description": "WASHER", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137065", "type": "CDM"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "WASHER CANCL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137070", "type": "CDM"}], "standard_charges": [{"gross_charge": 252.0, "discounted_cash": 189.0, "setting": "both", "billing_class": "facility"}]}, {"description": "WATER DIST 1 GAL LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316659", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "WATER DIST 1 GAL LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316659", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "WATER INJ STERL 100ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5325248", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "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": 197.0, "discounted_cash": 147.75, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "WATER INJ STERL 50ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5325254", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 173.0, "discounted_cash": 129.75, "setting": "both", "billing_class": "facility"}]}, {"description": "WATER INJ STERL 5ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5325249", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 189.0, "discounted_cash": 141.75, "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": 43.0, "discounted_cash": 32.25, "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": 144.0, "discounted_cash": 108.0, "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": 179.0, "discounted_cash": 134.25, "setting": "both", "billing_class": "facility"}]}, {"description": "WBC AUTO", "code_information": [{"code": "85048", "type": "CPT"}, {"code": "4125013", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "WBC AUTO", "code_information": [{"code": "85048", "type": "CPT"}, {"code": "4155013", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "WEARABLE DEFIB EVAL", "code_information": [{"code": "93292", "type": "CPT"}, {"code": "4613292", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 105.75, "setting": "both", "billing_class": "facility"}]}, {"description": "WEDGE ALLOGRAFT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137088", "type": "CDM"}], "standard_charges": [{"gross_charge": 23773.0, "discounted_cash": 17829.75, "setting": "both", "billing_class": "facility"}]}, {"description": "WEDGE TIBIAL PLATE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137087", "type": "CDM"}], "standard_charges": [{"gross_charge": 22318.0, "discounted_cash": 16738.5, "setting": "both", "billing_class": "facility"}]}, {"description": "WEST NILE VIRUS", "code_information": [{"code": "86789", "type": "CPT"}, {"code": "7256784", "type": "CDM"}], "standard_charges": [{"gross_charge": 280.0, "discounted_cash": 210.0, "setting": "both", "billing_class": "facility"}]}, {"description": "WEST NILE VIRUS IGM", "code_information": [{"code": "86788", "type": "CPT"}, {"code": "7006479", "type": "CDM"}], "standard_charges": [{"gross_charge": 403.0, "discounted_cash": 302.25, "setting": "both", "billing_class": "facility"}]}, {"description": "WEST NILE VIRUS IGM", "code_information": [{"code": "86788", "type": "CPT"}, {"code": "7256783", "type": "CDM"}], "standard_charges": [{"gross_charge": 161.0, "discounted_cash": 120.75, "setting": "both", "billing_class": "facility"}]}, {"description": "WEST NILE VIRUS IGM/2", "code_information": [{"code": "86788", "type": "CPT"}, {"code": "7256789", "type": "CDM"}], "standard_charges": [{"gross_charge": 280.0, "discounted_cash": 210.0, "setting": "both", "billing_class": "facility"}]}, {"description": "WEST NILE VIRUS/2", "code_information": [{"code": "86789", "type": "CPT"}, {"code": "7256785", "type": "CDM"}], "standard_charges": [{"gross_charge": 280.0, "discounted_cash": 210.0, "setting": "both", "billing_class": "facility"}]}, {"description": "WEST NILE VIRUS/3", "code_information": [{"code": "86789", "type": "CPT"}, {"code": "7256787", "type": "CDM"}], "standard_charges": [{"gross_charge": 403.0, "discounted_cash": 302.25, "setting": "both", "billing_class": "facility"}]}, {"description": "WEST NILE VIRUS/4", "code_information": [{"code": "86789", "type": "CPT"}, {"code": "7006478", "type": "CDM"}], "standard_charges": [{"gross_charge": 403.0, "discounted_cash": 302.25, "setting": "both", "billing_class": "facility"}]}, {"description": "WHFO WRST EXT NONMOLD", "code_information": [{"code": "L3908", "type": "HCPCS"}, {"code": "8130021", "type": "CDM"}], "standard_charges": [{"gross_charge": 173.0, "discounted_cash": 129.75, "setting": "both", "billing_class": "facility"}]}, {"description": "WIRE KIRCHNER PL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137095", "type": "CDM"}], "standard_charges": [{"gross_charge": 264.0, "discounted_cash": 198.0, "setting": "both", "billing_class": "facility"}]}, {"description": "WIRE KIRCHNER TH", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137100", "type": "CDM"}], "standard_charges": [{"gross_charge": 282.0, "discounted_cash": 211.5, "setting": "both", "billing_class": "facility"}]}, {"description": "WIRE KIRSCHNER W STOP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137102", "type": "CDM"}], "standard_charges": [{"gross_charge": 239.0, "discounted_cash": 179.25, "setting": "both", "billing_class": "facility"}]}, {"description": "WIRE TROCANTOR", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137110", "type": "CDM"}], "standard_charges": [{"gross_charge": 