{"hospital_name": "Amisub of South Carolina, Inc.", "last_updated_on": "2026-04-08", "version": "3.0.0", "pid": "1514657123", "rid": "11712", "location_name": ["Piedmont Medical Center"], "hospital_address": ["222 S Herlong Ave, Rock Hill, SC 29732"], "type_2_npi": ["1457382483"], "license_information": {"license_number": "HTL-0417", "state": "SC"}, "attestation": {"attestation": "To the best of its knowledge and belief, this hospital has included all applicable standard charge information in accordance with the requirements of 45 CFR 180.50, and the information encoded is true, accurate, and complete as of the date in the file. This hospital has included all payer-specific negotiated charges in dollars that can be expressed as a dollar amount. For payer-specific negotiated charges that cannot be expressed as a dollar amount in the machine-readable file or not knowable in advance, the hospital attests that the payer-specific negotiated charge is based on a contractual algorithm, percentage or formula that precludes the provision of a dollar amount and has provided all necessary information available to the hospital for the public to be able to derive the dollar amount, including, but not limited to, the specific fee schedule or components referenced in such percentage, algorithm or formula.", "confirm_attestation": true, "attester_name": "Geoffrey Vines"}, "standard_charge_information": [{"description": "11-DEOXYXORTISL", "code_information": [{"code": "82634", "type": "CPT"}, {"code": "7002517", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 749.0, "discounted_cash": 561.75, "setting": "both", "billing_class": "facility"}]}, {"description": "17-HYDROXY PREGNENOLONE", "code_information": [{"code": "84143", "type": "CPT"}, {"code": "7008414", "type": "CDM"}], "standard_charges": [{"gross_charge": 639.0, "discounted_cash": 479.25, "setting": "both", "billing_class": "facility"}]}, {"description": "17-HYDROXY PREGNENOLONE", "code_information": [{"code": "84143", "type": "CPT"}, {"code": "7258414", "type": "CDM"}], "standard_charges": [{"gross_charge": 145.0, "discounted_cash": 108.75, "setting": "both", "billing_class": "facility"}]}, {"description": "3D ECHO IMG CGEN CAR ANOMAL", "code_information": [{"code": "93319", "type": "CPT"}, {"code": "4610045", "type": "CDM"}, {"code": "483", "type": "RC"}], "standard_charges": [{"gross_charge": 1641.0, "discounted_cash": 1230.75, "setting": "both", "billing_class": "facility"}]}, {"description": "3D IMAGING W POSTPROCESS", "code_information": [{"code": "76377", "type": "CPT"}, {"code": "4636377", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1647.0, "discounted_cash": 1235.25, "setting": "both", "billing_class": "facility"}]}, {"description": "3D IMAGNG NO POSTPROCESS", "code_information": [{"code": "76376", "type": "CPT"}, {"code": "4636376", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1341.0, "discounted_cash": 1005.75, "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": 1400.0, "discounted_cash": 1050.0, "setting": "both", "billing_class": "facility"}]}, {"description": "3D IMAGNG NO POSTPROCESS", "code_information": [{"code": "76376", "type": "CPT"}, {"code": "5117637", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 1400.0, "discounted_cash": 1050.0, "setting": "both", "billing_class": "facility"}]}, {"description": "3D IMAGNG NO POSTPROCESS", "code_information": [{"code": "76376", "type": "CPT"}, {"code": "5126376", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 1400.0, "discounted_cash": 1050.0, "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": 6818.0, "discounted_cash": 5113.5, "setting": "both", "billing_class": "facility"}]}, {"description": "A-2 MACROGLOBULIN", "code_information": [{"code": "83883", "type": "CPT"}, {"code": "7253868", "type": "CDM"}], "standard_charges": [{"gross_charge": 130.0, "discounted_cash": 97.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AA 10% 1L TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5413180", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 179.0, "discounted_cash": 134.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AA 10% 500ML TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5413175", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 1940.0, "discounted_cash": 1455.0, "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": 11246.0, "discounted_cash": 8434.5, "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": 1830.0, "discounted_cash": 1372.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AA 3% ELEC 1L TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5413030", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 615.0, "discounted_cash": 461.25, "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": 1050.0, "discounted_cash": 787.5, "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": 237.0, "discounted_cash": 177.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AA 4.25% D10 EL/CA 2LTPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412009", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 259.0, "discounted_cash": 194.25, "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": 250.0, "discounted_cash": 187.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AA 4.25%D5 EL/CA 2L TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412012", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 258.0, "discounted_cash": 193.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AA 5% D15 2L TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412023", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 276.0, "discounted_cash": 207.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AA 5% D15 EL/CA 2L TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412004", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 318.0, "discounted_cash": 238.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AA 8% D14 2000ML TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5413221", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 407.0, "discounted_cash": 305.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AA 8% D14 ELEC 2000ML TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5413218", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 416.0, "discounted_cash": 312.0, "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": 1777.0, "discounted_cash": 1332.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AB DETECTION NOS DFA", "code_information": [{"code": "87299", "type": "CPT"}, {"code": "7257301", "type": "CDM"}], "standard_charges": [{"gross_charge": 114.0, "discounted_cash": 85.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AB ID LEUKOCYTE AB/6", "code_information": [{"code": "86021", "type": "CPT"}, {"code": "7006069", "type": "CDM"}], "standard_charges": [{"gross_charge": 352.0, "discounted_cash": 264.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AB ID LEUKOCYTE AB/7", "code_information": [{"code": "86021", "type": "CPT"}, {"code": "7006071", "type": "CDM"}], "standard_charges": [{"gross_charge": 558.0, "discounted_cash": 418.5, "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": 89.0, "discounted_cash": 66.75, "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": 89.0, "discounted_cash": 66.75, "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": 339.0, "discounted_cash": 254.25, "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": 339.0, "discounted_cash": 254.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ABACAVIR/DOLUT/LAMIV TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300023", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 411.0, "discounted_cash": 308.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ABACAVIR/DOLUT/LAMIV TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300023", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 411.0, "discounted_cash": 308.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ABACAVIR/LAMIVUDINE TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300007", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 183.0, "discounted_cash": 137.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ABACAVIR/LAMIVUDINE TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300007", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 183.0, "discounted_cash": 137.25, "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": 511.0, "discounted_cash": 383.25, "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": 511.0, "discounted_cash": 383.25, "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": 13018.0, "discounted_cash": 9763.5, "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": 13018.0, "discounted_cash": 9763.5, "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": 11420.0, "discounted_cash": 8565.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ABD AORTOGRPHY BY SERIAL", "code_information": [{"code": "75625", "type": "CPT"}, {"code": "4615627", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 8515.0, "discounted_cash": 6386.25, "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": 8515.0, "discounted_cash": 6386.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ABD ART/VEN FLOW ABD COMP", "code_information": [{"code": "93975", "type": "CPT"}, {"code": "4630040", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 3670.0, "discounted_cash": 2752.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ABD ART/VEN FLOW ABD COMP", "code_information": [{"code": "93975", "type": "CPT"}, {"code": "5062015", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 3670.0, "discounted_cash": 2752.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ABD ART/VEN FLOW LTD", "code_information": [{"code": "93976", "type": "CPT"}, {"code": "4633976", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 1092.0, "discounted_cash": 819.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ABD ART/VEN FLOW LTD", "code_information": [{"code": "93976", "type": "CPT"}, {"code": "5062017", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 1092.0, "discounted_cash": 819.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ABD PARACENTESIS W/IMAGE", "code_information": [{"code": "4919083", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4611.0, "discounted_cash": 3458.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ABD PARACENTESIS W/IMAGE", "code_information": [{"code": "5059083", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4872.0, "discounted_cash": 3654.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ABD PARACENTESIS W/IMAGE", "code_information": [{"code": "5069083", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4611.0, "discounted_cash": 3458.25, "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": 1031.0, "discounted_cash": 773.25, "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": 1031.0, "discounted_cash": 773.25, "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": 1031.0, "discounted_cash": 773.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ABDOMEN 1 VIEW", "code_information": [{"code": "74018", "type": "CPT"}, {"code": "5124018", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1031.0, "discounted_cash": 773.25, "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": 1158.0, "discounted_cash": 868.5, "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": 917.0, "discounted_cash": 687.75, "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": 841.0, "discounted_cash": 630.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ABDOMEN 2 VIEWS", "code_information": [{"code": "74019", "type": "CPT"}, {"code": "5124019", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 841.0, "discounted_cash": 630.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ABDOMEN 2+VWS SNGL VW CHEST", "code_information": [{"code": "74022", "type": "CPT"}, {"code": "4904022", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1993.0, "discounted_cash": 1494.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ABDOMEN 2+VWS SNGL VW CHEST", "code_information": [{"code": "74022", "type": "CPT"}, {"code": "5014022", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1993.0, "discounted_cash": 1494.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ABDOMEN 2+VWS SNGL VW CHEST", "code_information": [{"code": "74022", "type": "CPT"}, {"code": "5114022", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1993.0, "discounted_cash": 1494.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ABDOMEN 2+VWS SNGL VW CHEST", "code_information": [{"code": "74022", "type": "CPT"}, {"code": "5124022", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1993.0, "discounted_cash": 1494.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ABDOMEN 3/+ VIEWS", "code_information": [{"code": "74021", "type": "CPT"}, {"code": "4904021", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 981.0, "discounted_cash": 735.75, "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": 981.0, "discounted_cash": 735.75, "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": 981.0, "discounted_cash": 735.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ABDOMEN 3/+ VIEWS", "code_information": [{"code": "74021", "type": "CPT"}, {"code": "5124021", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 981.0, "discounted_cash": 735.75, "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": 553.0, "discounted_cash": 414.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ABDOMEN/CHEST DET FORBDY", "code_information": [{"code": "76010", "type": "CPT"}, {"code": "5117601", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 553.0, "discounted_cash": 414.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ABDOMEN/CHEST DET FORBDY", "code_information": [{"code": "76010", "type": "CPT"}, {"code": "5120006", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 553.0, "discounted_cash": 414.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ABG W CALC O2 SAT", "code_information": [{"code": "82803", "type": "CPT"}, {"code": "5501806", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 251.0, "discounted_cash": 188.25, "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": 509.0, "discounted_cash": 381.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ABL 1 KINASE VARIANTS", "code_information": [{"code": "81170", "type": "CPT"}, {"code": "7270006", "type": "CDM"}], "standard_charges": [{"gross_charge": 1273.0, "discounted_cash": 954.75, "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": 20073.0, "discounted_cash": 15054.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ABLATN RENL TUMORS CRYO", "code_information": [{"code": "5050593", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 27346.0, "discounted_cash": 20509.5, "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": 78.0, "discounted_cash": 58.5, "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": 78.0, "discounted_cash": 58.5, "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": 68.0, "discounted_cash": 51.0, "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": 68.0, "discounted_cash": 51.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ACEBUTOLOL 400MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300009", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 62.0, "discounted_cash": 46.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ACEBUTOLOL 400MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300009", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 62.0, "discounted_cash": 46.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETABULR COMP", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8131000", "type": "CDM"}], "standard_charges": [{"gross_charge": 28400.0, "discounted_cash": 21300.0, "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": 730.0, "discounted_cash": 547.5, "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": 730.0, "discounted_cash": 547.5, "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": 205.0, "discounted_cash": 153.75, "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": 205.0, "discounted_cash": 153.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETAZOLAMIDE 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300098", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 10.0, "discounted_cash": 7.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETAZOLAMIDE 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300098", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 10.0, "discounted_cash": 7.5, "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": 960.0, "discounted_cash": 720.0, "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": 960.0, "discounted_cash": 720.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETIC ACID 5% 30ML TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334014", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETIC ACID.25% .5L IRR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5414010", "type": "CDM"}, {"code": "270", "type": "RC"}], "standard_charges": [{"gross_charge": 29.0, "discounted_cash": 21.75, "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": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETONE QUALITATIVE", "code_information": [{"code": "82009", "type": "CPT"}, {"code": "7252009", "type": "CDM"}], "standard_charges": [{"gross_charge": 74.0, "discounted_cash": 55.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETONE QUANTITATIVE/2", "code_information": [{"code": "82010", "type": "CPT"}, {"code": "4102010", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 504.0, "discounted_cash": 378.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETONE QUANTITATIVE/2", "code_information": [{"code": "82010", "type": "CPT"}, {"code": "7252015", "type": "CDM"}], "standard_charges": [{"gross_charge": 193.0, "discounted_cash": 144.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ACETYLCHOLN BINDING AB", "code_information": [{"code": "86041", "type": "CPT"}, {"code": "7250514", "type": "CDM"}], "standard_charges": [{"gross_charge": 80.0, "discounted_cash": 60.0, "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": 82.0, "discounted_cash": 61.5, "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": 82.0, "discounted_cash": 61.5, "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": 28.0, "discounted_cash": 21.0, "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": 173.0, "discounted_cash": 129.75, "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": 205.0, "discounted_cash": 153.75, "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": 292.0, "discounted_cash": 219.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ACHR ANTIBODY", "code_information": [{"code": "83519", "type": "CPT"}, {"code": "7253580", "type": "CDM"}], "standard_charges": [{"gross_charge": 274.0, "discounted_cash": 205.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ACHR ANTIBODY/2", "code_information": [{"code": "83519", "type": "CPT"}, {"code": "7253581", "type": "CDM"}], "standard_charges": [{"gross_charge": 237.0, "discounted_cash": 177.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ACHR ANTIBODY/3", "code_information": [{"code": "83519", "type": "CPT"}, {"code": "7258385", "type": "CDM"}], "standard_charges": [{"gross_charge": 274.0, "discounted_cash": 205.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ACLIDINIUM 400MCG PW IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330098", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 936.0, "discounted_cash": 702.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ACLIDINIUM 400MCG PW IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330098", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 936.0, "discounted_cash": 702.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ACROMIOCLAVICULAR JTS BI", "code_information": [{"code": "73050", "type": "CPT"}, {"code": "4903050", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 933.0, "discounted_cash": 699.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ACROMIOCLAVICULAR JTS BI", "code_information": [{"code": "73050", "type": "CPT"}, {"code": "5113050", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 933.0, "discounted_cash": 699.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ACROMIOCLAVICULAR JTS BI", "code_information": [{"code": "73050", "type": "CPT"}, {"code": "5123050", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 933.0, "discounted_cash": 699.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ACTH", "code_information": [{"code": "82024", "type": "CPT"}, {"code": "7002024", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 391.0, "discounted_cash": 293.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ACTH", "code_information": [{"code": "82024", "type": "CPT"}, {"code": "7252024", "type": "CDM"}], "standard_charges": [{"gross_charge": 1209.0, "discounted_cash": 906.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80400", "type": "CPT"}, {"code": "7000400", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 623.0, "discounted_cash": 467.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80400", "type": "CPT"}, {"code": "7250400", "type": "CDM"}], "standard_charges": [{"gross_charge": 804.0, "discounted_cash": 603.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ACTIN SMOOTH MUSCLE AB", "code_information": [{"code": "86015", "type": "CPT"}, {"code": "7250516", "type": "CDM"}], "standard_charges": [{"gross_charge": 192.0, "discounted_cash": 144.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ACTINOMYCES AB", "code_information": [{"code": "86602", "type": "CPT"}, {"code": "7006602", "type": "CDM"}], "standard_charges": [{"gross_charge": 262.0, "discounted_cash": 196.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ACUTE GI BLOOD LOSS IMG", "code_information": [{"code": "78278", "type": "CPT"}, {"code": "5208280", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 3398.0, "discounted_cash": 2548.5, "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": 860.0, "discounted_cash": 645.0, "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": 330.0, "discounted_cash": 247.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ACUTE HEPATITIS PANEL", "code_information": [{"code": "80074", "type": "CPT"}, {"code": "4170074", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 677.0, "discounted_cash": 507.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ACUTE HEPATITIS PANEL", "code_information": [{"code": "80074", "type": "CPT"}, {"code": "7000074", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 848.0, "discounted_cash": 636.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ACUTE HEPATITIS PANEL", "code_information": [{"code": "80074", "type": "CPT"}, {"code": "7250074", "type": "CDM"}], "standard_charges": [{"gross_charge": 339.0, "discounted_cash": 254.25, "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": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "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": 19.0, "discounted_cash": 14.25, "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": 19.0, "discounted_cash": 14.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2013.0, "discounted_cash": 1509.75, "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": 2013.0, "discounted_cash": 1509.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ACYCLOVIR 5% 30GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334036", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 6808.0, "discounted_cash": 5106.0, "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": 6808.0, "discounted_cash": 5106.0, "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": 19.0, "discounted_cash": 14.25, "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": 19.0, "discounted_cash": 14.25, "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": 2.0, "discounted_cash": 1.5, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ACYLCARNITINES QN EA SPC", "code_information": [{"code": "82017", "type": "CPT"}, {"code": "7252005", "type": "CDM"}], "standard_charges": [{"gross_charge": 269.0, "discounted_cash": 201.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ADALIMUMAB", "code_information": [{"code": "80145", "type": "CPT"}, {"code": "7250008", "type": "CDM"}], "standard_charges": [{"gross_charge": 440.0, "discounted_cash": 330.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ADALIMUMAB", "code_information": [{"code": "80299", "type": "CPT"}, {"code": "7250295", "type": "CDM"}], "standard_charges": [{"gross_charge": 917.0, "discounted_cash": 687.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ADAMTS 13 ACTIVITY/2", "code_information": [{"code": "85397", "type": "CPT"}, {"code": "7258540", "type": "CDM"}], "standard_charges": [{"gross_charge": 542.0, "discounted_cash": 406.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ADAPTOR HUMERAL CONN DEPUY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013172", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1383.0, "discounted_cash": 1037.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ADENOSINE DEAMINASE", "code_information": [{"code": "84311", "type": "CPT"}, {"code": "7006366", "type": "CDM"}], "standard_charges": [{"gross_charge": 1186.0, "discounted_cash": 889.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ADENOSINE DEAMINASE", "code_information": [{"code": "84311", "type": "CPT"}, {"code": "7256366", "type": "CDM"}], "standard_charges": [{"gross_charge": 592.0, "discounted_cash": 444.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ADENOSINE DEAMINASE", "code_information": [{"code": "84311", "type": "CPT"}, {"code": "7256367", "type": "CDM"}], "standard_charges": [{"gross_charge": 336.0, "discounted_cash": 252.0, "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": 23.0, "discounted_cash": 17.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ADENOSINE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0153", "type": "HCPCS"}, {"code": "5318047", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 23.0, "discounted_cash": 17.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ADENOVIRUS AG DFA", "code_information": [{"code": "87260", "type": "CPT"}, {"code": "7002028", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 209.0, "discounted_cash": 156.75, "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": 4231.0, "discounted_cash": 3173.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY ADULT LEVEL II", "code_information": [{"code": "2000028", "type": "CDM"}, {"code": "199", "type": "RC"}], "standard_charges": [{"gross_charge": 4231.0, "discounted_cash": 3173.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY ADULT LEVEL II", "code_information": [{"code": "2010028", "type": "CDM"}, {"code": "199", "type": "RC"}], "standard_charges": [{"gross_charge": 4231.0, "discounted_cash": 3173.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY ADULT LEVEL II", "code_information": [{"code": "2060028", "type": "CDM"}, {"code": "199", "type": "RC"}], "standard_charges": [{"gross_charge": 4231.0, "discounted_cash": 3173.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY ADULT LEVEL II", "code_information": [{"code": "2100028", "type": "CDM"}, {"code": "199", "type": "RC"}], "standard_charges": [{"gross_charge": 4231.0, "discounted_cash": 3173.25, "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": 4231.0, "discounted_cash": 3173.25, "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": 4231.0, "discounted_cash": 3173.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY ADULT LEVEL II", "code_information": [{"code": "2310028", "type": "CDM"}, {"code": "199", "type": "RC"}], "standard_charges": [{"gross_charge": 4231.0, "discounted_cash": 3173.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY ADULT LEVEL II", "code_information": [{"code": "2320028", "type": "CDM"}, {"code": "199", "type": "RC"}], "standard_charges": [{"gross_charge": 4231.0, "discounted_cash": 3173.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY ADULT LEVEL II", "code_information": [{"code": "2340028", "type": "CDM"}, {"code": "199", "type": "RC"}], "standard_charges": [{"gross_charge": 4231.0, "discounted_cash": 3173.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY ADULT LEVEL II", "code_information": [{"code": "2350028", "type": "CDM"}, {"code": "199", "type": "RC"}], "standard_charges": [{"gross_charge": 4231.0, "discounted_cash": 3173.25, "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": 4231.0, "discounted_cash": 3173.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY LEVEL I", "code_information": [{"code": "1990027", "type": "CDM"}, {"code": "169", "type": "RC"}], "standard_charges": [{"gross_charge": 4231.0, "discounted_cash": 3173.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY LEVEL I", "code_information": [{"code": "2000027", "type": "CDM"}, {"code": "169", "type": "RC"}], "standard_charges": [{"gross_charge": 4231.0, "discounted_cash": 3173.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY LEVEL I", "code_information": [{"code": "2010027", "type": "CDM"}, {"code": "169", "type": "RC"}], "standard_charges": [{"gross_charge": 4231.0, "discounted_cash": 3173.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY LEVEL I", "code_information": [{"code": "2060027", "type": "CDM"}, {"code": "169", "type": "RC"}], "standard_charges": [{"gross_charge": 4231.0, "discounted_cash": 3173.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY LEVEL I", "code_information": [{"code": "2100027", "type": "CDM"}, {"code": "169", "type": "RC"}], "standard_charges": [{"gross_charge": 4231.0, "discounted_cash": 3173.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY LEVEL I", "code_information": [{"code": "2120027", "type": "CDM"}, {"code": "169", "type": "RC"}], "standard_charges": [{"gross_charge": 4231.0, "discounted_cash": 3173.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY LEVEL I", "code_information": [{"code": "2150027", "type": "CDM"}, {"code": "169", "type": "RC"}], "standard_charges": [{"gross_charge": 4231.0, "discounted_cash": 3173.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY LEVEL I", "code_information": [{"code": "2310027", "type": "CDM"}, {"code": "169", "type": "RC"}], "standard_charges": [{"gross_charge": 4231.0, "discounted_cash": 3173.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY LEVEL I", "code_information": [{"code": "2320027", "type": "CDM"}, {"code": "169", "type": "RC"}], "standard_charges": [{"gross_charge": 4231.0, "discounted_cash": 3173.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY LEVEL I", "code_information": [{"code": "2340027", "type": "CDM"}, {"code": "169", "type": "RC"}], "standard_charges": [{"gross_charge": 4231.0, "discounted_cash": 3173.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY LEVEL I", "code_information": [{"code": "2350027", "type": "CDM"}, {"code": "169", "type": "RC"}], "standard_charges": [{"gross_charge": 4231.0, "discounted_cash": 3173.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ADMIN DAY LEVEL I", "code_information": [{"code": "2500027", "type": "CDM"}, {"code": "169", "type": "RC"}], "standard_charges": [{"gross_charge": 4231.0, "discounted_cash": 3173.25, "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": 1238.0, "discounted_cash": 928.5, "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": 2333.0, "discounted_cash": 1749.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ADPTR TALAR DOME FLT CT INFNTY", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4010672", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 79374.0, "discounted_cash": 59530.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ADRENAL ANTIBODIES", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "7256243", "type": "CDM"}], "standard_charges": [{"gross_charge": 387.0, "discounted_cash": 290.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AFP FRACTION AND TOTAL", "code_information": [{"code": "82107", "type": "CPT"}, {"code": "4102107", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 281.0, "discounted_cash": 210.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AGGLUTININS FEBRIL EA AG", "code_information": [{"code": "86000", "type": "CPT"}, {"code": "4106000", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 213.0, "discounted_cash": 159.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AGGLUTININS FEBRIL EA AG", "code_information": [{"code": "86000", "type": "CPT"}, {"code": "4126000", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AGGLUTININS FEBRIL EA AG/2", "code_information": [{"code": "86000", "type": "CPT"}, {"code": "4106011", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AL AC/CA ACET PK PW", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334107", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "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": 34.0, "discounted_cash": 25.5, "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": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AL OH 320/5 30ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314162", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AL/MG OH 5ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314127", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AL/MG OH 5ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314127", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AL/MG OH/SIMETH TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5300402", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AL/MG OH/SIMETH TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5300402", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 423.0, "discounted_cash": 317.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALA(DELTA AMINOLVLN ACID", "code_information": [{"code": "82135", "type": "CPT"}, {"code": "7002135", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 204.0, "discounted_cash": 153.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1334.0, "discounted_cash": 1000.5, "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": 1334.0, "discounted_cash": 1000.5, "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": 929.0, "discounted_cash": 696.75, "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": 929.0, "discounted_cash": 696.75, "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": 665.0, "discounted_cash": 498.75, "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": 665.0, "discounted_cash": 498.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUMIN 5% PER 50ML IJ", "code_information": [{"code": "P9041", "type": "HCPCS"}, {"code": "5318031", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 584.0, "discounted_cash": 438.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUMIN 5% PER 50ML IJ", "code_information": [{"code": "P9041", "type": "HCPCS"}, {"code": "5318031", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 584.0, "discounted_cash": 438.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUMIN QUANT OTH SRC", "code_information": [{"code": "82042", "type": "CPT"}, {"code": "4172045", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUMIN QUANT OTH SRC", "code_information": [{"code": "82042", "type": "CPT"}, {"code": "7252045", "type": "CDM"}], "standard_charges": [{"gross_charge": 98.0, "discounted_cash": 73.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUMIN QUANT OTH SRC/2", "code_information": [{"code": "82042", "type": "CPT"}, {"code": "4102045", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 124.0, "discounted_cash": 93.0, "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": 44.0, "discounted_cash": 33.0, "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": 58.0, "discounted_cash": 43.5, "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": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUMIN SERUM", "code_information": [{"code": "82040", "type": "CPT"}, {"code": "7002040", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUMIN SERUM", "code_information": [{"code": "82040", "type": "CPT"}, {"code": "7252040", "type": "CDM"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "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": 3.0, "discounted_cash": 2.25, "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": 3.0, "discounted_cash": 2.25, "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": 12.0, "discounted_cash": 9.0, "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": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUTEROL .5% 5ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330110", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 41.0, "discounted_cash": 30.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUTEROL .5% 5ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330110", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 41.0, "discounted_cash": 30.75, "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": 10.0, "discounted_cash": 7.5, "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": 10.0, "discounted_cash": 7.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUTEROL 4MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300223", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUTEROL 4MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300223", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "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": 116.0, "discounted_cash": 87.0, "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": 116.0, "discounted_cash": 87.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUTEROL HFA 18GM IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330113", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 388.0, "discounted_cash": 291.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUTEROL HFA 18GM IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330113", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 388.0, "discounted_cash": 291.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUTEROL HFA 6.7GM IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330120", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 668.0, "discounted_cash": 501.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUTEROL HFA 6.7GM IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330120", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 668.0, "discounted_cash": 501.0, "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": 338.0, "discounted_cash": 253.5, "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": 338.0, "discounted_cash": 253.5, "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": 0.89, "discounted_cash": 0.67, "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": 0.89, "discounted_cash": 0.67, "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": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "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": 2340.0, "discounted_cash": 1755.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUTEROL/IPRATR 4GM IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330130", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2340.0, "discounted_cash": 1755.0, "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": 16.0, "discounted_cash": 12.0, "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": 16.0, "discounted_cash": 12.0, "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": 3156.0, "discounted_cash": 2367.0, "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": 3156.0, "discounted_cash": 2367.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUTEROL2MG/5ML 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314039", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ALBUTEROL2MG/5ML 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314039", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ALCOHOLS", "code_information": [{"code": "80320", "type": "CPT"}, {"code": "4170060", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALCOHOLS", "code_information": [{"code": "80320", "type": "CPT"}, {"code": "7250320", "type": "CDM"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ALCOHOLS/2", "code_information": [{"code": "80320", "type": "CPT"}, {"code": "7252055", "type": "CDM"}], "standard_charges": [{"gross_charge": 468.0, "discounted_cash": 351.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALCOHOLS/4", "code_information": [{"code": "80320", "type": "CPT"}, {"code": "7252078", "type": "CDM"}], "standard_charges": [{"gross_charge": 349.0, "discounted_cash": 261.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALDOLASE", "code_information": [{"code": "82085", "type": "CPT"}, {"code": "7002085", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 94.0, "discounted_cash": 70.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ALDOLASE", "code_information": [{"code": "82085", "type": "CPT"}, {"code": "7252085", "type": "CDM"}], "standard_charges": [{"gross_charge": 205.0, "discounted_cash": 153.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALDOSTERONE", "code_information": [{"code": "82088", "type": "CPT"}, {"code": "7002087", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 360.0, "discounted_cash": 270.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALDOSTERONE", "code_information": [{"code": "82088", "type": "CPT"}, {"code": "7252087", "type": "CDM"}], "standard_charges": [{"gross_charge": 973.0, "discounted_cash": 729.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALDOSTERONE/2", "code_information": [{"code": "82088", "type": "CPT"}, {"code": "7002089", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 360.0, "discounted_cash": 270.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALDOSTERONE/2", "code_information": [{"code": "82088", "type": "CPT"}, {"code": "7252089", "type": "CDM"}], "standard_charges": [{"gross_charge": 973.0, "discounted_cash": 729.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALENDRONATE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300230", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 319.0, "discounted_cash": 239.25, "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": 319.0, "discounted_cash": 239.25, "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": 631.0, "discounted_cash": 473.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 631.0, "discounted_cash": 473.25, "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": 594.0, "discounted_cash": 445.5, "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": 594.0, "discounted_cash": 445.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ALFUZOSIN 10MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300240", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 194.0, "discounted_cash": 145.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ALFUZOSIN 10MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300240", "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/MAG 30MLLQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314057", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALGINIC AC/AL/MAG 30MLLQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314057", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": 64.0, "discounted_cash": 48.0, "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": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALKALOIDS NOS/2", "code_information": [{"code": "80323", "type": "CPT"}, {"code": "7253887", "type": "CDM"}], "standard_charges": [{"gross_charge": 311.0, "discounted_cash": 233.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOGRAFT CARTILAGE", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "4027050", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 50903.0, "discounted_cash": 38177.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOGRAFT VIA DISC", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "4020407", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 81869.0, "discounted_cash": 61401.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOGRFT AMNIOTIC MEMBRN", "code_information": [{"code": "C1762", "type": "HCPCS"}, {"code": "4027051", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 14329.0, "discounted_cash": 10746.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOGRFT AMNIOTIC MEMBRN", "code_information": [{"code": "Q4100", "type": "HCPCS"}, {"code": "4027052", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 16226.0, "discounted_cash": 12169.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOGRFT AMNIOTIC MEMBRN", "code_information": [{"code": "Q4100", "type": "HCPCS"}, {"code": "4027052", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 16226.0, "discounted_cash": 12169.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOGRFT BARD FASLATA 8", "code_information": [{"code": "C1762", "type": "HCPCS"}, {"code": "8240480", "type": "CDM"}], "standard_charges": [{"gross_charge": 661.0, "discounted_cash": 495.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOGRFT BN FIBER PLIAFX PRIME", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4020551", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1177.75, "discounted_cash": 883.31, "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": 4577.0, "discounted_cash": 3432.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOGRFT CARTLG MSH VIAB", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4020509", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 99327.0, "discounted_cash": 74495.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOGRFT DERM COLL HUMAN", "code_information": [{"code": "Q4100", "type": "HCPCS"}, {"code": "4020503", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 757.0, "discounted_cash": 567.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOGRFT DERM COLL HUMAN", "code_information": [{"code": "Q4100", "type": "HCPCS"}, {"code": "4020503", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 757.0, "discounted_cash": 567.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOGRFT DURADRM ACELL14", "code_information": [{"code": "C2631", "type": "HCPCS"}, {"code": "8240484", "type": "CDM"}], "standard_charges": [{"gross_charge": 69999.0, "discounted_cash": 52499.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOGRFT DURADRM ACELL28", "code_information": [{"code": "C2631", "type": "HCPCS"}, {"code": "8240490", "type": "CDM"}], "standard_charges": [{"gross_charge": 9741.0, "discounted_cash": 7305.75, "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": 6653.0, "discounted_cash": 4989.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOGRFT NUCEL", "code_information": [{"code": "Q4100", "type": "HCPCS"}, {"code": "4020517", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 17674.0, "discounted_cash": 13255.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOGRFT NUCEL", "code_information": [{"code": "Q4100", "type": "HCPCS"}, {"code": "4020517", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 17674.0, "discounted_cash": 13255.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOGRFT OSTEOCHOND OCA CORES", "code_information": [{"code": "C1762", "type": "HCPCS"}, {"code": "4020559", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 99459.0, "discounted_cash": 74594.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOGRFT UMBILICAL CORD", "code_information": [{"code": "Q4100", "type": "HCPCS"}, {"code": "4027061", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 540.0, "discounted_cash": 405.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOGRFT UMBILICAL CORD", "code_information": [{"code": "Q4100", "type": "HCPCS"}, {"code": "4027061", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 540.0, "discounted_cash": 405.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOGRFT VIABLE OSTEOCHONDRAL", "code_information": [{"code": "C1762", "type": "HCPCS"}, {"code": "4020563", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 118211.0, "discounted_cash": 88658.25, "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": 3.0, "discounted_cash": 2.25, "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": 3.0, "discounted_cash": 2.25, "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": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLOPURINOL300MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300248", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "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": 49.0, "discounted_cash": 36.75, "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": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLRGN SPEC IGE QL MULTI", "code_information": [{"code": "86005", "type": "CPT"}, {"code": "7256006", "type": "CDM"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLRGN SPEC IGE QL MULTI/2", "code_information": [{"code": "86005", "type": "CPT"}, {"code": "7256009", "type": "CDM"}], "standard_charges": [{"gross_charge": 101.0, "discounted_cash": 75.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALLRGN SPEC IGE RECOMB EA", "code_information": [{"code": "86008", "type": "CPT"}, {"code": "7256050", "type": "CDM"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "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": 159.0, "discounted_cash": 119.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALOE/COLLAG/LIDO 85GM GL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5334079", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 621.0, "discounted_cash": 465.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALOE/COLLAG/LIDO 85GM GL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5334079", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 621.0, "discounted_cash": 465.75, "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": 52.0, "discounted_cash": 39.0, "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": 52.0, "discounted_cash": 39.0, "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": 50.0, "discounted_cash": 37.5, "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": 50.0, "discounted_cash": 37.5, "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": 44.0, "discounted_cash": 33.0, "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": 44.0, "discounted_cash": 33.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALPHA FETO PROTEIN SERUM", "code_information": [{"code": "82105", "type": "CPT"}, {"code": "4172114", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 383.0, "discounted_cash": 287.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALPHA FETO PROTEIN SERUM", "code_information": [{"code": "82105", "type": "CPT"}, {"code": "7002114", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 148.0, "discounted_cash": 111.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALPHA FETO PROTEIN SERUM", "code_information": [{"code": "82105", "type": "CPT"}, {"code": "7252114", "type": "CDM"}], "standard_charges": [{"gross_charge": 487.0, "discounted_cash": 365.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALPHA FETO PROTEIN SERUM/2", "code_information": [{"code": "82105", "type": "CPT"}, {"code": "7002118", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 225.0, "discounted_cash": 168.75, "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": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALPHA SUBUNIT", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7252666", "type": "CDM"}], "standard_charges": [{"gross_charge": 209.0, "discounted_cash": 156.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALPHA1PROT INH PER10MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0256", "type": "HCPCS"}, {"code": "5318082", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALPHA1PROT INH PER10MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0256", "type": "HCPCS"}, {"code": "5318082", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "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": 10.0, "discounted_cash": 7.5, "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": 10.0, "discounted_cash": 7.5, "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": 12.0, "discounted_cash": 9.0, "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": 12.0, "discounted_cash": 9.0, "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": 10.0, "discounted_cash": 7.5, "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": 10.0, "discounted_cash": 7.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ALPRAZOLAM 1MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300291", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 235.0, "discounted_cash": 176.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ALPRAZOLAM 1MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300291", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 235.0, "discounted_cash": 176.25, "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": 556.0, "discounted_cash": 417.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALPROSTADL PER1.25MCG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0270", "type": "HCPCS"}, {"code": "5318074", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALS NON-TRANSPORT", "code_information": [{"code": "A0998", "type": "HCPCS"}, {"code": "6303000", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 261.0, "discounted_cash": 195.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GY"}, {"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": 1049.0, "discounted_cash": 786.75, "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": 1049.0, "discounted_cash": 786.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALUMINUM", "code_information": [{"code": "82108", "type": "CPT"}, {"code": "7002110", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 178.0, "discounted_cash": 133.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ALUMINUM", "code_information": [{"code": "82108", "type": "CPT"}, {"code": "7252110", "type": "CDM"}], "standard_charges": [{"gross_charge": 336.0, "discounted_cash": 252.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ALVIMOPAN 12MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300420", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 421.0, "discounted_cash": 315.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ALVIMOPAN 12MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300420", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 421.0, "discounted_cash": 315.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMANTADINE 100MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300476", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "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": 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": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMB ALS1", "code_information": [{"code": "A0426", "type": "HCPCS"}, {"code": "6301100", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 1940.0, "discounted_cash": 1455.0, "setting": "both", "billing_class": "facility"}], "modifiers": "DH"}, {"description": "AMB ALS1", "code_information": [{"code": "A0426", "type": "HCPCS"}, {"code": "6301101", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 1940.0, "discounted_cash": 1455.0, "setting": "both", "billing_class": "facility"}], "modifiers": "EH"}, {"description": "AMB ALS1", "code_information": [{"code": "A0426", "type": "HCPCS"}, {"code": "6301104", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 1940.0, "discounted_cash": 1455.0, "setting": "both", "billing_class": "facility"}], "modifiers": "HH"}, {"description": "AMB ALS1", "code_information": [{"code": "A0426", "type": "HCPCS"}, {"code": "6301107", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 1940.0, "discounted_cash": 1455.0, "setting": "both", "billing_class": "facility"}], "modifiers": "JH"}, {"description": "AMB ALS1", "code_information": [{"code": "A0426", "type": "HCPCS"}, {"code": "6301110", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 1940.0, "discounted_cash": 1455.0, "setting": "both", "billing_class": "facility"}], "modifiers": "NH"}, {"description": "AMB ALS1", "code_information": [{"code": "A0426", "type": "HCPCS"}, {"code": "6301112", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 1940.0, "discounted_cash": 1455.0, "setting": "both", "billing_class": "facility"}], "modifiers": "PH"}, {"description": "AMB ALS1", "code_information": [{"code": "A0426", "type": "HCPCS"}, {"code": "6301113", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 1940.0, "discounted_cash": 1455.0, "setting": "both", "billing_class": "facility"}], "modifiers": "RH"}, {"description": "AMB ALS1", "code_information": [{"code": "A0426", "type": "HCPCS"}, {"code": "6301115", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 1940.0, "discounted_cash": 1455.0, "setting": "both", "billing_class": "facility"}], "modifiers": "SH"}, {"description": "AMB ALS1", "code_information": [{"code": "A0426", "type": "HCPCS"}, {"code": "6301126", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 1940.0, "discounted_cash": 1455.0, "setting": "both", "billing_class": "facility"}], "modifiers": "SI"}, {"description": "AMB ALS1-EMERG", "code_information": [{"code": "A0427", "type": "HCPCS"}, {"code": "6301300", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 3454.0, "discounted_cash": 2590.5, "setting": "both", "billing_class": "facility"}], "modifiers": "DH"}, {"description": "AMB ALS1-EMERG", "code_information": [{"code": "A0427", "type": "HCPCS"}, {"code": "6301301", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 3454.0, "discounted_cash": 2590.5, "setting": "both", "billing_class": "facility"}], "modifiers": "EH"}, {"description": "AMB ALS1-EMERG", "code_information": [{"code": "A0427", "type": "HCPCS"}, {"code": "6301304", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 3454.0, "discounted_cash": 2590.5, "setting": "both", "billing_class": "facility"}], "modifiers": "HH"}, {"description": "AMB ALS1-EMERG", "code_information": [{"code": "A0427", "type": "HCPCS"}, {"code": "6301306", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 3454.0, "discounted_cash": 2590.5, "setting": "both", "billing_class": "facility"}], "modifiers": "JH"}, {"description": "AMB ALS1-EMERG", "code_information": [{"code": "A0427", "type": "HCPCS"}, {"code": "6301309", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 3454.0, "discounted_cash": 2590.5, "setting": "both", "billing_class": "facility"}], "modifiers": "NH"}, {"description": "AMB ALS1-EMERG", "code_information": [{"code": "A0427", "type": "HCPCS"}, {"code": "6301311", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 3454.0, "discounted_cash": 2590.5, "setting": "both", "billing_class": "facility"}], "modifiers": "PH"}, {"description": "AMB ALS1-EMERG", "code_information": [{"code": "A0427", "type": "HCPCS"}, {"code": "6301312", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 3454.0, "discounted_cash": 2590.5, "setting": "both", "billing_class": "facility"}], "modifiers": "RH"}, {"description": "AMB ALS1-EMERG", "code_information": [{"code": "A0427", "type": "HCPCS"}, {"code": "6301314", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 3454.0, "discounted_cash": 2590.5, "setting": "both", "billing_class": "facility"}], "modifiers": "SH"}, {"description": "AMB ALS1-EMERG", "code_information": [{"code": "A0427", "type": "HCPCS"}, {"code": "6301324", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 3454.0, "discounted_cash": 2590.5, "setting": "both", "billing_class": "facility"}], "modifiers": "SI"}, {"description": "AMB ALS2", "code_information": [{"code": "A0433", "type": "HCPCS"}, {"code": "6300977", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 4325.0, "discounted_cash": 3243.75, "setting": "both", "billing_class": "facility"}], "modifiers": "DH"}, {"description": "AMB ALS2", "code_information": [{"code": "A0433", "type": "HCPCS"}, {"code": "6300978", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 4325.0, "discounted_cash": 3243.75, "setting": "both", "billing_class": "facility"}], "modifiers": "EH"}, {"description": "AMB ALS2", "code_information": [{"code": "A0433", "type": "HCPCS"}, {"code": "6300979", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 4325.0, "discounted_cash": 3243.75, "setting": "both", "billing_class": "facility"}], "modifiers": "HH"}, {"description": "AMB ALS2", "code_information": [{"code": "A0433", "type": "HCPCS"}, {"code": "6300982", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 4325.0, "discounted_cash": 3243.75, "setting": "both", "billing_class": "facility"}], "modifiers": "NH"}, {"description": "AMB ALS2", "code_information": [{"code": "A0433", "type": "HCPCS"}, {"code": "6300983", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 4325.0, "discounted_cash": 3243.75, "setting": "both", "billing_class": "facility"}], "modifiers": "PH"}, {"description": "AMB ALS2", "code_information": [{"code": "A0433", "type": "HCPCS"}, {"code": "6300984", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 4325.0, "discounted_cash": 3243.75, "setting": "both", "billing_class": "facility"}], "modifiers": "RH"}, {"description": "AMB ALS2", "code_information": [{"code": "A0433", "type": "HCPCS"}, {"code": "6300985", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 4325.0, "discounted_cash": 3243.75, "setting": "both", "billing_class": "facility"}], "modifiers": "SH"}, {"description": "AMB ALS2 NHOSP DIAL-HOSP", "code_information": [{"code": "A0433", "type": "HCPCS"}, {"code": "6300961", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 4325.0, "discounted_cash": 3243.75, "setting": "both", "billing_class": "facility"}], "modifiers": "JH"}, {"description": "AMB ALS2 SCENE-TRNS A/H", "code_information": [{"code": "A0433", "type": "HCPCS"}, {"code": "6300963", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 4325.0, "discounted_cash": 3243.75, "setting": "both", "billing_class": "facility"}], "modifiers": "SI"}, {"description": "AMB BLS", "code_information": [{"code": "A0428", "type": "HCPCS"}, {"code": "6300548", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 1531.0, "discounted_cash": 1148.25, "setting": "both", "billing_class": "facility"}], "modifiers": "QL"}, {"description": "AMB BLS", "code_information": [{"code": "A0428", "type": "HCPCS"}, {"code": "6300600", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 1531.0, "discounted_cash": 1148.25, "setting": "both", "billing_class": "facility"}], "modifiers": "DH"}, {"description": "AMB BLS", "code_information": [{"code": "A0428", "type": "HCPCS"}, {"code": "6300603", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 1531.0, "discounted_cash": 1148.25, "setting": "both", "billing_class": "facility"}], "modifiers": "EH"}, {"description": "AMB BLS", "code_information": [{"code": "A0428", "type": "HCPCS"}, {"code": "6300607", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 1531.0, "discounted_cash": 1148.25, "setting": "both", "billing_class": "facility"}], "modifiers": "HD"}, {"description": "AMB BLS", "code_information": [{"code": "A0428", "type": "HCPCS"}, {"code": "6300608", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 1531.0, "discounted_cash": 1148.25, "setting": "both", "billing_class": "facility"}], "modifiers": "HE"}, {"description": "AMB BLS", "code_information": [{"code": "A0428", "type": "HCPCS"}, {"code": "6300610", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 1531.0, "discounted_cash": 1148.25, "setting": "both", "billing_class": "facility"}], "modifiers": "HN"}, {"description": "AMB BLS", "code_information": [{"code": "A0428", "type": "HCPCS"}, {"code": "6300611", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 1531.0, "discounted_cash": 1148.25, "setting": "both", "billing_class": "facility"}], "modifiers": "HR"}, {"description": "AMB BLS", "code_information": [{"code": "A0428", "type": "HCPCS"}, {"code": "6300614", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 1531.0, "discounted_cash": 1148.25, "setting": "both", "billing_class": "facility"}], "modifiers": "JR"}, {"description": "AMB BLS", "code_information": [{"code": "A0428", "type": "HCPCS"}, {"code": "6300615", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 1531.0, "discounted_cash": 1148.25, "setting": "both", "billing_class": "facility"}], "modifiers": "NH"}, {"description": "AMB BLS", "code_information": [{"code": "A0428", "type": "HCPCS"}, {"code": "6300618", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 1531.0, "discounted_cash": 1148.25, "setting": "both", "billing_class": "facility"}], "modifiers": "RH"}, {"description": "AMB BLS", "code_information": [{"code": "A0428", "type": "HCPCS"}, {"code": "6300619", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 1531.0, "discounted_cash": 1148.25, "setting": "both", "billing_class": "facility"}], "modifiers": "RJ"}, {"description": "AMB BLS", "code_information": [{"code": "A0428", "type": "HCPCS"}, {"code": "6300620", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 1531.0, "discounted_cash": 1148.25, "setting": "both", "billing_class": "facility"}], "modifiers": "SH"}, {"description": "AMB BLS", "code_information": [{"code": "A0428", "type": "HCPCS"}, {"code": "6300625", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 1531.0, "discounted_cash": 1148.25, "setting": "both", "billing_class": "facility"}], "modifiers": "HI"}, {"description": "AMB BLS", "code_information": [{"code": "A0428", "type": "HCPCS"}, {"code": "6300642", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 1531.0, "discounted_cash": 1148.25, "setting": "both", "billing_class": "facility"}], "modifiers": "JH"}, {"description": "AMB BLS", "code_information": [{"code": "A0428", "type": "HCPCS"}, {"code": "6300644", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 1531.0, "discounted_cash": 1148.25, "setting": "both", "billing_class": "facility"}], "modifiers": "PH"}, {"description": "AMB BLS EMERG", "code_information": [{"code": "A0429", "type": "HCPCS"}, {"code": "6300700", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 2718.0, "discounted_cash": 2038.5, "setting": "both", "billing_class": "facility"}], "modifiers": "EH"}, {"description": "AMB BLS EMERG", "code_information": [{"code": "A0429", "type": "HCPCS"}, {"code": "6300701", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 2718.0, "discounted_cash": 2038.5, "setting": "both", "billing_class": "facility"}], "modifiers": "HH"}, {"description": "AMB BLS EMERG", "code_information": [{"code": "A0429", "type": "HCPCS"}, {"code": "6300702", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 2718.0, "discounted_cash": 2038.5, "setting": "both", "billing_class": "facility"}], "modifiers": "NH"}, {"description": "AMB BLS EMERG", "code_information": [{"code": "A0429", "type": "HCPCS"}, {"code": "6300704", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 2718.0, "discounted_cash": 2038.5, "setting": "both", "billing_class": "facility"}], "modifiers": "RH"}, {"description": "AMB BLS EMERG", "code_information": [{"code": "A0429", "type": "HCPCS"}, {"code": "6300705", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 2718.0, "discounted_cash": 2038.5, "setting": "both", "billing_class": "facility"}], "modifiers": "SH"}, {"description": "AMB BLS EMERG", "code_information": [{"code": "A0429", "type": "HCPCS"}, {"code": "6300714", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 2718.0, "discounted_cash": 2038.5, "setting": "both", "billing_class": "facility"}], "modifiers": "SI"}, {"description": "AMB BLS EMERG", "code_information": [{"code": "A0429", "type": "HCPCS"}, {"code": "6300715", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 2718.0, "discounted_cash": 2038.5, "setting": "both", "billing_class": "facility"}], "modifiers": "JH"}, {"description": "AMB BLS EMERG", "code_information": [{"code": "A0429", "type": "HCPCS"}, {"code": "6300716", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 2718.0, "discounted_cash": 2038.5, "setting": "both", "billing_class": "facility"}], "modifiers": "DH"}, {"description": "AMB BLS EMERG", "code_information": [{"code": "A0429", "type": "HCPCS"}, {"code": "6300717", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 2718.0, "discounted_cash": 2038.5, "setting": "both", "billing_class": "facility"}], "modifiers": "PH"}, {"description": "AMB BLS RES-R/D/C", "code_information": [{"code": "A0428", "type": "HCPCS"}, {"code": "6300539", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 1531.0, "discounted_cash": 1148.25, "setting": "both", "billing_class": "facility"}], "modifiers": "RE"}, {"description": "AMB DX/THER - HOSP P/M", "code_information": [{"code": "A0425", "type": "HCPCS"}, {"code": "6300403", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}], "modifiers": "DH"}, {"description": "AMB HOSP - DX/THER P/M", "code_information": [{"code": "A0425", "type": "HCPCS"}, {"code": "6300423", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}], "modifiers": "HD"}, {"description": "AMB HOSP - HOSP P/M", "code_information": [{"code": "A0425", "type": "HCPCS"}, {"code": "6300426", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}], "modifiers": "HH"}, {"description": "AMB HOSP - R/D/C P/M", "code_information": [{"code": "A0425", "type": "HCPCS"}, {"code": "6300424", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}], "modifiers": "HE"}, {"description": "AMB HOSP - RES P/M", "code_information": [{"code": "A0425", "type": "HCPCS"}, {"code": "6300431", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}], "modifiers": "HR"}, {"description": "AMB HOSP - SNF P/M", "code_information": [{"code": "A0425", "type": "HCPCS"}, {"code": "6300429", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}], "modifiers": "HN"}, {"description": "AMB HOSP DIAL- HOSP P/M", "code_information": [{"code": "A0425", "type": "HCPCS"}, {"code": "6300419", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GH"}, {"description": "AMB HOSP-TRNS AIR/HEL PM", "code_information": [{"code": "A0425", "type": "HCPCS"}, {"code": "6300427", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}], "modifiers": "HI"}, {"description": "AMB MILEAGE NON COVERED", "code_information": [{"code": "A0888", "type": "HCPCS"}, {"code": "6301540", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}], "modifiers": "RR"}, {"description": "AMB MILEAGE QL", "code_information": [{"code": "A0425", "type": "HCPCS"}, {"code": "6300890", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}], "modifiers": "QL"}, {"description": "AMB NHOSP DIAL - HOSP PM", "code_information": [{"code": "A0425", "type": "HCPCS"}, {"code": "6300440", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}], "modifiers": "JH"}, {"description": "AMB NHOSP DIAL - RES P/M", "code_information": [{"code": "A0425", "type": "HCPCS"}, {"code": "6300444", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}], "modifiers": "JR"}, {"description": "AMB PHY - HOSP P/M", "code_information": [{"code": "A0425", "type": "HCPCS"}, {"code": "6300457", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}], "modifiers": "PH"}, {"description": "AMB R/D/C - HOSP P/M", "code_information": [{"code": "A0425", "type": "HCPCS"}, {"code": "6300412", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}], "modifiers": "EH"}, {"description": "AMB RES - HOSP P/M", "code_information": [{"code": "A0425", "type": "HCPCS"}, {"code": "6300466", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}], "modifiers": "RH"}, {"description": "AMB RES - NHOSP DIAL P/M", "code_information": [{"code": "A0425", "type": "HCPCS"}, {"code": "6300468", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}], "modifiers": "RJ"}, {"description": "AMB RES - R/D/C P/M", "code_information": [{"code": "A0425", "type": "HCPCS"}, {"code": "6300464", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}], "modifiers": "RE"}, {"description": "AMB SCENE - HOSP P/M", "code_information": [{"code": "A0425", "type": "HCPCS"}, {"code": "6300472", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}], "modifiers": "SH"}, {"description": "AMB SCENE-TRNS AIR/HELI", "code_information": [{"code": "A0425", "type": "HCPCS"}, {"code": "6300473", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}], "modifiers": "SI"}, {"description": "AMB SCT", "code_information": [{"code": "A0434", "type": "HCPCS"}, {"code": "6301092", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 3881.0, "discounted_cash": 2910.75, "setting": "both", "billing_class": "facility"}], "modifiers": "HH"}, {"description": "AMB SCT", "code_information": [{"code": "A0434", "type": "HCPCS"}, {"code": "6301093", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 3881.0, "discounted_cash": 2910.75, "setting": "both", "billing_class": "facility"}], "modifiers": "HI"}, {"description": "AMB SNF - HOSP P/M", "code_information": [{"code": "A0425", "type": "HCPCS"}, {"code": "6300448", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}], "modifiers": "NH"}, {"description": "AMIKACIN", "code_information": [{"code": "80150", "type": "CPT"}, {"code": "4102124", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 276.0, "discounted_cash": 207.