443.0, "discounted_cash": 332.25, "setting": "both", "billing_class": "facility"}]}, {"description": "WIREGDE AMPLTZ", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8177990", "type": "CDM"}], "standard_charges": [{"gross_charge": 452.0, "discounted_cash": 339.0, "setting": "both", "billing_class": "facility"}]}, {"description": "WND COLLAGEN PDR", "code_information": [{"code": "A6010", "type": "HCPCS"}, {"code": "8028003", "type": "CDM"}], "standard_charges": [{"gross_charge": 1595.0, "discounted_cash": 1196.25, "setting": "both", "billing_class": "facility"}]}, {"description": "WND MATRIX NANOFIBER RESTRATA", "code_information": [{"code": "A6460", "type": "HCPCS"}, {"code": "8028002", "type": "CDM"}], "standard_charges": [{"gross_charge": 13111.0, "discounted_cash": 9833.25, "setting": "both", "billing_class": "facility"}]}, {"description": "WND MATRIX RESTRATA PER SQ CM", "code_information": [{"code": "A2007", "type": "HCPCS"}, {"code": "4028826", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 360.0, "discounted_cash": 270.0, "setting": "both", "billing_class": "facility"}]}, {"description": "WND MATRIX RESTRATA PER SQ CM", "code_information": [{"code": "A2007", "type": "HCPCS"}, {"code": "4028826", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 360.0, "discounted_cash": 270.0, "setting": "both", "billing_class": "facility"}]}, {"description": "WND MTRX NAN RESTRTA PRSQCM", "code_information": [{"code": "A2007", "type": "HCPCS"}, {"code": "4028825", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 170.0, "discounted_cash": 127.5, "setting": "both", "billing_class": "facility"}]}, {"description": "WND MTRX NAN RESTRTA PRSQCM", "code_information": [{"code": "A2007", "type": "HCPCS"}, {"code": "4028825", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 170.0, "discounted_cash": 127.5, "setting": "both", "billing_class": "facility"}]}, {"description": "WND PREP F/N/HF/G", "code_information": [{"code": "6900128", "type": "CDM"}], "standard_charges": [{"gross_charge": 4114.0, "discounted_cash": 3085.5, "setting": "both", "billing_class": "facility"}]}, {"description": "WOUND PREP TRK/ARM/LEG", "code_information": [{"code": "6900140", "type": "CDM"}], "standard_charges": [{"gross_charge": 13217.0, "discounted_cash": 9912.75, "setting": "both", "billing_class": "facility"}]}, {"description": "WRAP COMP SUSTAIN N-ELST", "code_information": [{"code": "A4465", "type": "HCPCS"}, {"code": "8035230", "type": "CDM"}], "standard_charges": [{"gross_charge": 195.0, "discounted_cash": 146.25, "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": 1398.0, "discounted_cash": 1048.5, "setting": "both", "billing_class": "facility"}]}, {"description": "WRIST 2 VIEWS", "code_information": [{"code": "73100", "type": "CPT"}, {"code": "5013100", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1398.0, "discounted_cash": 1048.5, "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": 1426.0, "discounted_cash": 1069.5, "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": 1558.0, "discounted_cash": 1168.5, "setting": "both", "billing_class": "facility"}]}, {"description": "WRIST 3 VIEWS MINIMUM", "code_information": [{"code": "73110", "type": "CPT"}, {"code": "5013110", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1286.0, "discounted_cash": 964.5, "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": 1558.0, "discounted_cash": 1168.5, "setting": "both", "billing_class": "facility"}]}, {"description": "WRIST ARTHROGRAPHY", "code_information": [{"code": "73115", "type": "CPT"}, {"code": "4903115", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2777.0, "discounted_cash": 2082.75, "setting": "both", "billing_class": "facility"}]}, {"description": "WSTNT B ENDOPROS VIABIL", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "8240421", "type": "CDM"}], "standard_charges": [{"gross_charge": 36318.0, "discounted_cash": 27238.5, "setting": "both", "billing_class": "facility"}]}, {"description": "WSTNT B ENDOPROS VIATOR", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "8240423", "type": "CDM"}], "standard_charges": [{"gross_charge": 54047.0, "discounted_cash": 40535.25, "setting": "both", "billing_class": "facility"}]}, {"description": "WSTNT B ENDPR UNISTEP+DS", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8240422", "type": "CDM"}], "standard_charges": [{"gross_charge": 7326.0, "discounted_cash": 5494.5, "setting": "both", "billing_class": "facility"}]}, {"description": "WSTNT B ENDPROS UNISTEP+", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8240435", "type": "CDM"}], "standard_charges": [{"gross_charge": 14480.0, "discounted_cash": 10860.0, "setting": "both", "billing_class": "facility"}]}, {"description": "WSTNT TBRNCH ENDP UNIST+", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8244100", "type": "CDM"}], "standard_charges": [{"gross_charge": 21706.0, "discounted_cash": 16279.5, "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": 1518.0, "discounted_cash": 1138.5, "setting": "both", "billing_class": "facility"}]}, {"description": "X-RAY ESOPHAGUS SNGL CM STDY", "code_information": [{"code": "74220", "type": "CPT"}, {"code": "5014220", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1518.0, "discounted_cash": 1138.5, "setting": "both", "billing_class": "facility"}]}, {"description": "X-RAY ESOPHAGUS SNGL CM STDY", "code_information": [{"code": "74220", "type": "CPT"}, {"code": "5114220", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1776.0, "discounted_cash": 1332.0, "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": 435.0, "discounted_cash": 326.25, "setting": "both", "billing_class": "facility"}]}, {"description": "XYLOMETAZOL NS.1%20ML SP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332859", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 179.0, "discounted_cash": 134.25, "setting": "both", "billing_class": "facility"}]}, {"description": "XYLOSE ABSORPTION TEST", "code_information": [{"code": "84620", "type": "CPT"}, {"code": "7004620", "type": "CDM"}], "standard_charges": [{"gross_charge": 1206.0, "discounted_cash": 904.5, "setting": "both", "billing_class": "facility"}]}, {"description": "XYLOSE ABSORPTION TEST", "code_information": [{"code": "84620", "type": "CPT"}, {"code": "7254620", "type": "CDM"}], "standard_charges": [{"gross_charge": 1206.0, "discounted_cash": 904.5, "setting": "both", "billing_class": "facility"}]}, {"description": "YERSINIA AB", "code_information": [{"code": "86793", "type": "CPT"}, {"code": "7016700", "type": "CDM"}], "standard_charges": [{"gross_charge": 509.0, "discounted_cash": 381.75, "setting": "both", "billing_class": "facility"}]}, {"description": "YO ANTIBODY SCRN", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "7254192", "type": "CDM"}], "standard_charges": [{"gross_charge": 629.0, "discounted_cash": 471.75, "setting": "both", "billing_class": "facility"}]}, {"description": "YTTRIUM90 NOSTRND PR EA", "code_information": [{"code": "C2616", "type": "HCPCS"}, {"code": "5192616", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 131999.0, "discounted_cash": 98999.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ZANAMIVIR 5MG IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5332880", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 671.0, "discounted_cash": 503.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ZANAMIVIR 5MG IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5332880", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 671.0, "discounted_cash": 503.25, "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": 52.0, "discounted_cash": 39.0, "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": 52.0, "discounted_cash": 39.0, "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": 12.0, "discounted_cash": 9.0, "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": 12.0, "discounted_cash": 9.0, "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": 19.0, "discounted_cash": 14.25, "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": 19.0, "discounted_cash": 14.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC", "code_information": [{"code": "84630", "type": "CPT"}, {"code": "7004630", "type": "CDM"}], "standard_charges": [{"gross_charge": 611.0, "discounted_cash": 458.25, "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": 62.0, "discounted_cash": 46.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC OX/CALAMINE4X360 EA", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335301", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 213.0, "discounted_cash": 159.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC OX/CALAMINE4X360 EA", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335301", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 213.0, "discounted_cash": 159.75, "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": 482.0, "discounted_cash": 361.5, "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": 482.0, "discounted_cash": 361.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC OX/PERU BAL 113GMOI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337768", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC OX/PERU BAL 113GMOI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337768", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC OXIDE 16% 120GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337775", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 59.0, "discounted_cash": 44.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC OXIDE 16% 120GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337775", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 59.0, "discounted_cash": 44.25, "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": 85.0, "discounted_cash": 63.75, "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": 85.0, "discounted_cash": 63.75, "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": 318.0, "discounted_cash": 238.5, "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": 318.0, "discounted_cash": 238.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC SULF 1MG/ML 10ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5325279", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "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": 34.0, "discounted_cash": 25.5, "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": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC SULFATE 220MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312512", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.63, "discounted_cash": 0.47, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC SULFATE 220MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312512", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 0.63, "discounted_cash": 0.47, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC/2", "code_information": [{"code": "84630", "type": "CPT"}, {"code": "7254631", "type": "CDM"}], "standard_charges": [{"gross_charge": 611.0, "discounted_cash": 458.