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMIKACIN", "code_information": [{"code": "80150", "type": "CPT"}, {"code": "4172124", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 217.0, "discounted_cash": 162.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMIKACIN", "code_information": [{"code": "80150", "type": "CPT"}, {"code": "7252124", "type": "CDM"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "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": "4102126", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 222.0, "discounted_cash": 166.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMIKACIN/2", "code_information": [{"code": "80150", "type": "CPT"}, {"code": "7252126", "type": "CDM"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMIKACIN/3", "code_information": [{"code": "80150", "type": "CPT"}, {"code": "4102129", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 222.0, "discounted_cash": 166.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMIKACIN/3", "code_information": [{"code": "80150", "type": "CPT"}, {"code": "7252127", "type": "CDM"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMILORIDE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300522", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMILORIDE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300522", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMILORIDE/HCTZ 5/50 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300526", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMILORIDE/HCTZ 5/50 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300526", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMINO ACIDS 6+ QNT", "code_information": [{"code": "82139", "type": "CPT"}, {"code": "7008213", "type": "CDM"}], "standard_charges": [{"gross_charge": 1236.0, "discounted_cash": 927.0, "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": 643.0, "discounted_cash": 482.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMINO ACIDS 6+ QNT/4", "code_information": [{"code": "82139", "type": "CPT"}, {"code": "7258220", "type": "CDM"}], "standard_charges": [{"gross_charge": 507.0, "discounted_cash": 380.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMINO ACIDS QNT SNGL/2", "code_information": [{"code": "82131", "type": "CPT"}, {"code": "7002131", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 807.0, "discounted_cash": 605.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMINO ACIDS QNT SNGL/2", "code_information": [{"code": "82131", "type": "CPT"}, {"code": "7252131", "type": "CDM"}], "standard_charges": [{"gross_charge": 300.0, "discounted_cash": 225.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 247.0, "discounted_cash": 185.25, "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": 247.0, "discounted_cash": 185.25, "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": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "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": 78.0, "discounted_cash": 58.5, "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": 78.0, "discounted_cash": 58.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "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": 55.0, "discounted_cash": 41.25, "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": 70.0, "discounted_cash": 52.5, "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": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMIODARONE", "code_information": [{"code": "80151", "type": "CPT"}, {"code": "7250284", "type": "CDM"}], "standard_charges": [{"gross_charge": 560.0, "discounted_cash": 420.0, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMIODARONE PER 30MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0282", "type": "HCPCS"}, {"code": "5318199", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 12.0, "discounted_cash": 9.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "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": 1.0, "discounted_cash": 0.75, "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": 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": 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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": 3.0, "discounted_cash": 2.25, "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": 3.0, "discounted_cash": 2.25, "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": 5.0, "discounted_cash": 3.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMMONIA", "code_information": [{"code": "82140", "type": "CPT"}, {"code": "4102140", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 235.0, "discounted_cash": 176.25, "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": 101.0, "discounted_cash": 75.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMMONIA", "code_information": [{"code": "82140", "type": "CPT"}, {"code": "4172140", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 185.0, "discounted_cash": 138.75, "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": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMMONIUM LACT12%140GMCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334148", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMMONIUM LACT12%140GMCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334148", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMMONIUM LACT12%225ML LT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336087", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMMONIUM LACT12%225ML LT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336087", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMNIOCENTESIS DIAG", "code_information": [{"code": "3120105", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 1579.0, "discounted_cash": 1184.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMNIOCENTESIS DIAG", "code_information": [{"code": "3120105", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1579.0, "discounted_cash": 1184.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMNIOCENTESIS DIAG", "code_information": [{"code": "5061145", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 829.0, "discounted_cash": 621.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXIC/CLAV125/5 150PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314236", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 784.0, "discounted_cash": 588.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXIC/CLAV125/5 150PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314236", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 784.0, "discounted_cash": 588.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXIC/CLAV125/5 75PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314235", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXIC/CLAV125/5 75PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314235", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXIC/CLAV200/5 100PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314232", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXIC/CLAV200/5 100PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314232", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "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": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "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": 49.0, "discounted_cash": 36.75, "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": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXIC/CLAV600/5 75PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314238", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXIC/CLAV600/5 75PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314238", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXICILLIN 125/5 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314249", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXICILLIN 125/5 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314249", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 128.0, "discounted_cash": 96.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 128.0, "discounted_cash": 96.0, "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": 16.0, "discounted_cash": 12.0, "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": 16.0, "discounted_cash": 12.0, "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": 12.0, "discounted_cash": 9.0, "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": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXICILLIN 875MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300727", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXICILLIN 875MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300727", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "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": 148.0, "discounted_cash": 111.0, "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": 148.0, "discounted_cash": 111.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXICILLIN/CLAV 250MGTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300712", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 152.0, "discounted_cash": 114.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXICILLIN/CLAV 250MGTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300712", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 152.0, "discounted_cash": 114.0, "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": 108.0, "discounted_cash": 81.0, "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": 108.0, "discounted_cash": 81.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXICILLIN/CLAV 875MGTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300713", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 230.0, "discounted_cash": 172.5, "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": 230.0, "discounted_cash": 172.5, "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": 383.0, "discounted_cash": 287.25, "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": 383.0, "discounted_cash": 287.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXICILLN 200/5 50ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314221", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 134.0, "discounted_cash": 100.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXICILLN 200/5 50ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314221", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 134.0, "discounted_cash": 100.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXICILLN 200/5 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314248", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXICILLN 200/5 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314248", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "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": 92.0, "discounted_cash": 69.0, "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": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXICILLN 400/5 50ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314259", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1002.0, "discounted_cash": 751.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXICILLN 400/5 50ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314259", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1002.0, "discounted_cash": 751.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXICILLN 400/5 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314258", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 44.0, "discounted_cash": 33.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXICILLN 400/5 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314258", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 44.0, "discounted_cash": 33.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXICILLN 50/ML 30ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314247", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXICILLN 50/ML 30ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314247", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXICILN 250/5 150ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314256", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 205.0, "discounted_cash": 153.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMOXICILN 250/5 150ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314256", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 205.0, "discounted_cash": 153.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPHET/DEXAMPHET 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327112", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 10.0, "discounted_cash": 7.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPHET/DEXAMPHET 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327112", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 10.0, "discounted_cash": 7.5, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPHETAM MIX 10MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327110", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPHETAM MIX 10MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327110", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPHETAMINE QUAN 1-2", "code_information": [{"code": "80324", "type": "CPT"}, {"code": "7052145", "type": "CDM"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPHETAMINE QUAN 1-2/2", "code_information": [{"code": "80324", "type": "CPT"}, {"code": "7052146", "type": "CDM"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "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": 328.0, "discounted_cash": 246.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 156.0, "discounted_cash": 117.0, "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": 156.0, "discounted_cash": 117.0, "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": 488.0, "discounted_cash": 366.0, "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": 488.0, "discounted_cash": 366.0, "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": 488.0, "discounted_cash": 366.0, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 488.0, "discounted_cash": 366.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 632.0, "discounted_cash": 474.0, "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": 632.0, "discounted_cash": 474.0, "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": 52.0, "discounted_cash": 39.0, "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": 52.0, "discounted_cash": 39.0, "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": 95.0, "discounted_cash": 71.25, "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": 95.0, "discounted_cash": 71.25, "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": 46.0, "discounted_cash": 34.5, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMPICILLIN PER 500MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0290", "type": "HCPCS"}, {"code": "5318265", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "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": 84.0, "discounted_cash": 63.0, "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": 496.0, "discounted_cash": 372.0, "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": 45.0, "discounted_cash": 33.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMYLASE", "code_information": [{"code": "82150", "type": "CPT"}, {"code": "4172150", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 390.0, "discounted_cash": 292.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMYLASE", "code_information": [{"code": "82150", "type": "CPT"}, {"code": "7252150", "type": "CDM"}], "standard_charges": [{"gross_charge": 41.0, "discounted_cash": 30.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMYLASE/2", "code_information": [{"code": "82150", "type": "CPT"}, {"code": "4102151", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 317.0, "discounted_cash": 237.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMYLASE/2", "code_information": [{"code": "82150", "type": "CPT"}, {"code": "4172151", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 249.0, "discounted_cash": 186.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMYLASE/2", "code_information": [{"code": "82150", "type": "CPT"}, {"code": "7252151", "type": "CDM"}], "standard_charges": [{"gross_charge": 98.0, "discounted_cash": 73.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AMYLASE/4", "code_information": [{"code": "82150", "type": "CPT"}, {"code": "4172153", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 89.0, "discounted_cash": 66.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AMYLASE/4", "code_information": [{"code": "82150", "type": "CPT"}, {"code": "7252153", "type": "CDM"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "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": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AMYLASE/5", "code_information": [{"code": "82150", "type": "CPT"}, {"code": "4172154", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "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": 304.0, "discounted_cash": 228.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANAGRELIDE 0.5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300755", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 304.0, "discounted_cash": 228.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANALYS GEN /TRANSMIT PROG SMPL", "code_information": [{"code": "95971", "type": "CPT"}, {"code": "6935971", "type": "CDM"}, {"code": "920", "type": "RC"}], "standard_charges": [{"gross_charge": 1242.0, "discounted_cash": 931.5, "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": 416.0, "discounted_cash": 312.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 416.0, "discounted_cash": 312.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANCA TITER EACH ANTIBODY", "code_information": [{"code": "86037", "type": "CPT"}, {"code": "7250245", "type": "CDM"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "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": 4456.0, "discounted_cash": 3342.0, "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": 3576.0, "discounted_cash": 2682.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANCH CSCRW PCHUTE ARTHRX", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8240503", "type": "CDM"}], "standard_charges": [{"gross_charge": 5047.0, "discounted_cash": 3785.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANCH LEAD SPINL STIM", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8178125", "type": "CDM"}], "standard_charges": [{"gross_charge": 5206.0, "discounted_cash": 3904.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANCH NEUROSTIM LD SWFT", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8170075", "type": "CDM"}], "standard_charges": [{"gross_charge": 2606.0, "discounted_cash": 1954.5, "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": 4517.0, "discounted_cash": 3387.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANCH ROTATOR", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8031026", "type": "CDM"}], "standard_charges": [{"gross_charge": 2680.0, "discounted_cash": 2010.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANCH SLEEVE LEAD", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8140996", "type": "CDM"}], "standard_charges": [{"gross_charge": 181.0, "discounted_cash": 135.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANCH SUT ALL Q-FIX 1.8MM", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4010722", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 13898.0, "discounted_cash": 10423.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANCH SUT ALL Q-FIX 2.8MM", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4010723", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6974.0, "discounted_cash": 5230.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANCH SUT ALLTHREAD", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4010699", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2940.0, "discounted_cash": 2205.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANCH SUT BIO-SUTURETAK", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4020700", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2498.0, "discounted_cash": 1873.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANCH SUT BIOCRKSCRW FT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4010700", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2724.0, "discounted_cash": 2043.0, "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": 4050.0, "discounted_cash": 3037.5, "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": 3413.0, "discounted_cash": 2559.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANCH SUTURE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8170090", "type": "CDM"}], "standard_charges": [{"gross_charge": 2084.0, "discounted_cash": 1563.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANCH/SCRW BN/BN TISS/BN2", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8240006", "type": "CDM"}], "standard_charges": [{"gross_charge": 2680.0, "discounted_cash": 2010.0, "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": 5169.0, "discounted_cash": 3876.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANCHOR SELF-PUNCHING FIBERTAK", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131021", "type": "CDM"}], "standard_charges": [{"gross_charge": 4421.0, "discounted_cash": 3315.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANDROSTENEDIONE", "code_information": [{"code": "82157", "type": "CPT"}, {"code": "7002157", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 317.0, "discounted_cash": 237.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANDROSTENEDIONE", "code_information": [{"code": "82157", "type": "CPT"}, {"code": "7252157", "type": "CDM"}], "standard_charges": [{"gross_charge": 1042.0, "discounted_cash": 781.5, "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": 1233.0, "discounted_cash": 924.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANESTHESIA INIT 30 MIN", "code_information": [{"code": "3703560", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 2621.0, "discounted_cash": 1965.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANGIO EXIST CATH F/U STU", "code_information": [{"code": "75898", "type": "CPT"}, {"code": "4615898", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 5386.0, "discounted_cash": 4039.5, "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": 5386.0, "discounted_cash": 4039.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANGIO EXIST CATH F/U STU", "code_information": [{"code": "75898", "type": "CPT"}, {"code": "4955898", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 5386.0, "discounted_cash": 4039.5, "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": 9570.0, "discounted_cash": 7177.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANGIO EXTREMITY BILAT", "code_information": [{"code": "75716", "type": "CPT"}, {"code": "4905718", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 9570.0, "discounted_cash": 7177.5, "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": 9570.0, "discounted_cash": 7177.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANGIO EXTREMITY UNILAT", "code_information": [{"code": "75710", "type": "CPT"}, {"code": "4615712", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 8578.0, "discounted_cash": 6433.5, "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": 8578.0, "discounted_cash": 6433.5, "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": 8578.0, "discounted_cash": 6433.5, "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": 4926.0, "discounted_cash": 3694.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANGIO PULM SEL BI", "code_information": [{"code": "75743", "type": "CPT"}, {"code": "4615744", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 6662.0, "discounted_cash": 4996.5, "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": 6662.0, "discounted_cash": 4996.5, "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": 4211.0, "discounted_cash": 3158.25, "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": 4211.0, "discounted_cash": 3158.25, "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": 5091.0, "discounted_cash": 3818.25, "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": 11708.0, "discounted_cash": 8781.0, "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": 14340.0, "discounted_cash": 10755.0, "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": 14340.0, "discounted_cash": 10755.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANGIOTENSIN CONV ENZYME", "code_information": [{"code": "82164", "type": "CPT"}, {"code": "7002164", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 157.0, "discounted_cash": 117.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANGIOTENSIN CONV ENZYME", "code_information": [{"code": "82164", "type": "CPT"}, {"code": "7252164", "type": "CDM"}], "standard_charges": [{"gross_charge": 446.0, "discounted_cash": 334.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANGIOTENSIN CONV ENZYME/2", "code_information": [{"code": "82164", "type": "CPT"}, {"code": "7252165", "type": "CDM"}], "standard_charges": [{"gross_charge": 148.0, "discounted_cash": 111.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANGIOTENSIN II 0.5MG/ML 1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5318283", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1873.0, "discounted_cash": 1404.75, "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": 25249.0, "discounted_cash": 18936.75, "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": 25249.0, "discounted_cash": 18936.75, "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": 23903.0, "discounted_cash": 17927.25, "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": 23903.0, "discounted_cash": 17927.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANGIPLASTY VEN INIT+S&I", "code_information": [{"code": "4957248", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 23903.0, "discounted_cash": 17927.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANIDULAFUNGIN PER 1 MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0348", "type": "HCPCS"}, {"code": "5318330", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 45.0, "discounted_cash": 33.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANIDULAFUNGIN PER 1 MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0348", "type": "HCPCS"}, {"code": "5318330", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 45.0, "discounted_cash": 33.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANKLE 2 VIEWS", "code_information": [{"code": "73600", "type": "CPT"}, {"code": "4903600", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 911.0, "discounted_cash": 683.25, "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": 911.0, "discounted_cash": 683.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANKLE 2 VIEWS", "code_information": [{"code": "73600", "type": "CPT"}, {"code": "5123600", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 911.0, "discounted_cash": 683.25, "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": 1371.0, "discounted_cash": 1028.25, "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": 1371.0, "discounted_cash": 1028.25, "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": 1371.0, "discounted_cash": 1028.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANKLE 3 VIEWS MINIMUM", "code_information": [{"code": "73610", "type": "CPT"}, {"code": "5123610", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1371.0, "discounted_cash": 1028.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANKLE ARTHROGRAPHY", "code_information": [{"code": "73615", "type": "CPT"}, {"code": "4903615", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2388.0, "discounted_cash": 1791.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTACID K/NA BICAR EFFTB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5300770", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTACID K/NA BICAR EFFTB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5300770", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "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": 2232.0, "discounted_cash": 1674.0, "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": 2232.0, "discounted_cash": 1674.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTI HMGCR AB", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7253613", "type": "CDM"}], "standard_charges": [{"gross_charge": 356.0, "discounted_cash": 267.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTI NMDA RECEPTOR AB", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "7258615", "type": "CDM"}], "standard_charges": [{"gross_charge": 1957.0, "discounted_cash": 1467.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTI-GLIADIN AB", "code_information": [{"code": "86258", "type": "CPT"}, {"code": "7002320", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 518.0, "discounted_cash": 388.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTI-GLOMERULAR BSMNT", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "4173516", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 698.0, "discounted_cash": 523.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTI-GLOMERULAR BSMNT", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "7252322", "type": "CDM"}], "standard_charges": [{"gross_charge": 887.0, "discounted_cash": 665.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTI-PLA2R", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "7253607", "type": "CDM"}], "standard_charges": [{"gross_charge": 865.0, "discounted_cash": 648.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTI-RI", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "7006465", "type": "CDM"}], "standard_charges": [{"gross_charge": 688.0, "discounted_cash": 516.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTI-RI", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "7256465", "type": "CDM"}], "standard_charges": [{"gross_charge": 242.0, "discounted_cash": 181.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTI-STREPTOLYSN O TITER", "code_information": [{"code": "86060", "type": "CPT"}, {"code": "4176060", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 103.0, "discounted_cash": 77.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTI-STREPTOLYSN O TITER", "code_information": [{"code": "86060", "type": "CPT"}, {"code": "7006060", "type": "CDM"}], "standard_charges": [{"gross_charge": 75.0, "discounted_cash": 56.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTI-STREPTOLYSN O TITER", "code_information": [{"code": "86060", "type": "CPT"}, {"code": "7256060", "type": "CDM"}], "standard_charges": [{"gross_charge": 131.0, "discounted_cash": 98.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTI-STREPTOLYSN SCREEN", "code_information": [{"code": "86063", "type": "CPT"}, {"code": "4126061", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "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": 507.0, "discounted_cash": 380.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIBDY IDENT RBC EA PNL", "code_information": [{"code": "86870", "type": "CPT"}, {"code": "4176024", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 432.0, "discounted_cash": 324.0, "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": 1644.0, "discounted_cash": 1233.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIBDY IDENT RBC EA PNL", "code_information": [{"code": "86870", "type": "CPT"}, {"code": "7196024", "type": "CDM"}], "standard_charges": [{"gross_charge": 549.0, "discounted_cash": 411.75, "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": 403.0, "discounted_cash": 302.25, "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": 300.0, "discounted_cash": 225.0, "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": 296.0, "discounted_cash": 222.0, "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": 330.0, "discounted_cash": 247.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIEPILEPTIC NOS 1-3", "code_information": [{"code": "80339", "type": "CPT"}, {"code": "7000292", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 142.0, "discounted_cash": 106.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIEPILEPTIC NOS 1-3/5", "code_information": [{"code": "80339", "type": "CPT"}, {"code": "7250349", "type": "CDM"}], "standard_charges": [{"gross_charge": 306.0, "discounted_cash": 229.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTINEURONAL CELL ABS", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7258356", "type": "CDM"}], "standard_charges": [{"gross_charge": 191.0, "discounted_cash": 143.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTINUCLEAR AB(ANA)", "code_information": [{"code": "86038", "type": "CPT"}, {"code": "7006043", "type": "CDM"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTINUCLEAR AB(ANA)/2", "code_information": [{"code": "86038", "type": "CPT"}, {"code": "7006058", "type": "CDM"}], "standard_charges": [{"gross_charge": 244.0, "discounted_cash": 183.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTINUCLEAR AB(ANA)/2", "code_information": [{"code": "86038", "type": "CPT"}, {"code": "7256043", "type": "CDM"}], "standard_charges": [{"gross_charge": 213.0, "discounted_cash": 159.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTINUCLEAR AB(ANA)/3", "code_information": [{"code": "86038", "type": "CPT"}, {"code": "7256058", "type": "CDM"}], "standard_charges": [{"gross_charge": 388.0, "discounted_cash": 291.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTINUCLEAR AB(ANA)TITER", "code_information": [{"code": "86039", "type": "CPT"}, {"code": "7006041", "type": "CDM"}], "standard_charges": [{"gross_charge": 179.0, "discounted_cash": 134.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIPARIETAL CELL AB", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "7258376", "type": "CDM"}], "standard_charges": [{"gross_charge": 191.0, "discounted_cash": 143.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIPHOSPHATIDYLSERINE AB", "code_information": [{"code": "86148", "type": "CPT"}, {"code": "7006137", "type": "CDM"}], "standard_charges": [{"gross_charge": 440.0, "discounted_cash": 330.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIPHOSPHATIDYLSERINE AB", "code_information": [{"code": "86148", "type": "CPT"}, {"code": "7256142", "type": "CDM"}], "standard_charges": [{"gross_charge": 223.0, "discounted_cash": 167.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIPHOSPHATIDYLSERINE AB/2", "code_information": [{"code": "86148", "type": "CPT"}, {"code": "7006138", "type": "CDM"}], "standard_charges": [{"gross_charge": 440.0, "discounted_cash": 330.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIPHOSPHATIDYLSERINE AB/2", "code_information": [{"code": "86148", "type": "CPT"}, {"code": "7256143", "type": "CDM"}], "standard_charges": [{"gross_charge": 223.0, "discounted_cash": 167.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIPHOSPHATIDYLSERINE AB/3", "code_information": [{"code": "86148", "type": "CPT"}, {"code": "7006139", "type": "CDM"}], "standard_charges": [{"gross_charge": 440.0, "discounted_cash": 330.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIPHOSPHATIDYLSERINE AB/3", "code_information": [{"code": "86148", "type": "CPT"}, {"code": "7256144", "type": "CDM"}], "standard_charges": [{"gross_charge": 223.0, "discounted_cash": 167.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIPROTEINASE 3 AB", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7253553", "type": "CDM"}], "standard_charges": [{"gross_charge": 220.0, "discounted_cash": 165.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIPROTEINASE 3 AB/2", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7258377", "type": "CDM"}], "standard_charges": [{"gross_charge": 165.0, "discounted_cash": 123.75, "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": 129.0, "discounted_cash": 96.75, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 129.0, "discounted_cash": 96.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTITHROMBIN III ACTIVITY", "code_information": [{"code": "85300", "type": "CPT"}, {"code": "4175301", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 51.0, "discounted_cash": 38.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTITHROMBIN III ACTIVITY", "code_information": [{"code": "85300", "type": "CPT"}, {"code": "7255300", "type": "CDM"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTITHROMBIN III ANTIGEN", "code_information": [{"code": "85301", "type": "CPT"}, {"code": "7005301", "type": "CDM"}], "standard_charges": [{"gross_charge": 1251.0, "discounted_cash": 938.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTITHROMBIN III ANTIGEN", "code_information": [{"code": "85301", "type": "CPT"}, {"code": "7255301", "type": "CDM"}], "standard_charges": [{"gross_charge": 457.0, "discounted_cash": 342.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTITRYPSIN ALPHA 1 TOTL", "code_information": [{"code": "82103", "type": "CPT"}, {"code": "7006067", "type": "CDM"}], "standard_charges": [{"gross_charge": 147.0, "discounted_cash": 110.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTITRYPSIN ALPHA 1 TOTL", "code_information": [{"code": "82103", "type": "CPT"}, {"code": "7256067", "type": "CDM"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTITRYPSIN ALPHA 1 TOTL/2", "code_information": [{"code": "82103", "type": "CPT"}, {"code": "7256068", "type": "CDM"}], "standard_charges": [{"gross_charge": 414.0, "discounted_cash": 310.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTITRYPSIN ALPHA PHENO", "code_information": [{"code": "82104", "type": "CPT"}, {"code": "7002104", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1018.0, "discounted_cash": 763.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTITRYPSIN ALPHA PHENO", "code_information": [{"code": "82104", "type": "CPT"}, {"code": "7252104", "type": "CDM"}], "standard_charges": [{"gross_charge": 174.0, "discounted_cash": 130.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIVEN BLK WIDOW IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5318642", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 615.0, "discounted_cash": 461.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ANTIVEN CROTAL IMM FAB 2 EQ IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0841", "type": "HCPCS"}, {"code": "5319635", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2417.0, "discounted_cash": 1812.75, "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": 2417.0, "discounted_cash": 1812.75, "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": 27396.0, "discounted_cash": 20547.0, "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": 27396.0, "discounted_cash": 20547.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AORT/INF/IV/BPG COMP", "code_information": [{"code": "93978", "type": "CPT"}, {"code": "4630020", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 3522.0, "discounted_cash": 2641.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AORT/IVC/IV/BPG UNI/LTD", "code_information": [{"code": "93979", "type": "CPT"}, {"code": "4630030", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 2277.0, "discounted_cash": 1707.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AORT/IVC/IV/BPG UNI/LTD", "code_information": [{"code": "93979", "type": "CPT"}, {"code": "5067150", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 2277.0, "discounted_cash": 1707.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AORT/IVC/IV/BPG UNI/LTD", "code_information": [{"code": "93979", "type": "CPT"}, {"code": "5123979", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 2277.0, "discounted_cash": 1707.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AORTIC VALVE #2", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8141010", "type": "CDM"}], "standard_charges": [{"gross_charge": 58907.0, "discounted_cash": 44180.25, "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": 3.0, "discounted_cash": 2.25, "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": 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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP 160M/5M 120ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314012", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP 160M/5M 120ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314012", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "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": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP 325MG SU", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5338020", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP 325MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5300017", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP 500MG ES CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5300013", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP 500MG ES CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5300013", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 0.68, "discounted_cash": 0.51, "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": 0.68, "discounted_cash": 0.51, "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": 12.0, "discounted_cash": 9.0, "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": 12.0, "discounted_cash": 9.0, "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": 82.0, "discounted_cash": 61.5, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP 80M/.8M 15ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314009", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 82.0, "discounted_cash": 61.5, "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": 21.0, "discounted_cash": 15.75, "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": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP 80MG/.8ML DOSE LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314006", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP 80MG/.8ML DOSE LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314006", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP NOS PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0131", "type": "HCPCS"}, {"code": "5318338", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "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": 12.0, "discounted_cash": 9.0, "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": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP/BUTAL/CAF/ TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327036", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP/BUTAL/CAF/ TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327036", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "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": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP/COD 120/12 15ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327010", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "APAP/COD 120/12 15ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327010", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "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": 14.0, "discounted_cash": 10.5, "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": 39.0, "discounted_cash": 29.25, "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": 39.0, "discounted_cash": 29.25, "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": 31.0, "discounted_cash": 23.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "APLIGRAF PER SQ CM", "code_information": [{"code": "Q4101", "type": "HCPCS"}, {"code": "8240451", "type": "CDM"}], "standard_charges": [{"gross_charge": 350.0, "discounted_cash": 262.5, "setting": "both", "billing_class": "facility"}]}, {"description": "APOLIPOPROTEIN/3", "code_information": [{"code": "82172", "type": "CPT"}, {"code": "7252174", "type": "CDM"}], "standard_charges": [{"gross_charge": 123.0, "discounted_cash": 92.25, "setting": "both", "billing_class": "facility"}]}, {"description": "APP LC SKNSB FNHG 1ST 25SC", "code_information": [{"code": "6900018", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1545.0, "discounted_cash": 1158.75, "setting": "both", "billing_class": "facility"}]}, {"description": "APP LC SKNSB FNHG 1ST 25SC", "code_information": [{"code": "6900018", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 1545.0, "discounted_cash": 1158.75, "setting": "both", "billing_class": "facility"}]}, {"description": "APP LC SKNSB T/A/L 1ST 25SC", "code_information": [{"code": "6900023", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1300.0, "discounted_cash": 975.0, "setting": "both", "billing_class": "facility"}]}, {"description": "APP LC SKNSB T/A/L 1ST 25SC", "code_information": [{"code": "6900023", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 1300.0, "discounted_cash": 975.0, "setting": "both", "billing_class": "facility"}]}, {"description": "APP SKNSUB F/N/H/G 1ST 25SC", "code_information": [{"code": "6900029", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1545.0, "discounted_cash": 1158.75, "setting": "both", "billing_class": "facility"}]}, {"description": "APP SKNSUB F/N/H/G 1ST 25SC", "code_information": [{"code": "6900029", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 1545.0, "discounted_cash": 1158.75, "setting": "both", "billing_class": "facility"}]}, {"description": "APP SKNSUB F/N/H/G EA ADL 25SC", "code_information": [{"code": "6900030", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1416.0, "discounted_cash": 1062.0, "setting": "both", "billing_class": "facility"}]}, {"description": "APP SKNSUB F/N/H/G EA ADL 25SC", "code_information": [{"code": "6900030", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 1416.0, "discounted_cash": 1062.0, "setting": "both", "billing_class": "facility"}]}, {"description": "APP SKNSUB GRFT T/A/L ADL25SC", "code_information": [{"code": "6900026", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1416.0, "discounted_cash": 1062.0, "setting": "both", "billing_class": "facility"}]}, {"description": "APP SKNSUB GRFT T/A/L ADL25SC", "code_information": [{"code": "6900026", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 1416.0, "discounted_cash": 1062.0, "setting": "both", "billing_class": "facility"}]}, {"description": "APP SKNSUB GRFT T/A/L<1ST 25SC", "code_information": [{"code": "6900025", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1545.0, "discounted_cash": 1158.75, "setting": "both", "billing_class": "facility"}]}, {"description": "APP SKNSUB GRFT T/A/L<1ST 25SC", "code_information": [{"code": "6900025", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 1545.0, "discounted_cash": 1158.75, "setting": "both", "billing_class": "facility"}]}, {"description": "APPLY ML COMPRS LWR LEG", "code_information": [{"code": "6900091", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1843.0, "discounted_cash": 1382.25, "setting": "both", "billing_class": "facility"}]}, {"description": "APPLY ML COMPRS LWR LEG", "code_information": [{"code": "6900091", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 1843.0, "discounted_cash": 1382.25, "setting": "both", "billing_class": "facility"}]}, {"description": "APPLY RIGID LEG CAST", "code_information": [{"code": "6900090", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2872.0, "discounted_cash": 2154.0, "setting": "both", "billing_class": "facility"}]}, {"description": "APPLY RIGID LEG CAST", "code_information": [{"code": "6900090", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 2872.0, "discounted_cash": 2154.0, "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": 114.0, "discounted_cash": 85.5, "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": 114.0, "discounted_cash": 85.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AQUAPORIN-4 AB ELISA", "code_information": [{"code": "86051", "type": "CPT"}, {"code": "7250243", "type": "CDM"}], "standard_charges": [{"gross_charge": 1036.0, "discounted_cash": 777.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AQUAPORINE 4 AB", "code_information": [{"code": "86052", "type": "CPT"}, {"code": "7253012", "type": "CDM"}], "standard_charges": [{"gross_charge": 1722.0, "discounted_cash": 1291.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AQUAPORINE 4 AB/2", "code_information": [{"code": "86052", "type": "CPT"}, {"code": "7256829", "type": "CDM"}], "standard_charges": [{"gross_charge": 2468.0, "discounted_cash": 1851.0, "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": 10.0, "discounted_cash": 7.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ARFORMOTEROL15MCG/2ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330217", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 10.0, "discounted_cash": 7.5, "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": 10.0, "discounted_cash": 7.5, "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": 10.0, "discounted_cash": 7.5, "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": 191.0, "discounted_cash": 143.25, "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": 367.0, "discounted_cash": 275.25, "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": 367.0, "discounted_cash": 275.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 499.0, "discounted_cash": 374.25, "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": 499.0, "discounted_cash": 374.25, "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": 504.0, "discounted_cash": 378.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ARIPIPRAZOLE 30MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300786", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 504.0, "discounted_cash": 378.0, "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": 416.0, "discounted_cash": 312.0, "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": 416.0, "discounted_cash": 312.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ARIPIPRAZOLE 5MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314277", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 274.0, "discounted_cash": 205.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ARIPIPRAZOLE 5MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314277", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 274.0, "discounted_cash": 205.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ARIPIPRAZOLE PER.25MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0400", "type": "HCPCS"}, {"code": "5318334", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "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": 16.0, "discounted_cash": 12.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "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": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ARMODAFANIL 150MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300795", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 148.0, "discounted_cash": 111.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ARMODAFANIL 150MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300795", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 148.0, "discounted_cash": 111.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ARSENIC/3", "code_information": [{"code": "82175", "type": "CPT"}, {"code": "7002175", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 247.0, "discounted_cash": 185.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ARSENIC/3", "code_information": [{"code": "82175", "type": "CPT"}, {"code": "7252175", "type": "CDM"}], "standard_charges": [{"gross_charge": 348.0, "discounted_cash": 261.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ARSENIC/4", "code_information": [{"code": "82175", "type": "CPT"}, {"code": "7002186", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 247.0, "discounted_cash": 185.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTERIAL CATH MONIT/SAMP", "code_information": [{"code": "4612005", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 9967.0, "discounted_cash": 7475.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTERIAL CATH MONIT/SAMP", "code_information": [{"code": "4912005", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 12281.0, "discounted_cash": 9210.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTERIOG CAR NKHD SEL", "code_information": [{"code": "4616226", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 25916.0, "discounted_cash": 19437.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTERIOG CAR NKHD SEL", "code_information": [{"code": "4916226", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 25916.0, "discounted_cash": 19437.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTERIOG CAR NKHD SEL", "code_information": [{"code": "4956224", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 25916.0, "discounted_cash": 19437.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTERIOG EXT CAR SEL", "code_information": [{"code": "4616232", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2929.0, "discounted_cash": 2196.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTERIOG EXT CAR SEL", "code_information": [{"code": "4956227", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2929.0, "discounted_cash": 2196.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTERIOG SUBC/INOM", "code_information": [{"code": "4616228", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 11211.0, "discounted_cash": 8408.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTERIOG SUBC/INOM", "code_information": [{"code": "4916228", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 11211.0, "discounted_cash": 8408.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTERIOG SUBC/INOM", "code_information": [{"code": "4956225", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 11211.0, "discounted_cash": 8408.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTERIOG VERT SEL", "code_information": [{"code": "4616230", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 9919.0, "discounted_cash": 7439.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTERIOG VERT SEL", "code_information": [{"code": "4916230", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 9919.0, "discounted_cash": 7439.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTERIOG VERT SEL", "code_information": [{"code": "4956226", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 9919.0, "discounted_cash": 7439.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTERIOGR CAR HD SEL", "code_information": [{"code": "4616224", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 25933.0, "discounted_cash": 19449.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTERIOGR CAR HD SEL", "code_information": [{"code": "4956223", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 25933.0, "discounted_cash": 19449.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTERIOGR CAR NK SEL", "code_information": [{"code": "4616222", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 15016.0, "discounted_cash": 11262.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTERIOGR CAR NK SEL", "code_information": [{"code": "4916222", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 15016.0, "discounted_cash": 11262.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTERIOGR CAR NK SEL", "code_information": [{"code": "4956222", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 15016.0, "discounted_cash": 11262.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTEROGRAM ARCH NON SEL", "code_information": [{"code": "4616221", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 12656.0, "discounted_cash": 9492.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ARTEROGRAM ARCH NON SEL", "code_information": [{"code": "4956221", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 12656.0, "discounted_cash": 9492.0, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ASA 300MG SU", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5338095", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ASA 325MG EC TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301108", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ASA 325MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301113", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ASA 81MG EC TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301109", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ASA BUFFERED 325MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301112", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.19, "discounted_cash": 0.14, "setting": "both", "billing_class": "facility"}]}, {"description": "ASA BUFFERED 325MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301112", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 0.19, "discounted_cash": 0.14, "setting": "both", "billing_class": "facility"}]}, {"description": "ASA/AL OH/MG OH TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301114", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ASA/AL OH/MG OH TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301114", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 60.0, "discounted_cash": 45.0, "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": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ASA/BUTAL/CAFF TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327168", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ASA/BUTAL/CAFF TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327168", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ASA/NA BICARB TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301118", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ASA/NA BICARB TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301118", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ASCN PIP FNGR RPLCMNT", "code_information": [{"code": "L8659", "type": "HCPCS"}, {"code": "8130166", "type": "CDM"}], "standard_charges": [{"gross_charge": 14170.0, "discounted_cash": 10627.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ASCORBIC ACID", "code_information": [{"code": "82180", "type": "CPT"}, {"code": "7002180", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 128.0, "discounted_cash": 96.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ASCORBIC ACID", "code_information": [{"code": "82180", "type": "CPT"}, {"code": "7252180", "type": "CDM"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ASCORBIC ACID 1GM/2ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5318315", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "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": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ASCORBIC ACID 500MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301061", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ASCORBIC ACID 500MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301061", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ASCORBIC ACID500MG/1MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5318328", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 10.0, "discounted_cash": 7.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ASCORBIC ACID500MG/2MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5318312", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 62.0, "discounted_cash": 46.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 97.0, "discounted_cash": 72.75, "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": 97.0, "discounted_cash": 72.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ASP ABS/HEMAT/CYST", "code_information": [{"code": "4910160", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2718.0, "discounted_cash": 2038.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ASP ABS/HEMAT/CYST", "code_information": [{"code": "5050160", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2718.0, "discounted_cash": 2038.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ASP ABS/HEMAT/CYST", "code_information": [{"code": "5061160", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2957.0, "discounted_cash": 2217.75, "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": 772.0, "discounted_cash": 579.0, "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": 7332.0, "discounted_cash": 5499.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ASPERGILLUS AB", "code_information": [{"code": "86606", "type": "CPT"}, {"code": "4176606", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 190.0, "discounted_cash": 142.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ASPERGILLUS AB", "code_information": [{"code": "86606", "type": "CPT"}, {"code": "7256606", "type": "CDM"}], "standard_charges": [{"gross_charge": 241.0, "discounted_cash": 180.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ASPERGILLUS AB/2", "code_information": [{"code": "86606", "type": "CPT"}, {"code": "7006931", "type": "CDM"}], "standard_charges": [{"gross_charge": 94.0, "discounted_cash": 70.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ASPERGILLUS AB/3", "code_information": [{"code": "86606", "type": "CPT"}, {"code": "7006932", "type": "CDM"}], "standard_charges": [{"gross_charge": 94.0, "discounted_cash": 70.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ASPERGILLUS AB/3", "code_information": [{"code": "86606", "type": "CPT"}, {"code": "7256931", "type": "CDM"}], "standard_charges": [{"gross_charge": 101.0, "discounted_cash": 75.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ASPERGILLUS AB/4", "code_information": [{"code": "86606", "type": "CPT"}, {"code": "7006933", "type": "CDM"}], "standard_charges": [{"gross_charge": 94.0, "discounted_cash": 70.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ASPERGILLUS AB/5", "code_information": [{"code": "86606", "type": "CPT"}, {"code": "7256933", "type": "CDM"}], "standard_charges": [{"gross_charge": 101.0, "discounted_cash": 75.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ASPERGILLUS IA", "code_information": [{"code": "87305", "type": "CPT"}, {"code": "7257306", "type": "CDM"}], "standard_charges": [{"gross_charge": 256.0, "discounted_cash": 192.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ASPERGILLUS IA/2", "code_information": [{"code": "87305", "type": "CPT"}, {"code": "7258730", "type": "CDM"}], "standard_charges": [{"gross_charge": 692.0, "discounted_cash": 519.0, "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": 10895.0, "discounted_cash": 8171.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ASPIR BREAST CYST", "code_information": [{"code": "5011900", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2161.0, "discounted_cash": 1620.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ASPIR BREAST CYST", "code_information": [{"code": "5066650", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2563.0, "discounted_cash": 1922.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ASPIR BREAST CYST", "code_information": [{"code": "5129000", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2161.0, "discounted_cash": 1620.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ASPIR BREAST CYST ADD", "code_information": [{"code": "5019001", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1156.0, "discounted_cash": 867.0, "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": 1098.0, "discounted_cash": 823.5, "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": 1098.0, "discounted_cash": 823.5, "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": 1098.0, "discounted_cash": 823.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ASPIR/INJ MAJOR JT W/US", "code_information": [{"code": "4910611", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1991.0, "discounted_cash": 1493.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ASPIR/INJ SM JNT WO/US", "code_information": [{"code": "4910600", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 546.0, "discounted_cash": 409.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ASSAY ORGANIC ACIDS QNT", "code_information": [{"code": "83918", "type": "CPT"}, {"code": "7003918", "type": "CDM"}], "standard_charges": [{"gross_charge": 1094.0, "discounted_cash": 820.5, "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": 1331.0, "discounted_cash": 998.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ASSAY TOXIN/ANTITOXIN", "code_information": [{"code": "87230", "type": "CPT"}, {"code": "4177077", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1047.0, "discounted_cash": 785.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ASSAY TOXIN/ANTITOXIN", "code_information": [{"code": "87230", "type": "CPT"}, {"code": "7007077", "type": "CDM"}], "standard_charges": [{"gross_charge": 232.0, "discounted_cash": 174.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ASXL1 FULL GENE SEQUENCE", "code_information": [{"code": "81175", "type": "CPT"}, {"code": "7270007", "type": "CDM"}], "standard_charges": [{"gross_charge": 3737.0, "discounted_cash": 2802.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ATAZAN/COBIC 300/150 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301119", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 283.0, "discounted_cash": 212.