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC/CAL/RESORCIN 35GMOI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337754", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 94.0, "discounted_cash": 70.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC/CAL/RESORCIN 35GMOI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337754", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 94.0, "discounted_cash": 70.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC/COD LIV 40% 57GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334937", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC/COD LIV 40% 57GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334937", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC/COD LIV 40%113GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334940", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC/COD LIV 40%113GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334940", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC/COD LIV 40%28GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334936", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC/COD LIV 40%28GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334936", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "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": 99.0, "discounted_cash": 74.25, "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": 99.0, "discounted_cash": 74.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ZIPRASIDONE 40MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312533", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ZIPRASIDONE 40MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312533", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "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": 99.0, "discounted_cash": 74.25, "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": 109.0, "discounted_cash": 81.75, "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": 109.0, "discounted_cash": 81.75, "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": 509.0, "discounted_cash": 381.75, "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": 509.0, "discounted_cash": 381.75, "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": 1632.0, "discounted_cash": 1224.0, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1632.0, "discounted_cash": 1224.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ZOLMITRIPTAN 2.5 MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312527", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 371.0, "discounted_cash": 278.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ZOLMITRIPTAN 2.5 MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312527", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 371.0, "discounted_cash": 278.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ZOLMITRIPTAN 5 MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312528", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 245.0, "discounted_cash": 183.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ZOLMITRIPTAN 5 MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312528", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 245.0, "discounted_cash": 183.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ZOLPIDEM 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312530", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ZOLPIDEM 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312530", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ZOLPIDEM 12.5MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312539", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 62.0, "discounted_cash": 46.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ZOLPIDEM 12.5MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312539", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 62.0, "discounted_cash": 46.5, "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": 65.0, "discounted_cash": 48.75, "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": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ZOLPIDEM 6.25MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312526", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 62.0, "discounted_cash": 46.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ZOLPIDEM 6.25MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312526", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 62.0, "discounted_cash": 46.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ZONISAMIDE", "code_information": [{"code": "80203", "type": "CPT"}, {"code": "7250056", "type": "CDM"}], "standard_charges": [{"gross_charge": 262.0, "discounted_cash": 196.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "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": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ZONISAMIDE 25MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312537", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ZONISAMIDE 25MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312537", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ZONISAMIDE20MG/ML 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316670", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ZONISAMIDE20MG/ML 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316670", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}]}