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ATAZAN/COBIC 300/150 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301119", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 283.0, "discounted_cash": 212.25, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 480.0, "discounted_cash": 360.0, "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": 480.0, "discounted_cash": 360.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ATAZANAVIR 300MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301123", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 213.0, "discounted_cash": 159.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ATAZANAVIR 300MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301123", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 213.0, "discounted_cash": 159.75, "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": 12.0, "discounted_cash": 9.0, "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": 12.0, "discounted_cash": 9.0, "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": 10.0, "discounted_cash": 7.5, "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": 10.0, "discounted_cash": 7.5, "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": 3.0, "discounted_cash": 2.25, "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": 3.0, "discounted_cash": 2.25, "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": 299.0, "discounted_cash": 224.25, "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": 299.0, "discounted_cash": 224.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ATHERECT ILIAC OPEN PERC", "code_information": [{"code": "4610146", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 26411.0, "discounted_cash": 19808.25, "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": 58.0, "discounted_cash": 43.5, "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": 58.0, "discounted_cash": 43.5, "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": 12.0, "discounted_cash": 9.0, "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": 12.0, "discounted_cash": 9.0, "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": 317.0, "discounted_cash": 237.75, "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": 317.0, "discounted_cash": 237.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ATORVASTATIN 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301145", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "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": 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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ATOVAQ/PROGUAN250/100 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301151", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ATOVAQ/PROGUAN250/100 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301151", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "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": 242.0, "discounted_cash": 181.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 242.0, "discounted_cash": 181.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ATRIAL APPENDGE OCCLUSN", "code_information": [{"code": "4619379", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 35961.0, "discounted_cash": 26970.75, "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": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ATROPINE 1% 1ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330268", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 339.0, "discounted_cash": 254.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ATROPINE 1% 1ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330268", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 339.0, "discounted_cash": 254.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 519.0, "discounted_cash": 389.25, "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": 519.0, "discounted_cash": 389.25, "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": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ATROPINE 1% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330282", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ATROPINE PER 0.01MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0461", "type": "HCPCS"}, {"code": "5318387", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.44, "discounted_cash": 0.33, "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": 0.44, "discounted_cash": 0.33, "setting": "both", "billing_class": "facility"}]}, {"description": "ATROPINE PER 0.01MGPFSIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0461", "type": "HCPCS"}, {"code": "5318388", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ATROPINE PER 0.01MGPFSIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0461", "type": "HCPCS"}, {"code": "5318388", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ATROPN/HYOSC/PB/SCOP TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304269", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ATROPN/HYOSC/PB/SCOP TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304269", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "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": 307.0, "discounted_cash": 230.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AUTOP G&M W/BRN", "code_information": [{"code": "88025", "type": "CPT"}, {"code": "7098025", "type": "CDM"}], "standard_charges": [{"gross_charge": 2600.0, "discounted_cash": 1950.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AXLE DISTAL FEMORAL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8131030", "type": "CDM"}], "standard_charges": [{"gross_charge": 8632.0, "discounted_cash": 6474.0, "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": 10.0, "discounted_cash": 7.5, "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": 10.0, "discounted_cash": 7.5, "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": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AZATHIOPRINE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7500", "type": "HCPCS"}, {"code": "5301215", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "AZELASTINE .05% 6ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330333", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 204.0, "discounted_cash": 153.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AZELASTINE .05% 6ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330333", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 204.0, "discounted_cash": 153.0, "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": 1320.0, "discounted_cash": 990.0, "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": 1320.0, "discounted_cash": 990.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AZELASTINE NASAL 34ML SP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330335", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1310.0, "discounted_cash": 982.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AZELASTINE NASAL 34ML SP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330335", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1310.0, "discounted_cash": 982.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 549.0, "discounted_cash": 411.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AZITHROM PER500MG IVPBIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0456", "type": "HCPCS"}, {"code": "5318424", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 549.0, "discounted_cash": 411.75, "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": 540.0, "discounted_cash": 405.0, "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": 540.0, "discounted_cash": 405.0, "setting": "both", "billing_class": "facility"}]}, {"description": "AZITHROMYC 100/5 15ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314300", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 158.0, "discounted_cash": 118.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AZITHROMYC 100/5 15ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314300", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 158.0, "discounted_cash": 118.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AZITHROMYC 200/5 15ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314301", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 173.0, "discounted_cash": 129.75, "setting": "both", "billing_class": "facility"}]}, {"description": "AZITHROMYC 200/5 15ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314301", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 173.0, "discounted_cash": 129.75, "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": 11.0, "discounted_cash": 8.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 11.0, "discounted_cash": 8.25, "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": 674.0, "discounted_cash": 505.5, "setting": "both", "billing_class": "facility"}]}, {"description": "AZITHROMYCIN 600MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301223", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 674.0, "discounted_cash": 505.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 970.0, "discounted_cash": 727.5, "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": 970.0, "discounted_cash": 727.5, "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": 12.0, "discounted_cash": 9.0, "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": 12.0, "discounted_cash": 9.0, "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": 509.0, "discounted_cash": 381.75, "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": 271.0, "discounted_cash": 203.25, "setting": "both", "billing_class": "facility"}]}, {"description": "B-TYP NATRIURETC PEPTIDE", "code_information": [{"code": "83880", "type": "CPT"}, {"code": "4173527", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 400.0, "discounted_cash": 300.0, "setting": "both", "billing_class": "facility"}]}, {"description": "B-TYP NATRIURETC PEPTIDE/2", "code_information": [{"code": "83880", "type": "CPT"}, {"code": "4103528", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 729.0, "discounted_cash": 546.75, "setting": "both", "billing_class": "facility"}]}, {"description": "B-TYP NATRIURETC PEPTIDE/2", "code_information": [{"code": "83880", "type": "CPT"}, {"code": "4173528", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 573.0, "discounted_cash": 429.75, "setting": "both", "billing_class": "facility"}]}, {"description": "B-TYP NATRIURETC PEPTIDE/2", "code_information": [{"code": "83880", "type": "CPT"}, {"code": "7258450", "type": "CDM"}], "standard_charges": [{"gross_charge": 271.0, "discounted_cash": 203.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BACITRA/POLYMYX 3.5GM OO", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330353", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "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": 78.0, "discounted_cash": 58.5, "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": 28.0, "discounted_cash": 21.0, "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": 28.0, "discounted_cash": 21.0, "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": 689.0, "discounted_cash": 516.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BACITRACIN/POLYB 30GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334303", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BACITRACIN/POLYB 30GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334303", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BACITRACIN500U/1GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334294", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BACITRACIN500U/1GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334294", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 26.0, "discounted_cash": 19.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BACITRACIN500U/GM15GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334291", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "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": 34.0, "discounted_cash": 25.5, "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": 19.0, "discounted_cash": 14.25, "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": 19.0, "discounted_cash": 14.25, "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": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BACLOFEN 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301361", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BACTERIUM AB NES/4", "code_information": [{"code": "86609", "type": "CPT"}, {"code": "7006612", "type": "CDM"}], "standard_charges": [{"gross_charge": 289.0, "discounted_cash": 216.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BACTERIUM AB NES/7", "code_information": [{"code": "86609", "type": "CPT"}, {"code": "7256746", "type": "CDM"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 83.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BAHA ABUTMNT REPLCMNT", "code_information": [{"code": "L9900", "type": "HCPCS"}, {"code": "4023022", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 23034.0, "discounted_cash": 17275.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BALOON DILATE URETER", "code_information": [{"code": "4910706", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2140.0, "discounted_cash": 1605.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BALSALAZIDE 750MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301370", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BALSALAZIDE 750MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301370", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BARBITURATE", "code_information": [{"code": "80345", "type": "CPT"}, {"code": "7058221", "type": "CDM"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BARBITURATE/4", "code_information": [{"code": "80345", "type": "CPT"}, {"code": "7252210", "type": "CDM"}], "standard_charges": [{"gross_charge": 266.0, "discounted_cash": 199.5, "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": 283.0, "discounted_cash": 212.25, "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": 283.0, "discounted_cash": 212.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BARIUM SUSP 2.1%450ML LQ", "code_information": [{"code": "5355176", "type": "CDM"}, {"code": "255", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BARRIER ADH SEPRA GEL", "code_information": [{"code": "C1765", "type": "HCPCS"}, {"code": "8172007", "type": "CDM"}], "standard_charges": [{"gross_charge": 3549.0, "discounted_cash": 2661.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BARRIER ADHESION", "code_information": [{"code": "C1765", "type": "HCPCS"}, {"code": "8240009", "type": "CDM"}], "standard_charges": [{"gross_charge": 1525.0, "discounted_cash": 1143.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BARS ARCH", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8172010", "type": "CDM"}], "standard_charges": [{"gross_charge": 2680.0, "discounted_cash": 2010.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BARTONELLA AB", "code_information": [{"code": "86611", "type": "CPT"}, {"code": "7256608", "type": "CDM"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BARTONELLA AB/3", "code_information": [{"code": "86611", "type": "CPT"}, {"code": "7256611", "type": "CDM"}], "standard_charges": [{"gross_charge": 116.0, "discounted_cash": 87.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BARTONELLA AB/4", "code_information": [{"code": "86611", "type": "CPT"}, {"code": "7256612", "type": "CDM"}], "standard_charges": [{"gross_charge": 116.0, "discounted_cash": 87.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BARTONELLA AB/5", "code_information": [{"code": "86611", "type": "CPT"}, {"code": "7256613", "type": "CDM"}], "standard_charges": [{"gross_charge": 116.0, "discounted_cash": 87.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BARTONELLA AB/6", "code_information": [{"code": "86611", "type": "CPT"}, {"code": "7006623", "type": "CDM"}], "standard_charges": [{"gross_charge": 192.0, "discounted_cash": 144.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BARTONELLA AB/6", "code_information": [{"code": "86611", "type": "CPT"}, {"code": "7256614", "type": "CDM"}], "standard_charges": [{"gross_charge": 116.0, "discounted_cash": 87.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BARTONELLA AB/7", "code_information": [{"code": "86611", "type": "CPT"}, {"code": "7006624", "type": "CDM"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BARTONELLA AB/8", "code_information": [{"code": "86611", "type": "CPT"}, {"code": "7006626", "type": "CDM"}], "standard_charges": [{"gross_charge": 192.0, "discounted_cash": 144.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BARTONELLA AB/9", "code_information": [{"code": "86611", "type": "CPT"}, {"code": "7006627", "type": "CDM"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BARTONELLA AMP PRB", "code_information": [{"code": "87471", "type": "CPT"}, {"code": "7257471", "type": "CDM"}], "standard_charges": [{"gross_charge": 594.0, "discounted_cash": 445.5, "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": 30822.0, "discounted_cash": 23116.5, "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": 13833.0, "discounted_cash": 10374.75, "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": 13232.0, "discounted_cash": 9924.0, "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": 9058.0, "discounted_cash": 6793.5, "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": 11200.0, "discounted_cash": 8400.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BASE TIB UNCTD AS AESCULAP CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013350", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10081.0, "discounted_cash": 7560.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BASE TIBIAL COATD RP DEPUY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012827", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9058.0, "discounted_cash": 6793.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BASE TIBIAL COATED DEPUY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012826", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10869.0, "discounted_cash": 8151.75, "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": 15689.0, "discounted_cash": 11766.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BASEPLATE GLENOID MEDACTA CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013464", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 14580.0, "discounted_cash": 10935.0, "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": 23980.0, "discounted_cash": 17985.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BASEPLATE MODULAR INHANCE", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8131246", "type": "CDM"}], "standard_charges": [{"gross_charge": 15163.0, "discounted_cash": 11372.25, "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": 12028.0, "discounted_cash": 9021.0, "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": 486.0, "discounted_cash": 364.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BASIC METABOL PN ION CA", "code_information": [{"code": "80047", "type": "CPT"}, {"code": "4180047", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 367.0, "discounted_cash": 275.25, "setting": "both", "billing_class": "facility"}], "modifiers": "QW"}, {"description": "BASIC METABOLIC PANEL", "code_information": [{"code": "80048", "type": "CPT"}, {"code": "4100166", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 572.0, "discounted_cash": 429.0, "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": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BASIC METABOLIC PANEL", "code_information": [{"code": "80048", "type": "CPT"}, {"code": "4170166", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 450.0, "discounted_cash": 337.5, "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": 638.0, "discounted_cash": 478.5, "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": 886.0, "discounted_cash": 664.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BCR/ABL1 MAJOR BREAKPNT", "code_information": [{"code": "81206", "type": "CPT"}, {"code": "7270009", "type": "CDM"}], "standard_charges": [{"gross_charge": 834.0, "discounted_cash": 625.5, "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": 1018.0, "discounted_cash": 763.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 7498.0, "discounted_cash": 5623.5, "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": 7498.0, "discounted_cash": 5623.5, "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": 530.0, "discounted_cash": 397.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 530.0, "discounted_cash": 397.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BECLOMETHASN40MCG7.3GMIH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330382", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1401.0, "discounted_cash": 1050.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BECLOMETHASN40MCG7.3GMIH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330382", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1401.0, "discounted_cash": 1050.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BECLOMETHASN40MCG8.7GMIH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330384", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1371.0, "discounted_cash": 1028.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BECLOMETHASN40MCG8.7GMIH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330384", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1371.0, "discounted_cash": 1028.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BECLOMETHASN80MCG7.3GMIH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330381", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1210.0, "discounted_cash": 907.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BECLOMETHASN80MCG7.3GMIH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330381", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1210.0, "discounted_cash": 907.5, "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": 2148.0, "discounted_cash": 1611.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2148.0, "discounted_cash": 1611.0, "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": 237.0, "discounted_cash": 177.75, "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": 237.0, "discounted_cash": 177.75, "setting": "both", "billing_class": "facility"}], "modifiers": "JA"}, {"description": "BELLADNNA PHENBRB5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314330", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 98.0, "discounted_cash": 73.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BELLADNNA PHENBRB5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314330", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 98.0, "discounted_cash": 73.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BELLADONNA OPIUM 30MGSU", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5327802", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 177.0, "discounted_cash": 132.75, "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": 359.0, "discounted_cash": 269.25, "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": 101.0, "discounted_cash": 75.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 101.0, "discounted_cash": 75.75, "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": 124.0, "discounted_cash": 93.0, "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": 124.0, "discounted_cash": 93.0, "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": 101.0, "discounted_cash": 75.75, "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": 101.0, "discounted_cash": 75.75, "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": 143.0, "discounted_cash": 107.25, "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": 143.0, "discounted_cash": 107.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 201.0, "discounted_cash": 150.75, "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": 201.0, "discounted_cash": 150.75, "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": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "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": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZO/BUTA/TETR DOSE SP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334393", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZO/TETRA 5ML SP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5334391", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZOC SPRAY PER DOSE TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330396", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": 424.0, "discounted_cash": 318.0, "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": 424.0, "discounted_cash": 318.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZOCAIN 20%5.25GM MMGL", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334427", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 105.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZOCAIN 20%5.25GM MMGL", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334427", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 105.75, "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": 201.0, "discounted_cash": 150.75, "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": 201.0, "discounted_cash": 150.75, "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": 63.0, "discounted_cash": 47.25, "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": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZOCAINE 20% 30GM R OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5338130", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "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": 12.0, "discounted_cash": 9.0, "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": 12.0, "discounted_cash": 9.0, "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": 118.0, "discounted_cash": 88.5, "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": 118.0, "discounted_cash": 88.5, "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": 124.0, "discounted_cash": 93.0, "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": 124.0, "discounted_cash": 93.0, "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": 149.0, "discounted_cash": 111.75, "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": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZOCAINE20%82.5ML SP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334428", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZODIAZEPINES 1-12", "code_information": [{"code": "80346", "type": "CPT"}, {"code": "7058015", "type": "CDM"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZODIAZEPINES 1-12/5", "code_information": [{"code": "80346", "type": "CPT"}, {"code": "7252183", "type": "CDM"}], "standard_charges": [{"gross_charge": 601.0, "discounted_cash": 450.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZODIAZEPINES 1-12/7", "code_information": [{"code": "80346", "type": "CPT"}, {"code": "7252512", "type": "CDM"}], "standard_charges": [{"gross_charge": 679.0, "discounted_cash": 509.25, "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": 31.0, "discounted_cash": 23.25, "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": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZOIN TINCTURE 30ML TS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334443", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 621.0, "discounted_cash": 465.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZOIN TINCTURE 30ML TS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334443", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 621.0, "discounted_cash": 465.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZOIN TINCTURE 60ML TS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334445", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 83.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZOIN TINCTURE 60ML TS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334445", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 83.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZOIN TINCTURE120ML TS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334444", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 101.0, "discounted_cash": 75.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZOIN TINCTURE120ML TS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334444", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 101.0, "discounted_cash": 75.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZONATATE 100MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301499", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 10.0, "discounted_cash": 7.5, "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": 10.0, "discounted_cash": 7.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZTROPINE 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301522", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "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": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZTROPINE 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301526", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZTROPINE 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301526", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BENZTROPINE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0515", "type": "HCPCS"}, {"code": "5318538", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 609.0, "discounted_cash": 456.75, "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": 609.0, "discounted_cash": 456.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BERACTANT 25MG/ML 8ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5331535", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 12217.0, "discounted_cash": 9162.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BETA 2 GLYCOPROT I AB EA", "code_information": [{"code": "86146", "type": "CPT"}, {"code": "7006115", "type": "CDM"}], "standard_charges": [{"gross_charge": 804.0, "discounted_cash": 603.0, "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": 499.0, "discounted_cash": 374.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BETA 2 GLYCOPROT I AB EA/2", "code_information": [{"code": "86146", "type": "CPT"}, {"code": "7006116", "type": "CDM"}], "standard_charges": [{"gross_charge": 978.0, "discounted_cash": 733.5, "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": 574.0, "discounted_cash": 430.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BETA 2 GLYCOPROT I AB EA/3", "code_information": [{"code": "86146", "type": "CPT"}, {"code": "7006117", "type": "CDM"}], "standard_charges": [{"gross_charge": 804.0, "discounted_cash": 603.0, "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": 499.0, "discounted_cash": 374.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BETA-2-MICROGLOBLN", "code_information": [{"code": "82232", "type": "CPT"}, {"code": "4172232", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 200.0, "discounted_cash": 150.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BETA-2-MICROGLOBLN", "code_information": [{"code": "82232", "type": "CPT"}, {"code": "7252231", "type": "CDM"}], "standard_charges": [{"gross_charge": 254.0, "discounted_cash": 190.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BETA-2-MICROGLOBLN/2", "code_information": [{"code": "82232", "type": "CPT"}, {"code": "7002232", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 213.0, "discounted_cash": 159.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BETA-2-MICROGLOBLN/2", "code_information": [{"code": "82232", "type": "CPT"}, {"code": "7252232", "type": "CDM"}], "standard_charges": [{"gross_charge": 152.0, "discounted_cash": 114.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 220.0, "discounted_cash": 165.0, "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": 220.0, "discounted_cash": 165.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BETAMETHASON-D.05%15GOI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334505", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BETAMETHASON-D.05%15GOI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334505", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BETAMETHASON-D.05%45GMCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334515", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 385.0, "discounted_cash": 288.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BETAMETHASON-D.05%45GMCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334515", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 385.0, "discounted_cash": 288.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BETAMETHASON-D.05%60MLLT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334525", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 571.0, "discounted_cash": 428.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BETAMETHASON-D.05%60MLLT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334525", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 571.0, "discounted_cash": 428.25, "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": 427.0, "discounted_cash": 320.25, "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": 427.0, "discounted_cash": 320.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BETAMETHASON-V.1%15GMOI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334535", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BETAMETHASON-V.1%15GMOI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334535", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BETAMETHASON-V.1%60MLLT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334550", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BETAMETHASON-V.1%60MLLT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334550", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 124.0, "discounted_cash": 93.0, "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": 124.0, "discounted_cash": 93.0, "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": 1357.0, "discounted_cash": 1017.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BETAXOLOL .25% 10ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330406", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1357.0, "discounted_cash": 1017.75, "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": 592.0, "discounted_cash": 444.0, "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": 592.0, "discounted_cash": 444.0, "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": 592.0, "discounted_cash": 444.0, "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": 592.0, "discounted_cash": 444.0, "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": 174.0, "discounted_cash": 130.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 174.0, "discounted_cash": 130.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 190.0, "discounted_cash": 142.5, "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": 190.0, "discounted_cash": 142.5, "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": 919.0, "discounted_cash": 689.25, "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": 919.0, "discounted_cash": 689.25, "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": 237.0, "discounted_cash": 177.75, "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": 237.0, "discounted_cash": 177.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BG FECAL COLLECTION", "code_information": [{"code": "A4330", "type": "HCPCS"}, {"code": "8031126", "type": "CDM"}], "standard_charges": [{"gross_charge": 423.0, "discounted_cash": 317.25, "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": 621.0, "discounted_cash": 465.75, "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": 621.0, "discounted_cash": 465.75, "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": 403.0, "discounted_cash": 302.25, "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": 403.0, "discounted_cash": 302.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BILE ACIDS TOTAL", "code_information": [{"code": "82239", "type": "CPT"}, {"code": "7002241", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1323.0, "discounted_cash": 992.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BILE ACIDS TOTAL/2", "code_information": [{"code": "82239", "type": "CPT"}, {"code": "7252241", "type": "CDM"}], "standard_charges": [{"gross_charge": 130.0, "discounted_cash": 97.5, "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": 8657.0, "discounted_cash": 6492.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BILIARY ENDO DIL WO STNT", "code_information": [{"code": "4918205", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 12383.0, "discounted_cash": 9287.25, "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": 102.0, "discounted_cash": 76.5, "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": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BILIRUBIN DIRECT", "code_information": [{"code": "82248", "type": "CPT"}, {"code": "4172253", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 81.0, "discounted_cash": 60.75, "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": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BILIRUBIN TOTAL", "code_information": [{"code": "82247", "type": "CPT"}, {"code": "4172250", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 103.0, "discounted_cash": 77.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BILIRUBIN TOTAL", "code_information": [{"code": "82247", "type": "CPT"}, {"code": "7252247", "type": "CDM"}], "standard_charges": [{"gross_charge": 131.0, "discounted_cash": 98.25, "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": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BILIRUBIN TOTAL/2", "code_information": [{"code": "82247", "type": "CPT"}, {"code": "4172252", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 81.0, "discounted_cash": 60.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BILIRUBIN TOTAL/2", "code_information": [{"code": "82247", "type": "CPT"}, {"code": "7252250", "type": "CDM"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "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": 183.0, "discounted_cash": 137.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BIMATOPROST.01% 2.5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330416", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1158.0, "discounted_cash": 868.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BIMATOPROST.01% 2.5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330416", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1158.0, "discounted_cash": 868.5, "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": 1020.0, "discounted_cash": 765.0, "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": 1020.0, "discounted_cash": 765.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BIOFIRE 22 TRGT SARSCOV2", "code_information": [{"code": "202U", "type": "CPT"}, {"code": "7250513", "type": "CDM"}], "standard_charges": [{"gross_charge": 1817.0, "discounted_cash": 1362.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BIOPSY BONE DEEP", "code_information": [{"code": "4917503", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2205.0, "discounted_cash": 1653.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BIOPSY BONE DEEP", "code_information": [{"code": "5057503", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2205.0, "discounted_cash": 1653.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BIOPSY BONE SUPERFICIAL", "code_information": [{"code": "4907504", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2511.0, "discounted_cash": 1883.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BIOPSY BONE SUPERFICIAL", "code_information": [{"code": "4917504", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2243.0, "discounted_cash": 1682.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BIOPSY BONE SUPERFICIAL", "code_information": [{"code": "5057504", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2205.0, "discounted_cash": 1653.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BIOTINIDASE EA SPEC", "code_information": [{"code": "82261", "type": "CPT"}, {"code": "7252261", "type": "CDM"}], "standard_charges": [{"gross_charge": 293.0, "discounted_cash": 219.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BIPAP INITIAL", "code_information": [{"code": "94660", "type": "CPT"}, {"code": "3111857", "type": "CDM"}, {"code": "410", "type": "RC"}], "standard_charges": [{"gross_charge": 1959.0, "discounted_cash": 1469.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BIPAP INITIAL", "code_information": [{"code": "94660", "type": "CPT"}, {"code": "5501857", "type": "CDM"}, {"code": "410", "type": "RC"}], "standard_charges": [{"gross_charge": 1959.0, "discounted_cash": 1469.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BIPAP MANAGEMENT DLY", "code_information": [{"code": "94660", "type": "CPT"}, {"code": "3114660", "type": "CDM"}, {"code": "410", "type": "RC"}], "standard_charges": [{"gross_charge": 1754.0, "discounted_cash": 1315.5, "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": 1754.0, "discounted_cash": 1315.5, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BISMUTH SUBSALI 15ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316006", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BISMUTH SUBSALI 15ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316006", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "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": 12.0, "discounted_cash": 9.0, "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": 12.0, "discounted_cash": 9.0, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BISMUTH SUBSLCY262MG CTB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301616", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BISOPRL/HCTZ 2.5/6.25 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301607", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BISOPRL/HCTZ 2.5/6.25 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301607", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BISOPROL/HCTZ 10/6.25 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301609", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BISOPROL/HCTZ 10/6.25 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301609", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BISOPROL/HCTZ 5/6.25 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301608", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BISOPROL/HCTZ 5/6.25 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301608", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "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": 128.0, "discounted_cash": 96.0, "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": 128.0, "discounted_cash": 96.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "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": 76.0, "discounted_cash": 57.0, "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": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BIVALIRUDIN PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0583", "type": "HCPCS"}, {"code": "5318617", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BLASTOMYCES AB", "code_information": [{"code": "86612", "type": "CPT"}, {"code": "7006168", "type": "CDM"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 105.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BLASTOMYCES AB/2", "code_information": [{"code": "86612", "type": "CPT"}, {"code": "7258696", "type": "CDM"}], "standard_charges": [{"gross_charge": 165.0, "discounted_cash": 123.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD AUTOSLV INTRA/PSOP", "code_information": [{"code": "86891", "type": "CPT"}, {"code": "3216891", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 4692.0, "discounted_cash": 3519.0, "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": 2564.0, "discounted_cash": 1923.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD CUTTR TURBOHAWK SUPR", "code_information": [{"code": "C1714", "type": "HCPCS"}, {"code": "8172283", "type": "CDM"}], "standard_charges": [{"gross_charge": 37241.0, "discounted_cash": 27930.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD DEGLYCEROLIZED RBC", "code_information": [{"code": "P9039", "type": "HCPCS"}, {"code": "4500027", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 1892.0, "discounted_cash": 1419.0, "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": 965.0, "discounted_cash": 723.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD LEUKO REDCD FROZEN DEGLYCE", "code_information": [{"code": "P9054", "type": "HCPCS"}, {"code": "4509054", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 1799.0, "discounted_cash": 1349.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD PLASMA FROZEN", "code_information": [{"code": "P9017", "type": "HCPCS"}, {"code": "4500018", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 223.0, "discounted_cash": 167.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD PLATELET PHERESIS", "code_information": [{"code": "P9034", "type": "HCPCS"}, {"code": "4500026", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 594.0, "discounted_cash": 445.5, "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": 1545.0, "discounted_cash": 1158.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD RBC IRRAD PED", "code_information": [{"code": "P9038", "type": "HCPCS"}, {"code": "4506129", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 1092.0, "discounted_cash": 819.0, "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": 1055.0, "discounted_cash": 791.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD RCELLS WASHED", "code_information": [{"code": "P9022", "type": "HCPCS"}, {"code": "4500011", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 674.0, "discounted_cash": 505.5, "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": 142.0, "discounted_cash": 106.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD SMR EXAM W/DIFF", "code_information": [{"code": "85007", "type": "CPT"}, {"code": "4175007", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 83.25, "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": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD SMR EXAM W/O DIFF", "code_information": [{"code": "85008", "type": "CPT"}, {"code": "4175008", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "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": 219.0, "discounted_cash": 164.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD TYPE ABO", "code_information": [{"code": "86900", "type": "CPT"}, {"code": "4126080", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 505.0, "discounted_cash": 378.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD TYPE ABO", "code_information": [{"code": "86900", "type": "CPT"}, {"code": "4176080", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 172.0, "discounted_cash": 129.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD TYPE ABO", "code_information": [{"code": "86900", "type": "CPT"}, {"code": "7196080", "type": "CDM"}], "standard_charges": [{"gross_charge": 505.0, "discounted_cash": 378.75, "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": 675.0, "discounted_cash": 506.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD TYPE ANTIGEN DONOR EA", "code_information": [{"code": "86902", "type": "CPT"}, {"code": "4176906", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 54.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD TYPE ANTIGEN DONOR EA", "code_information": [{"code": "86902", "type": "CPT"}, {"code": "7196902", "type": "CDM"}], "standard_charges": [{"gross_charge": 1420.0, "discounted_cash": 1065.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD TYPE PAT SERUM SCRN", "code_information": [{"code": "86904", "type": "CPT"}, {"code": "4176073", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 123.0, "discounted_cash": 92.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD TYPE PAT SERUM SCRN", "code_information": [{"code": "86904", "type": "CPT"}, {"code": "7198691", "type": "CDM"}], "standard_charges": [{"gross_charge": 157.0, "discounted_cash": 117.75, "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": 171.0, "discounted_cash": 128.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD TYPE RH (D)", "code_information": [{"code": "86901", "type": "CPT"}, {"code": "4126100", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 158.0, "discounted_cash": 118.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD TYPE RH (D)", "code_information": [{"code": "86901", "type": "CPT"}, {"code": "4176100", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 134.0, "discounted_cash": 100.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD TYPE RH (D)", "code_information": [{"code": "86901", "type": "CPT"}, {"code": "7196100", "type": "CDM"}], "standard_charges": [{"gross_charge": 97.0, "discounted_cash": 72.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD TYPE RH PHENOTYP CMP", "code_information": [{"code": "86906", "type": "CPT"}, {"code": "7196906", "type": "CDM"}], "standard_charges": [{"gross_charge": 154.0, "discounted_cash": 115.5, "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": 38.0, "discounted_cash": 28.5, "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": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BLD UREA NITROGEN QUAN", "code_information": [{"code": "84520", "type": "CPT"}, {"code": "4174520", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 30.0, "discounted_cash": 22.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BLEEDING TIME", "code_information": [{"code": "85002", "type": "CPT"}, {"code": "4105003", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 254.0, "discounted_cash": 190.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BLEEDING TIME", "code_information": [{"code": "85002", "type": "CPT"}, {"code": "4175003", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 200.0, "discounted_cash": 150.0, "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": 1235.0, "discounted_cash": 926.25, "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": 1235.0, "discounted_cash": 926.25, "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": 19.0, "discounted_cash": 14.25, "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": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BLISTEX 9.9GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334608", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BLISTEX 9.9GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334608", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BLLN MOLDING & OCCULUSION", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8057700", "type": "CDM"}], "standard_charges": [{"gross_charge": 4979.0, "discounted_cash": 3734.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BLN DISSECT SPACEMAKER", "code_information": [{"code": "C1726", "type": "HCPCS"}, {"code": "8240010", "type": "CDM"}], "standard_charges": [{"gross_charge": 7134.0, "discounted_cash": 5350.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BLOOD ADMINISTRATION 1-2 UNITS", "code_information": [{"code": "36430", "type": "CPT"}, {"code": "6290011", "type": "CDM"}, {"code": "391", "type": "RC"}], "standard_charges": [{"gross_charge": 1438.0, "discounted_cash": 1078.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BLOOD ADMINISTRATION 3-4 UNITS", "code_information": [{"code": "36430", "type": "CPT"}, {"code": "6290012", "type": "CDM"}, {"code": "391", "type": "RC"}], "standard_charges": [{"gross_charge": 1578.0, "discounted_cash": 1183.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BLOOD ADMINISTRATION 5-6 UNITS", "code_information": [{"code": "36430", "type": "CPT"}, {"code": "6290013", "type": "CDM"}, {"code": "391", "type": "RC"}], "standard_charges": [{"gross_charge": 1743.0, "discounted_cash": 1307.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BLOOD ADMINISTRATION 7-8 UNITS", "code_information": [{"code": "36430", "type": "CPT"}, {"code": "6290014", "type": "CDM"}, {"code": "391", "type": "RC"}], "standard_charges": [{"gross_charge": 1914.0, "discounted_cash": 1435.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BLOOD ADMINISTRATION 9-10 UNIT", "code_information": [{"code": "36430", "type": "CPT"}, {"code": "6290015", "type": "CDM"}, {"code": "391", "type": "RC"}], "standard_charges": [{"gross_charge": 2107.0, "discounted_cash": 1580.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BLOOD ADMINISTRATION >10 UNITS", "code_information": [{"code": "36430", "type": "CPT"}, {"code": "6290016", "type": "CDM"}, {"code": "391", "type": "RC"}], "standard_charges": [{"gross_charge": 2318.0, "discounted_cash": 1738.5, "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": 216.0, "discounted_cash": 162.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BLOOD DIRECTED UNIT", "code_information": [{"code": "P9021", "type": "HCPCS"}, {"code": "4506100", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 1341.0, "discounted_cash": 1005.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BLOOD GAS ARTERIAL STICK", "code_information": [{"code": "36600", "type": "CPT"}, {"code": "5501104", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 384.0, "discounted_cash": 288.0, "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": 168.0, "discounted_cash": 126.0, "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": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BLOOD HEMOGLBN", "code_information": [{"code": "85018", "type": "CPT"}, {"code": "4175018", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 132.0, "discounted_cash": 99.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BLOOD PLASMAPHERESIS", "code_information": [{"code": "4202320", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6319.0, "discounted_cash": 4739.25, "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": 170.0, "discounted_cash": 127.5, "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": 697.0, "discounted_cash": 522.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BLOOD WHOLE", "code_information": [{"code": "P9010", "type": "HCPCS"}, {"code": "4500001", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 1130.0, "discounted_cash": 847.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BLS NON-TRANSPORT", "code_information": [{"code": "6303001", "type": "CDM"}, {"code": "540", "type": "RC"}], "standard_charges": [{"gross_charge": 130.0, "discounted_cash": 97.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BN BLOCKS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131260", "type": "CDM"}], "standard_charges": [{"gross_charge": 6569.0, "discounted_cash": 4926.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BN CEMENT GV SPECTRUM40", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131319", "type": "CDM"}], "standard_charges": [{"gross_charge": 3838.0, "discounted_cash": 2878.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BN CHIPS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131275", "type": "CDM"}], "standard_charges": [{"gross_charge": 4980.0, "discounted_cash": 3735.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BN FILLER", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131276", "type": "CDM"}], "standard_charges": [{"gross_charge": 13197.0, "discounted_cash": 9897.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BN GEL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8031368", "type": "CDM"}], "standard_charges": [{"gross_charge": 5169.0, "discounted_cash": 3876.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BN GEL/PUTTY 10CC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8031369", "type": "CDM"}], "standard_charges": [{"gross_charge": 20863.0, "discounted_cash": 15647.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BN GEL/PUTTY 1CC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8038143", "type": "CDM"}], "standard_charges": [{"gross_charge": 2709.0, "discounted_cash": 2031.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BN GEL/PUTTY 2CC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8031363", "type": "CDM"}], "standard_charges": [{"gross_charge": 6491.0, "discounted_cash": 4868.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BN GEL/PUTTY 5CC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8031366", "type": "CDM"}], "standard_charges": [{"gross_charge": 6422.0, "discounted_cash": 4816.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BN GRANUELS 15CC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131282", "type": "CDM"}], "standard_charges": [{"gross_charge": 9193.0, "discounted_cash": 6894.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BN GRANUELS 30CC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131283", "type": "CDM"}], "standard_charges": [{"gross_charge": 14701.0, "discounted_cash": 11025.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BN GRFT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131285", "type": "CDM"}], "standard_charges": [{"gross_charge": 3599.0, "discounted_cash": 2699.25, "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": 44923.0, "discounted_cash": 33692.25, "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": 44663.0, "discounted_cash": 33497.25, "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": 34359.0, "discounted_cash": 25769.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BN GRFT INFS XSM", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011002", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 17201.0, "discounted_cash": 12900.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BN GRFT INJ 10CC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131294", "type": "CDM"}], "standard_charges": [{"gross_charge": 11619.0, "discounted_cash": 8714.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BN GRFT INJ 5CC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131289", "type": "CDM"}], "standard_charges": [{"gross_charge": 11099.0, "discounted_cash": 8324.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BN GRFT INJ HI-STR 15CC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131292", "type": "CDM"}], "standard_charges": [{"gross_charge": 34537.0, "discounted_cash": 25902.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BN GRFT INJ HI-STR 5CC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131291", "type": "CDM"}], "standard_charges": [{"gross_charge": 23392.0, "discounted_cash": 17544.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BN PASTE 1", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8031372", "type": "CDM"}], "standard_charges": [{"gross_charge": 13039.0, "discounted_cash": 9779.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BN PLUGS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131290", "type": "CDM"}], "standard_charges": [{"gross_charge": 196.0, "discounted_cash": 147.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BN STRIP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011050", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12549.0, "discounted_cash": 9411.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BOLT LOCKING 1", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131317", "type": "CDM"}], "standard_charges": [{"gross_charge": 4619.0, "discounted_cash": 3464.25, "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": 1093.0, "discounted_cash": 819.75, "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": 1093.0, "discounted_cash": 819.75, "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": 1093.0, "discounted_cash": 819.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BONE AGE STUDIES", "code_information": [{"code": "77072", "type": "CPT"}, {"code": "5127072", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1093.0, "discounted_cash": 819.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BONE IMAG 3 PHASE STUDY", "code_information": [{"code": "78315", "type": "CPT"}, {"code": "5208315", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 3063.0, "discounted_cash": 2297.25, "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": 2397.0, "discounted_cash": 1797.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BONE IMAGING MULTIPLE", "code_information": [{"code": "78305", "type": "CPT"}, {"code": "5208305", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 4704.0, "discounted_cash": 3528.0, "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": 3538.0, "discounted_cash": 2653.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BONE LENGTH STUDIES", "code_information": [{"code": "77073", "type": "CPT"}, {"code": "5117073", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 915.0, "discounted_cash": 686.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BONE LENGTH STUDIES", "code_information": [{"code": "77073", "type": "CPT"}, {"code": "5127073", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 915.0, "discounted_cash": 686.25, "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": 3397.0, "discounted_cash": 2547.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BONE PUTTY", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8031657", "type": "CDM"}], "standard_charges": [{"gross_charge": 25236.0, "discounted_cash": 18927.0, "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": 1542.0, "discounted_cash": 1156.5, "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": 1542.0, "discounted_cash": 1156.5, "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": 1542.0, "discounted_cash": 1156.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BONE SURVEY COMPLETE", "code_information": [{"code": "77075", "type": "CPT"}, {"code": "5127075", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1542.0, "discounted_cash": 1156.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BONE SURVEY INFANT", "code_information": [{"code": "77076", "type": "CPT"}, {"code": "4906065", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1659.0, "discounted_cash": 1244.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BORDETELLA AB", "code_information": [{"code": "86615", "type": "CPT"}, {"code": "7256924", "type": "CDM"}], "standard_charges": [{"gross_charge": 444.0, "discounted_cash": 333.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BORDETELLA AB/3", "code_information": [{"code": "86615", "type": "CPT"}, {"code": "7256929", "type": "CDM"}], "standard_charges": [{"gross_charge": 159.0, "discounted_cash": 119.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BORDETELLA AB/4", "code_information": [{"code": "86615", "type": "CPT"}, {"code": "7007434", "type": "CDM"}], "standard_charges": [{"gross_charge": 553.0, "discounted_cash": 414.75, "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": 283.0, "discounted_cash": 212.25, "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": 283.0, "discounted_cash": 212.25, "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": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BOTULINUM TOXIN A PERUIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0585", "type": "HCPCS"}, {"code": "5318651", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BRAF V600E VARIANT", "code_information": [{"code": "81210", "type": "CPT"}, {"code": "7270012", "type": "CDM"}], "standard_charges": [{"gross_charge": 1215.0, "discounted_cash": 911.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BRAIN < 4VWS W VASC FLOW", "code_information": [{"code": "78601", "type": "CPT"}, {"code": "5208601", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 2819.0, "discounted_cash": 2114.25, "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": 1620.0, "discounted_cash": 1215.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BRCA 1&2 GENE FULL SEQ ALYS", "code_information": [{"code": "81163", "type": "CPT"}, {"code": "7270174", "type": "CDM"}], "standard_charges": [{"gross_charge": 2381.0, "discounted_cash": 1785.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BRIMO-TIMOL .2/.5 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330426", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1013.0, "discounted_cash": 759.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BRIMO-TIMOL .2/.5 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330426", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1013.0, "discounted_cash": 759.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BRIMONIDINE .1% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330427", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 719.0, "discounted_cash": 539.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BRIMONIDINE .1% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330427", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 719.0, "discounted_cash": 539.25, "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": 367.0, "discounted_cash": 275.25, "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": 367.0, "discounted_cash": 275.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BRIMONIDINE .2% 10ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330438", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1312.0, "discounted_cash": 984.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BRIMONIDINE .2% 10ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330438", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1312.0, "discounted_cash": 984.0, "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": 292.0, "discounted_cash": 219.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 292.0, "discounted_cash": 219.0, "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": 1030.0, "discounted_cash": 772.5, "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": 1030.0, "discounted_cash": 772.5, "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": 461.0, "discounted_cash": 345.75, "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": 461.0, "discounted_cash": 345.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BRN IMG PET PERFSN EVAL", "code_information": [{"code": "78609", "type": "CPT"}, {"code": "5238609", "type": "CDM"}, {"code": "404", "type": "RC"}], "standard_charges": [{"gross_charge": 13718.0, "discounted_cash": 10288.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 293.0, "discounted_cash": 219.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BROMOCRIPTINE 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301680", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 293.0, "discounted_cash": 219.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BROMPHEN/PE/DM 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314410", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 340.0, "discounted_cash": 255.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BROMPHEN/PE/DM 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314410", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 340.0, "discounted_cash": 255.0, "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": 70.0, "discounted_cash": 52.5, "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": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BRONCH ASPIRATN INITIAL", "code_information": [{"code": "5500671", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 12285.0, "discounted_cash": 9213.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BRONCH ASPIRATN SUBSEQ", "code_information": [{"code": "5500673", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3501.0, "discounted_cash": 2625.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BRONCH EBUS SAMPLNG 3/> NODE", "code_information": [{"code": "5501653", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 10278.0, "discounted_cash": 7708.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BRONCH NON-DIAG BEDSIDE", "code_information": [{"code": "5500674", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 11341.0, "discounted_cash": 8505.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BRONCH THRU TRACHEOSTMY", "code_information": [{"code": "5500663", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3928.0, "discounted_cash": 2946.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BRONCHOSCOPE ASCOPE 4", "code_information": [{"code": "A4649", "type": "HCPCS"}, {"code": "8031429", "type": "CDM"}], "standard_charges": [{"gross_charge": 4120.0, "discounted_cash": 3090.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BRONCHOSCOPY DIAGNOSTIC", "code_information": [{"code": "5500655", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 11341.0, "discounted_cash": 8505.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BRONCHOSCOPY DX W/BRSH", "code_information": [{"code": "5501011", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 11341.0, "discounted_cash": 8505.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BRONCHOSCOPY W BIOPSY", "code_information": [{"code": "5500660", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 11341.0, "discounted_cash": 8505.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BRONCHOSCP GLIDESCOPE BFLEX", "code_information": [{"code": "A4649", "type": "HCPCS"}, {"code": "8031428", "type": "CDM"}], "standard_charges": [{"gross_charge": 1085.0, "discounted_cash": 813.75, "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": 3081.0, "discounted_cash": 2310.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BRONCHSCPY ALVEOLAR LVG", "code_information": [{"code": "5501012", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 11341.0, "discounted_cash": 8505.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BRSH CYTOLOGY", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8172788", "type": "CDM"}], "standard_charges": [{"gross_charge": 140.0, "discounted_cash": 105.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BRUCELLA AB", "code_information": [{"code": "86622", "type": "CPT"}, {"code": "7006622", "type": "CDM"}], "standard_charges": [{"gross_charge": 576.0, "discounted_cash": 432.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BRUCELLA AB/2", "code_information": [{"code": "86622", "type": "CPT"}, {"code": "7256628", "type": "CDM"}], "standard_charges": [{"gross_charge": 183.0, "discounted_cash": 137.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BRUCELLA AB/3", "code_information": [{"code": "86622", "type": "CPT"}, {"code": "7256635", "type": "CDM"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "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": 11424.0, "discounted_cash": 8568.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BSE TB UNCTD ALL PLY MEDACT CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013456", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 14917.0, "discounted_cash": 11187.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BSK RETRV", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8041071", "type": "CDM"}], "standard_charges": [{"gross_charge": 2780.0, "discounted_cash": 2085.0, "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": 143.0, "discounted_cash": 107.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2462.0, "discounted_cash": 1846.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BUDE/FORMOT160/4.5 6GMIH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330463", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2462.0, "discounted_cash": 1846.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BUDE/FORMT160/4 1DOSE IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330466", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BUDE/FORMT160/4 1DOSE IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330466", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BUDE/FORMT160/4.5 10GMIH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330460", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2080.0, "discounted_cash": 1560.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BUDE/FORMT160/4.5 10GMIH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330460", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2080.0, "discounted_cash": 1560.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BUDES/FORMOT80/4.5 6GMIH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330462", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1833.0, "discounted_cash": 1374.75, "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": 1833.0, "discounted_cash": 1374.75, "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": 29.0, "discounted_cash": 21.75, "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": 29.0, "discounted_cash": 21.75, "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": 29.0, "discounted_cash": 21.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 29.0, "discounted_cash": 21.75, "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": 97.0, "discounted_cash": 72.75, "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": 97.0, "discounted_cash": 72.75, "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": 292.0, "discounted_cash": 219.0, "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": 292.0, "discounted_cash": 219.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BUDESONIDE NAS 7GM IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330436", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 197.0, "discounted_cash": 147.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BUDESONIDE NAS 7GM IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330436", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 197.0, "discounted_cash": 147.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BUDESONIDE NAS 8.6GM SP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330337", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1247.0, "discounted_cash": 935.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BUDESONIDE NAS 8.6GM SP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330337", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1247.0, "discounted_cash": 935.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BUDESONIDE180MCG PW IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330428", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 925.0, "discounted_cash": 693.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BUDESONIDE180MCG PW IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330428", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 925.0, "discounted_cash": 693.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BULLOUS PEMPHIGOID AB", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "7253031", "type": "CDM"}], "standard_charges": [{"gross_charge": 207.0, "discounted_cash": 155.25, "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": 44.0, "discounted_cash": 33.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 44.0, "discounted_cash": 33.0, "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": 14.0, "discounted_cash": 10.5, "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": 14.0, "discounted_cash": 10.5, "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": 97.0, "discounted_cash": 72.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BUMETANIDE PER .5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1939", "type": "HCPCS"}, {"code": "5318684", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 97.0, "discounted_cash": 72.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.89, "discounted_cash": 0.67, "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": 0.89, "discounted_cash": 0.67, "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": 0.31, "discounted_cash": 0.23, "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": 0.31, "discounted_cash": 0.23, "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": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPIVACAIN LIPO PER1MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0666", "type": "HCPCS"}, {"code": "5318692", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "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": 0.25, "discounted_cash": 0.19, "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": 0.25, "discounted_cash": 0.19, "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": 0.03, "discounted_cash": 0.02, "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": 0.03, "discounted_cash": 0.02, "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": 11.0, "discounted_cash": 8.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPRENORPHINE 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301754", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 11.0, "discounted_cash": 8.25, "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": 14.0, "discounted_cash": 10.5, "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": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPRENORPHINE/3", "code_information": [{"code": "80348", "type": "CPT"}, {"code": "7253963", "type": "CDM"}], "standard_charges": [{"gross_charge": 177.0, "discounted_cash": 132.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPROPION 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301746", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "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": 174.0, "discounted_cash": 130.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 174.0, "discounted_cash": 130.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPROPION 150MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301749", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 173.0, "discounted_cash": 129.75, "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": 173.0, "discounted_cash": 129.75, "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": 293.0, "discounted_cash": 219.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 293.0, "discounted_cash": 219.75, "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": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BUPROPION 75MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301745", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BURR HOLE COVER II", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8172867", "type": "CDM"}], "standard_charges": [{"gross_charge": 2842.0, "discounted_cash": 2131.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BUSHING DISTAL FEMORAL", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8131342", "type": "CDM"}], "standard_charges": [{"gross_charge": 2522.0, "discounted_cash": 1891.5, "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": 10.0, "discounted_cash": 7.5, "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": 10.0, "discounted_cash": 7.5, "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": 12.0, "discounted_cash": 9.0, "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": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BUTORPHANOL NS 2.5ML SP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330440", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 901.0, "discounted_cash": 675.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BUTORPHANOL NS 2.5ML SP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330440", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 901.0, "discounted_cash": 675.75, "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": 134.0, "discounted_cash": 100.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BUTORPHANOL PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0595", "type": "HCPCS"}, {"code": "5318752", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 134.0, "discounted_cash": 100.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BUTTON CBL HEX LCK PLT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131343", "type": "CDM"}], "standard_charges": [{"gross_charge": 2458.0, "discounted_cash": 1843.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BUTTON DSTL CLV PLT KNTLS ASSM", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011052", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12064.0, "discounted_cash": 9048.0, "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": 1957.0, "discounted_cash": 1467.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BX BONE SPRFICIAL OPEN", "code_information": [{"code": "6909897", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1545.0, "discounted_cash": 1158.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BX BONE SPRFICIAL OPEN", "code_information": [{"code": "6909897", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 1545.0, "discounted_cash": 1158.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BX BRST 1ST LESION MR", "code_information": [{"code": "5259185", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 13303.0, "discounted_cash": 9977.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BX BRST 1ST LESION STRTC", "code_information": [{"code": "5019081", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 12286.0, "discounted_cash": 9214.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BX BRST 1ST LESION STRTC", "code_information": [{"code": "5129081", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 12286.0, "discounted_cash": 9214.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BX BRST 1ST LESION US", "code_information": [{"code": "5019183", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 14743.0, "discounted_cash": 11057.25, "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": 14743.0, "discounted_cash": 11057.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BX BRST ADD LESION MR", "code_information": [{"code": "5259186", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4764.0, "discounted_cash": 3573.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BX BRST ADD LESION STRTC", "code_information": [{"code": "5019182", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3088.0, "discounted_cash": 2316.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BX BRST ADD LESION STRTC", "code_information": [{"code": "5129182", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3088.0, "discounted_cash": 2316.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BX BRST ADD LESION US", "code_information": [{"code": "5019184", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3735.0, "discounted_cash": 2801.25, "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": 4404.0, "discounted_cash": 3303.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BX BRST ADD LESION US", "code_information": [{"code": "5129184", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3735.0, "discounted_cash": 2801.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BX LIVER PERC NDL", "code_information": [{"code": "4918215", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2134.0, "discounted_cash": 1600.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BX LIVER PERC NDL", "code_information": [{"code": "5058215", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2134.0, "discounted_cash": 1600.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BX LIVER PERC NDL", "code_information": [{"code": "5067520", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2134.0, "discounted_cash": 1600.5, "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": 2607.0, "discounted_cash": 1955.25, "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": 2607.0, "discounted_cash": 1955.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BX MUSCLE PERC NDL", "code_information": [{"code": "4917511", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4698.0, "discounted_cash": 3523.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BX MUSCLE PERC NDL", "code_information": [{"code": "5057511", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3608.0, "discounted_cash": 2706.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BX MUSCLE PERC NDL", "code_information": [{"code": "5067515", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3707.0, "discounted_cash": 2780.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BX PANCREAS PERC NDL", "code_information": [{"code": "4917512", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7400.0, "discounted_cash": 5550.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BX PANCREAS PERC NDL", "code_information": [{"code": "5057512", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6801.0, "discounted_cash": 5100.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BX PLEURA PERC NDL", "code_information": [{"code": "5057505", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1865.0, "discounted_cash": 1398.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BX RENAL PERC NDL", "code_information": [{"code": "5057514", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2358.0, "discounted_cash": 1768.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BX RENAL PERC NDL", "code_information": [{"code": "5067535", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2878.0, "discounted_cash": 2158.5, "setting": "both", "billing_class": "facility"}]}, {"description": "BX SOFT PELVIS/HIP DEEP", "code_information": [{"code": "5057515", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2500.0, "discounted_cash": 1875.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BX SOFT PELVIS/HIP SPFC", "code_information": [{"code": "5057040", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2084.0, "discounted_cash": 1563.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BX SOFT PELVIS/HIP SPFC", "code_information": [{"code": "5067040", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2084.0, "discounted_cash": 1563.0, "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": 4791.0, "discounted_cash": 3593.25, "setting": "both", "billing_class": "facility"}]}, {"description": "BX SOFT TISSUE NECK/THOR", "code_information": [{"code": "5068575", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2576.0, "discounted_cash": 1932.0, "setting": "both", "billing_class": "facility"}]}, {"description": "BX THYROID PERC NDL", "code_information": [{"code": "5057509", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2805.0, "discounted_cash": 2103.75, "setting": "both", "billing_class": "facility"}]}, {"description": "BX THYROID PERC NDL", "code_information": [{"code": "5067545", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2236.0, "discounted_cash": 1677.0, "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": 764.0, "discounted_cash": 573.0, "setting": "both", "billing_class": "facility"}]}, {"description": "C DIFF TOXIN AMP PROBE", "code_information": [{"code": "87493", "type": "CPT"}, {"code": "4177493", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 601.0, "discounted_cash": 450.75, "setting": "both", "billing_class": "facility"}]}, {"description": "C FUNGI SKIN HAIR NAIL", "code_information": [{"code": "87101", "type": "CPT"}, {"code": "4107101", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 128.0, "discounted_cash": 96.0, "setting": "both", "billing_class": "facility"}]}, {"description": "C FUNGI SKIN HAIR NAIL", "code_information": [{"code": "87101", "type": "CPT"}, {"code": "4177101", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 100.0, "discounted_cash": 75.0, "setting": "both", "billing_class": "facility"}]}, {"description": "C-PEPTIDE", "code_information": [{"code": "84681", "type": "CPT"}, {"code": "4103976", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 91.0, "discounted_cash": 68.25, "setting": "both", "billing_class": "facility"}]}, {"description": "C-PEPTIDE", "code_information": [{"code": "84681", "type": "CPT"}, {"code": "4173976", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 253.0, "discounted_cash": 189.75, "setting": "both", "billing_class": "facility"}]}, {"description": "C-PEPTIDE", "code_information": [{"code": "84681", "type": "CPT"}, {"code": "7003976", "type": "CDM"}], "standard_charges": [{"gross_charge": 232.0, "discounted_cash": 174.0, "setting": "both", "billing_class": "facility"}]}, {"description": "C-PEPTIDE", "code_information": [{"code": "84681", "type": "CPT"}, {"code": "7253976", "type": "CDM"}], "standard_charges": [{"gross_charge": 322.0, "discounted_cash": 241.5, "setting": "both", "billing_class": "facility"}]}, {"description": "C-REACTIVE PROTEIN", "code_information": [{"code": "86140", "type": "CPT"}, {"code": "4106021", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 101.0, "discounted_cash": 75.75, "setting": "both", "billing_class": "facility"}]}, {"description": "C-REACTIVE PROTEIN", "code_information": [{"code": "86140", "type": "CPT"}, {"code": "4176021", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 80.0, "discounted_cash": 60.0, "setting": "both", "billing_class": "facility"}]}, {"description": "C-REACTIVE PROTEIN", "code_information": [{"code": "86140", "type": "CPT"}, {"code": "7006021", "type": "CDM"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "C-REACTIVE PROTEIN", "code_information": [{"code": "86140", "type": "CPT"}, {"code": "7256021", "type": "CDM"}], "standard_charges": [{"gross_charge": 146.0, "discounted_cash": 109.5, "setting": "both", "billing_class": "facility"}]}, {"description": "C-REACTIVE PROTEIN/2", "code_information": [{"code": "86140", "type": "CPT"}, {"code": "4126025", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "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": 3556.0, "discounted_cash": 2667.0, "setting": "both", "billing_class": "facility"}]}, {"description": "C1 INHIBITOR (EIA) FUNCT", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7003954", "type": "CDM"}], "standard_charges": [{"gross_charge": 425.0, "discounted_cash": 318.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CA CARB VITD 250/125TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301833", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CA CARB VITD 250/125TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301833", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CA CARB VITD 500/200TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301834", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CA CARB VITD 600/200 TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301826", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CA CARB VITD 600/200 TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301826", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CA CIT/VITD 200/200 TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301828", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CA CIT/VITD 200/200 TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301828", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CA CIT/VITD 315/200 TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301832", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CA CIT/VITD 315/200 TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301832", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CA GLUC 1GM NS 100ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5318826", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 431.0, "discounted_cash": 323.25, "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": 0.45, "discounted_cash": 0.34, "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": 0.45, "discounted_cash": 0.34, "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": 371.0, "discounted_cash": 278.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 371.0, "discounted_cash": 278.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CACL PER 2MG PFS IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0618", "type": "HCPCS"}, {"code": "5318804", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.05, "discounted_cash": 0.04, "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": 0.05, "discounted_cash": 0.04, "setting": "both", "billing_class": "facility"}]}, {"description": "CADMIUM", "code_information": [{"code": "82300", "type": "CPT"}, {"code": "7252300", "type": "CDM"}], "standard_charges": [{"gross_charge": 473.0, "discounted_cash": 354.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CADMIUM/2", "code_information": [{"code": "82300", "type": "CPT"}, {"code": "7002302", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 209.0, "discounted_cash": 156.75, "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": 719.0, "discounted_cash": 539.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CAFFEINE CIT 60MG/3ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314439", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 719.0, "discounted_cash": 539.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CAFFEINE CIT PER 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0706", "type": "HCPCS"}, {"code": "5318762", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "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": 53.0, "discounted_cash": 39.75, "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": 399.0, "discounted_cash": 299.25, "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": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CALAMINE 120ML LT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334659", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CALAMINE 180ML LT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334655", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCIPOTRIENE 60GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334666", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 157.0, "discounted_cash": 117.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCIPOTRIENE 60GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334666", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 157.0, "discounted_cash": 117.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCITONIN", "code_information": [{"code": "82308", "type": "CPT"}, {"code": "7002308", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 290.0, "discounted_cash": 217.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCITONIN", "code_information": [{"code": "82308", "type": "CPT"}, {"code": "7252308", "type": "CDM"}], "standard_charges": [{"gross_charge": 794.0, "discounted_cash": 595.5, "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": 147.0, "discounted_cash": 110.25, "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": 147.0, "discounted_cash": 110.25, "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": 10392.0, "discounted_cash": 7794.0, "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": 10392.0, "discounted_cash": 7794.0, "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": 982.0, "discounted_cash": 736.5, "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": 982.0, "discounted_cash": 736.5, "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": 95.0, "discounted_cash": 71.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "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": 26.0, "discounted_cash": 19.5, "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": 26.0, "discounted_cash": 19.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCITRIOL1MCG/ML 15MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314471", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1778.0, "discounted_cash": 1333.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCITRIOL1MCG/ML 15MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314471", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1778.0, "discounted_cash": 1333.5, "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": 68.0, "discounted_cash": 51.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "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": 71.0, "discounted_cash": 53.25, "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": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCIUM", "code_information": [{"code": "82310", "type": "CPT"}, {"code": "4172310", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 56.0, "discounted_cash": 42.0, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCIUM ACETATE 667MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301810", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCIUM CARB 1.25GM TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301813", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.9, "discounted_cash": 0.68, "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": 0.9, "discounted_cash": 0.68, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCIUM CARB 500MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301815", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCIUM CARB 600MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301816", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCIUM CARB 600MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301816", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCIUM CARBONATE CTB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301819", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCIUM GLUCON 1000MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301846", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCIUM GLUCON 1000MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301846", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCIUM GLUCONT 500MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301842", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCIUM GLUCONT 500MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301842", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCIUM IONIZED", "code_information": [{"code": "82330", "type": "CPT"}, {"code": "4102330", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 387.0, "discounted_cash": 290.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCIUM IONIZED", "code_information": [{"code": "82330", "type": "CPT"}, {"code": "4172330", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 305.0, "discounted_cash": 228.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCIUM IONIZED", "code_information": [{"code": "82330", "type": "CPT"}, {"code": "7002330", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 159.0, "discounted_cash": 119.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCIUM IONIZED", "code_information": [{"code": "82330", "type": "CPT"}, {"code": "7252330", "type": "CDM"}], "standard_charges": [{"gross_charge": 382.0, "discounted_cash": 286.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCIUM URINE QUAN", "code_information": [{"code": "82340", "type": "CPT"}, {"code": "4102340", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 314.0, "discounted_cash": 235.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCIUM URINE QUAN", "code_information": [{"code": "82340", "type": "CPT"}, {"code": "4172340", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 247.0, "discounted_cash": 185.25, "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": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCIUM URINE QUAN/2", "code_information": [{"code": "82340", "type": "CPT"}, {"code": "7252341", "type": "CDM"}], "standard_charges": [{"gross_charge": 58.0, "discounted_cash": 43.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCIUM/2", "code_information": [{"code": "82310", "type": "CPT"}, {"code": "7252310", "type": "CDM"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCULUS INFRARED SPCTRO", "code_information": [{"code": "82365", "type": "CPT"}, {"code": "7002365", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCULUS INFRARED SPCTRO", "code_information": [{"code": "82365", "type": "CPT"}, {"code": "7252365", "type": "CDM"}], "standard_charges": [{"gross_charge": 89.0, "discounted_cash": 66.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CALCULUS QUAN", "code_information": [{"code": "82360", "type": "CPT"}, {"code": "7252360", "type": "CDM"}], "standard_charges": [{"gross_charge": 130.0, "discounted_cash": 97.5, "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": 1642.0, "discounted_cash": 1231.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CALPROTECTIN FECAL", "code_information": [{"code": "83993", "type": "CPT"}, {"code": "7254001", "type": "CDM"}], "standard_charges": [{"gross_charge": 858.0, "discounted_cash": 643.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CALR EXON 9 VARIANTS", "code_information": [{"code": "81219", "type": "CPT"}, {"code": "7270014", "type": "CDM"}], "standard_charges": [{"gross_charge": 967.0, "discounted_cash": 725.25, "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": 16.0, "discounted_cash": 12.0, "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": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CAMPHOR/PHENOL 22.5ML TS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334701", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CAMPHOR/PHENOL 22.5ML TS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334701", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CANDESARTAN 16MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301914", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 147.0, "discounted_cash": 110.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CANDESARTAN 16MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301914", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 147.0, "discounted_cash": 110.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CANDESARTAN 32MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301915", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 269.0, "discounted_cash": 201.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CANDESARTAN 32MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301915", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 269.0, "discounted_cash": 201.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CANDESARTAN 4MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301912", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 192.0, "discounted_cash": 144.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CANDESARTAN 4MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301912", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 192.0, "discounted_cash": 144.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CANDESARTAN 8MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301913", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 193.0, "discounted_cash": 144.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CANDESARTAN 8MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301913", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 193.0, "discounted_cash": 144.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CANDIDA SKIN TEST PER IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5318851", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 290.0, "discounted_cash": 217.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CANGRELOR PER 1MG IJ", "code_information": [{"code": "C9460", "type": "HCPCS"}, {"code": "5318855", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CANGRELOR PER 1MG IJ", "code_information": [{"code": "C9460", "type": "HCPCS"}, {"code": "5318855", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CANNABINOID GC/MS QUANT", "code_information": [{"code": "80349", "type": "CPT"}, {"code": "7052546", "type": "CDM"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CANNABINOID GC/MS QUANT", "code_information": [{"code": "80349", "type": "CPT"}, {"code": "7258316", "type": "CDM"}], "standard_charges": [{"gross_charge": 288.0, "discounted_cash": 216.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CANNABINOID GC/MS QUANT/2", "code_information": [{"code": "80349", "type": "CPT"}, {"code": "7002542", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 201.0, "discounted_cash": 150.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CANNULA DECLOT W/CATH", "code_information": [{"code": "4913742", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3073.0, "discounted_cash": 2304.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CAP BLD COLL", "code_information": [{"code": "36416", "type": "CPT"}, {"code": "4206417", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 75.0, "discounted_cash": 56.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CAP BLD COLL/2", "code_information": [{"code": "36416", "type": "CPT"}, {"code": "4203641", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 74.0, "discounted_cash": 55.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CAP LOCKING SCREW NCB", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131507", "type": "CDM"}], "standard_charges": [{"gross_charge": 2194.0, "discounted_cash": 1645.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CAP NERVE AXOGUARD", "code_information": [{"code": "C1763", "type": "HCPCS"}, {"code": "4020889", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 22010.0, "discounted_cash": 16507.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CAP ULNAR TOTAL ELBOW", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8131506", "type": "CDM"}], "standard_charges": [{"gross_charge": 9246.0, "discounted_cash": 6934.5, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 34.0, "discounted_cash": 25.5, "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": 34.0, "discounted_cash": 25.5, "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": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CAPSAICIN .025%42.5GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334730", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "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": 75.0, "discounted_cash": 56.25, "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": 75.0, "discounted_cash": 56.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CAPSAICIN .075% 60GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334732", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 210.0, "discounted_cash": 157.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CAPSAICIN .075% 60GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334732", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 210.0, "discounted_cash": 157.5, "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": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CAPTOPRIL 12.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301922", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CAPTOPRIL 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301923", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CAPTOPRIL 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301923", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "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": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CAPTOPRIL/HCTZ 25/15 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301941", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CAPTOPRIL/HCTZ 25/15 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301941", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CAPTOPRIL/HCTZ 50/25 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301947", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CAPTOPRIL/HCTZ 50/25 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301947", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "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": 622.0, "discounted_cash": 466.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CAR/BED TEST EA ADD 30", "code_information": [{"code": "94781", "type": "CPT"}, {"code": "3114781", "type": "CDM"}, {"code": "920", "type": "RC"}], "standard_charges": [{"gross_charge": 277.0, "discounted_cash": 207.75, "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": 431.0, "discounted_cash": 323.25, "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": 101.0, "discounted_cash": 75.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBAMAZAPINE", "code_information": [{"code": "80156", "type": "CPT"}, {"code": "4172372", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 339.0, "discounted_cash": 254.25, "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": 10.0, "discounted_cash": 7.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 10.0, "discounted_cash": 7.5, "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": 32.0, "discounted_cash": 24.0, "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": 32.0, "discounted_cash": 24.0, "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": 20.0, "discounted_cash": 15.0, "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": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBAMAZEPINE 200MG XRCP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301979", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBAMAZEPINE 200MG XRCP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301979", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "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": 52.0, "discounted_cash": 39.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBAMAZEPINE 300MG XRCP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301980", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 82.0, "discounted_cash": 61.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBAMAZEPINE 300MG XRCP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301980", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 82.0, "discounted_cash": 61.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBAMAZEPINE FREE", "code_information": [{"code": "80157", "type": "CPT"}, {"code": "7250157", "type": "CDM"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "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": 50.0, "discounted_cash": 37.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "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": 23.0, "discounted_cash": 17.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBAMIDE PEROXID15ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314484", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 23.0, "discounted_cash": 17.25, "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": 53.0, "discounted_cash": 39.75, "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": 53.0, "discounted_cash": 39.75, "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": 82.0, "discounted_cash": 61.5, "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": 82.0, "discounted_cash": 61.5, "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": 39.0, "discounted_cash": 29.25, "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": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBIDOP/LEVO25/100 ODTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302037", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBIDOP/LEVO25/100 ODTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302037", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBIDOPA 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302028", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBIDOPA 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302028", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBIDOPA/LEVD 10/100 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302027", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "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": 19.0, "discounted_cash": 14.25, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBIDOPA/LEVD 25/250DT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302034", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBIDOPA/LEVD 25/250DT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302034", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "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": 3.0, "discounted_cash": 2.25, "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": 3.0, "discounted_cash": 2.25, "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": 111.0, "discounted_cash": 83.25, "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": 111.0, "discounted_cash": 83.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBINOX/PSE/DM30MLDR LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314494", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1362.0, "discounted_cash": 1021.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBINOX/PSE/DM30MLDR LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314494", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1362.0, "discounted_cash": 1021.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBINOX/PSE2-25/1 30 LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314489", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 592.0, "discounted_cash": 444.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBINOX/PSE2-25/1 30 LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314489", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 592.0, "discounted_cash": 444.0, "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": 45.0, "discounted_cash": 33.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBON DIOXIDE", "code_information": [{"code": "82374", "type": "CPT"}, {"code": "4172374", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "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": 58.0, "discounted_cash": 43.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBON MONOXIDE QUAN", "code_information": [{"code": "82375", "type": "CPT"}, {"code": "4172375", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 87.0, "discounted_cash": 65.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CARBON MONOXIDE QUAN", "code_information": [{"code": "82375", "type": "CPT"}, {"code": "7252375", "type": "CDM"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 83.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 794.0, "discounted_cash": 595.5, "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": 794.0, "discounted_cash": 595.5, "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": 90.0, "discounted_cash": 67.5, "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": 90.0, "discounted_cash": 67.5, "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": 282.0, "discounted_cash": 211.5, "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": 131.0, "discounted_cash": 98.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CARCINO-EMBRYONIC AG", "code_information": [{"code": "82378", "type": "CPT"}, {"code": "7006151", "type": "CDM"}], "standard_charges": [{"gross_charge": 98.0, "discounted_cash": 73.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CARCINO-EMBRYONIC AG/2", "code_information": [{"code": "82378", "type": "CPT"}, {"code": "7256151", "type": "CDM"}], "standard_charges": [{"gross_charge": 436.0, "discounted_cash": 327.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CARDIAC DOPPLER FU/LTD", "code_information": [{"code": "93321", "type": "CPT"}, {"code": "4633328", "type": "CDM"}, {"code": "483", "type": "RC"}], "standard_charges": [{"gross_charge": 904.0, "discounted_cash": 678.0, "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": 2543.0, "discounted_cash": 1907.25, "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": 161.0, "discounted_cash": 120.75, "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": 78.0, "discounted_cash": 58.5, "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": 161.0, "discounted_cash": 120.75, "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": 78.0, "discounted_cash": 58.5, "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": 161.0, "discounted_cash": 120.75, "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": 78.0, "discounted_cash": 58.5, "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": 784.0, "discounted_cash": 588.0, "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": 3680.0, "discounted_cash": 2760.0, "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": 3680.0, "discounted_cash": 2760.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CARDIOVERSION ELECTIVE", "code_information": [{"code": "92960", "type": "CPT"}, {"code": "4632960", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 3680.0, "discounted_cash": 2760.0, "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": 14.0, "discounted_cash": 10.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "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": 33216.0, "discounted_cash": 24912.0, "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": 33216.0, "discounted_cash": 24912.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CARNITINE", "code_information": [{"code": "82379", "type": "CPT"}, {"code": "7252379", "type": "CDM"}], "standard_charges": [{"gross_charge": 178.0, "discounted_cash": 133.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CAROTENE", "code_information": [{"code": "82380", "type": "CPT"}, {"code": "7252380", "type": "CDM"}], "standard_charges": [{"gross_charge": 44.0, "discounted_cash": 33.0, "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": 1210.0, "discounted_cash": 907.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1210.0, "discounted_cash": 907.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CARVEDILOL 10MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302081", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 178.0, "discounted_cash": 133.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CARVEDILOL 10MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302081", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 178.0, "discounted_cash": 133.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CARVEDILOL 12.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302079", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "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": 216.0, "discounted_cash": 162.0, "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": 216.0, "discounted_cash": 162.0, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CARVEDILOL 3.125MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302077", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CARVEDILOL 40MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302083", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 384.0, "discounted_cash": 288.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CARVEDILOL 40MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302083", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 384.0, "discounted_cash": 288.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CARVEDILOL 6.25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302078", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 210.0, "discounted_cash": 157.5, "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": 210.0, "discounted_cash": 157.5, "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": 1070.0, "discounted_cash": 802.5, "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": 1070.0, "discounted_cash": 802.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CASTOR OIL 30ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314521", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CASTOR OIL 30ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314521", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CASTOR OIL EMUL 60ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314524", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 75.0, "discounted_cash": 56.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CASTOR OIL EMUL 60ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314524", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 75.0, "discounted_cash": 56.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATECHOLAMINES FRAC", "code_information": [{"code": "82384", "type": "CPT"}, {"code": "7252384", "type": "CDM"}], "standard_charges": [{"gross_charge": 986.0, "discounted_cash": 739.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATECHOLAMINES FRAC/2", "code_information": [{"code": "82384", "type": "CPT"}, {"code": "7002020", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 322.0, "discounted_cash": 241.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATECHOLAMINES FRAC/2", "code_information": [{"code": "82384", "type": "CPT"}, {"code": "7252385", "type": "CDM"}], "standard_charges": [{"gross_charge": 304.0, "discounted_cash": 228.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATECHOLAMINES FRAC/3", "code_information": [{"code": "82384", "type": "CPT"}, {"code": "7252386", "type": "CDM"}], "standard_charges": [{"gross_charge": 860.0, "discounted_cash": 645.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATECHOLAMINES FRAC/4", "code_information": [{"code": "82384", "type": "CPT"}, {"code": "7002386", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 322.0, "discounted_cash": 241.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH 3D DX ESPHGS MAPNG", "code_information": [{"code": "C1732", "type": "HCPCS"}, {"code": "8055002", "type": "CDM"}], "standard_charges": [{"gross_charge": 13731.0, "discounted_cash": 10298.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ABL BIDRCT THRMCOOL", "code_information": [{"code": "C1732", "type": "HCPCS"}, {"code": "8055003", "type": "CDM"}], "standard_charges": [{"gross_charge": 27001.0, "discounted_cash": 20250.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ABL IRRIG TACTICATH", "code_information": [{"code": "C2630", "type": "HCPCS"}, {"code": "8055011", "type": "CDM"}], "standard_charges": [{"gross_charge": 32426.0, "discounted_cash": 24319.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ABL PENTARAY NAV", "code_information": [{"code": "C1732", "type": "HCPCS"}, {"code": "8056048", "type": "CDM"}], "standard_charges": [{"gross_charge": 15730.0, "discounted_cash": 11797.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ACCESS BENCHMARK BMX", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8051736", "type": "CDM"}], "standard_charges": [{"gross_charge": 11969.0, "discounted_cash": 8976.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ACCESS DUAL LUMEN", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8056003", "type": "CDM"}], "standard_charges": [{"gross_charge": 1722.0, "discounted_cash": 1291.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ACUNAV ULTRSND DIAG", "code_information": [{"code": "C1759", "type": "HCPCS"}, {"code": "8240022", "type": "CDM"}], "standard_charges": [{"gross_charge": 23937.0, "discounted_cash": 17952.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ANG QUICK-CROSS", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8240029", "type": "CDM"}], "standard_charges": [{"gross_charge": 1658.0, "discounted_cash": 1243.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ANG TRANSLUM NLSR2", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056028", "type": "CDM"}], "standard_charges": [{"gross_charge": 4277.0, "discounted_cash": 3207.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ANG TRANSLUM NLSR2", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8240126", "type": "CDM"}], "standard_charges": [{"gross_charge": 6538.0, "discounted_cash": 4903.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ANG TRANSLUM NLSR3", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056029", "type": "CDM"}], "standard_charges": [{"gross_charge": 6355.0, "discounted_cash": 4766.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ANG TRANSLUM NLSR3", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8240128", "type": "CDM"}], "standard_charges": [{"gross_charge": 20833.0, "discounted_cash": 15624.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ANG TRANSLUM NLSR4", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8240141", "type": "CDM"}], "standard_charges": [{"gross_charge": 22265.0, "discounted_cash": 16698.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ANG TRANSLUMNL NLSR", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056027", "type": "CDM"}], "standard_charges": [{"gross_charge": 3080.0, "discounted_cash": 2310.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ANG TRANSLUMNL NLSR", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8240125", "type": "CDM"}], "standard_charges": [{"gross_charge": 8959.0, "discounted_cash": 6719.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ANGIO", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8057001", "type": "CDM"}], "standard_charges": [{"gross_charge": 812.0, "discounted_cash": 609.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ANGIO COBRA", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056012", "type": "CDM"}], "standard_charges": [{"gross_charge": 392.0, "discounted_cash": 294.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ANGIO OMNI FLUSH", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056013", "type": "CDM"}], "standard_charges": [{"gross_charge": 775.0, "discounted_cash": 581.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ANGIOJET RHEO THROM", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8240026", "type": "CDM"}], "standard_charges": [{"gross_charge": 19369.0, "discounted_cash": 14526.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ASH SPLIT MEDCOMP", "code_information": [{"code": "C1750", "type": "HCPCS"}, {"code": "8245820", "type": "CDM"}], "standard_charges": [{"gross_charge": 7952.0, "discounted_cash": 5964.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ASPIRATION AXS VECTA 71", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8057703", "type": "CDM"}], "standard_charges": [{"gross_charge": 32479.0, "discounted_cash": 24359.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ASPIRATION LIGHTNING BOLT", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8050018", "type": "CDM"}], "standard_charges": [{"gross_charge": 78193.0, "discounted_cash": 58644.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ASPIRATION XTORQ INDIGO", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8177027", "type": "CDM"}], "standard_charges": [{"gross_charge": 69976.0, "discounted_cash": 52482.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ATHER STEALTH 360", "code_information": [{"code": "C1724", "type": "HCPCS"}, {"code": "8056043", "type": "CDM"}], "standard_charges": [{"gross_charge": 34403.0, "discounted_cash": 25802.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ATHERECTOMY DIRECT", "code_information": [{"code": "C1714", "type": "HCPCS"}, {"code": "8056045", "type": "CDM"}], "standard_charges": [{"gross_charge": 23112.0, "discounted_cash": 17334.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ATHR TRANSLUM DIREC", "code_information": [{"code": "C1714", "type": "HCPCS"}, {"code": "8240127", "type": "CDM"}], "standard_charges": [{"gross_charge": 4930.0, "discounted_cash": 3697.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ATHR TRANSLUM ROTAT", "code_information": [{"code": "C1724", "type": "HCPCS"}, {"code": "8240129", "type": "CDM"}], "standard_charges": [{"gross_charge": 40302.0, "discounted_cash": 30226.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ATHRECTMY ATHEROCAT", "code_information": [{"code": "C1714", "type": "HCPCS"}, {"code": "8240740", "type": "CDM"}], "standard_charges": [{"gross_charge": 34211.0, "discounted_cash": 25658.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ATTAIN COMND SURVLV", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056426", "type": "CDM"}], "standard_charges": [{"gross_charge": 2166.0, "discounted_cash": 1624.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH B BLN RAPIDEXCHANGE", "code_information": [{"code": "C1726", "type": "HCPCS"}, {"code": "8240749", "type": "CDM"}], "standard_charges": [{"gross_charge": 2486.0, "discounted_cash": 1864.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BAL DIL SINUS", "code_information": [{"code": "C1726", "type": "HCPCS"}, {"code": "8056054", "type": "CDM"}], "standard_charges": [{"gross_charge": 3871.0, "discounted_cash": 2903.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BALLOON CODA", "code_information": [{"code": "C2628", "type": "HCPCS"}, {"code": "8056063", "type": "CDM"}], "standard_charges": [{"gross_charge": 3394.0, "discounted_cash": 2545.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BALN DILATN N VASCL", "code_information": [{"code": "C1726", "type": "HCPCS"}, {"code": "8055081", "type": "CDM"}], "standard_charges": [{"gross_charge": 4488.0, "discounted_cash": 3366.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLLN CORONARY SAPPHIRE", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8245431", "type": "CDM"}], "standard_charges": [{"gross_charge": 1799.0, "discounted_cash": 1349.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLLN GUIDE FLOWGATE", "code_information": [{"code": "C2628", "type": "HCPCS"}, {"code": "8056092", "type": "CDM"}], "standard_charges": [{"gross_charge": 17200.0, "discounted_cash": 12900.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLN CUT INTERVENTNL", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8245095", "type": "CDM"}], "standard_charges": [{"gross_charge": 17099.0, "discounted_cash": 12824.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLN CUTTING", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056031", "type": "CDM"}], "standard_charges": [{"gross_charge": 10225.0, "discounted_cash": 7668.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLN DIL AGILTRAC", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8240069", "type": "CDM"}], "standard_charges": [{"gross_charge": 5344.0, "discounted_cash": 4008.0, "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": 1877.0, "discounted_cash": 1407.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLN DIL CRE", "code_information": [{"code": "C1726", "type": "HCPCS"}, {"code": "8240030", "type": "CDM"}], "standard_charges": [{"gross_charge": 2846.0, "discounted_cash": 2134.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLN DIL D114S OTW", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8240765", "type": "CDM"}], "standard_charges": [{"gross_charge": 4618.0, "discounted_cash": 3463.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLN DIL DIA ULT THN", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8240762", "type": "CDM"}], "standard_charges": [{"gross_charge": 2814.0, "discounted_cash": 2110.5, "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": 2496.0, "discounted_cash": 1872.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLN DIL MARSHAL", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8240070", "type": "CDM"}], "standard_charges": [{"gross_charge": 3871.0, "discounted_cash": 2903.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLN DIL OTW", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8055082", "type": "CDM"}], "standard_charges": [{"gross_charge": 2720.0, "discounted_cash": 2040.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLN DIL SPRINTER", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8245164", "type": "CDM"}], "standard_charges": [{"gross_charge": 2486.0, "discounted_cash": 1864.5, "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": 4549.0, "discounted_cash": 3411.75, "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": 3695.0, "discounted_cash": 2771.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLN DIL UROMAX UHP", "code_information": [{"code": "C1726", "type": "HCPCS"}, {"code": "8240761", "type": "CDM"}], "standard_charges": [{"gross_charge": 2920.0, "discounted_cash": 2190.0, "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": 5021.0, "discounted_cash": 3765.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLN PTCA SCOREFLEX", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056901", "type": "CDM"}], "standard_charges": [{"gross_charge": 7020.0, "discounted_cash": 5265.0, "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": 11924.0, "discounted_cash": 8943.0, "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": 4860.0, "discounted_cash": 3645.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLN TMP OCCLSN COM", "code_information": [{"code": "C2628", "type": "HCPCS"}, {"code": "8245260", "type": "CDM"}], "standard_charges": [{"gross_charge": 1122.0, "discounted_cash": 841.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BLN VENOGRAM", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056101", "type": "CDM"}], "standard_charges": [{"gross_charge": 2147.0, "discounted_cash": 1610.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BORE LARGE", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8055021", "type": "CDM"}], "standard_charges": [{"gross_charge": 20920.0, "discounted_cash": 15690.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH BROVIAC", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8173300", "type": "CDM"}], "standard_charges": [{"gross_charge": 2505.0, "discounted_cash": 1878.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH CERVICAL RIPENING", "code_information": [{"code": "C1726", "type": "HCPCS"}, {"code": "8031589", "type": "CDM"}], "standard_charges": [{"gross_charge": 191.0, "discounted_cash": 143.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH CLOTTRIEVER", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8056324", "type": "CDM"}], "standard_charges": [{"gross_charge": 51785.0, "discounted_cash": 38838.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH CNTRL VEIN", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8056365", "type": "CDM"}], "standard_charges": [{"gross_charge": 3158.0, "discounted_cash": 2368.5, "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": 27795.0, "discounted_cash": 20846.25, "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": 27795.0, "discounted_cash": 20846.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH COR DIAG OPTITORQUE", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8058045", "type": "CDM"}], "standard_charges": [{"gross_charge": 1056.0, "discounted_cash": 792.0, "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": 25241.0, "discounted_cash": 18930.75, "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": 25241.0, "discounted_cash": 18930.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH CORONARY DIL TREK", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056359", "type": "CDM"}], "standard_charges": [{"gross_charge": 839.0, "discounted_cash": 629.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH CROSSING CTO VIANCE", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056372", "type": "CDM"}], "standard_charges": [{"gross_charge": 14187.0, "discounted_cash": 10640.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH CRYOABL ARCTC FRONT", "code_information": [{"code": "C1733", "type": "HCPCS"}, {"code": "8056374", "type": "CDM"}], "standard_charges": [{"gross_charge": 21392.0, "discounted_cash": 16044.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH DEFLECTABLE SELECTSITE", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8050001", "type": "CDM"}], "standard_charges": [{"gross_charge": 3662.0, "discounted_cash": 2746.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH DELIVERY LONG SHTH", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056911", "type": "CDM"}], "standard_charges": [{"gross_charge": 4443.0, "discounted_cash": 3332.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH DIAG EP MAPPING", "code_information": [{"code": "C1730", "type": "HCPCS"}, {"code": "8058050", "type": "CDM"}], "standard_charges": [{"gross_charge": 4951.0, "discounted_cash": 3713.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH DIAG HALO XP AUTOID", "code_information": [{"code": "C1731", "type": "HCPCS"}, {"code": "8056386", "type": "CDM"}], "standard_charges": [{"gross_charge": 15600.0, "discounted_cash": 11700.0, "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": 22489.0, "discounted_cash": 16866.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH DIAG QUADRAPLR DEFLECTBL", "code_information": [{"code": "C1730", "type": "HCPCS"}, {"code": "8051730", "type": "CDM"}], "standard_charges": [{"gross_charge": 3020.0, "discounted_cash": 2265.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH DIAL VAXCEL CHRON", "code_information": [{"code": "C1750", "type": "HCPCS"}, {"code": "8240050", "type": "CDM"}], "standard_charges": [{"gross_charge": 8967.0, "discounted_cash": 6725.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH DIALYSIS HEMOSPLT", "code_information": [{"code": "C1750", "type": "HCPCS"}, {"code": "8056034", "type": "CDM"}], "standard_charges": [{"gross_charge": 3580.0, "discounted_cash": 2685.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH DIAMONDBACK 360", "code_information": [{"code": "C1724", "type": "HCPCS"}, {"code": "4031310", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 28857.0, "discounted_cash": 21642.75, "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": 3500.0, "discounted_cash": 2625.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH DIL PTA ATLAS", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8240793", "type": "CDM"}], "standard_charges": [{"gross_charge": 2677.0, "discounted_cash": 2007.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH DIL VOYAGER OTW", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "4031339", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2698.0, "discounted_cash": 2023.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH DILAT BLLN OTW", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056379", "type": "CDM"}], "standard_charges": [{"gross_charge": 1674.0, "discounted_cash": 1255.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH DISTAL ACCESS AXS CAT 6", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8051735", "type": "CDM"}], "standard_charges": [{"gross_charge": 30072.0, "discounted_cash": 22554.0, "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": 18117.0, "discounted_cash": 13587.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH DRAINAGE", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8240082", "type": "CDM"}], "standard_charges": [{"gross_charge": 3643.0, "discounted_cash": 2732.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH DRAINAGE ALL PURP", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "4031340", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 746.0, "discounted_cash": 559.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH DRAINAGE BILIARY", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8240081", "type": "CDM"}], "standard_charges": [{"gross_charge": 1053.0, "discounted_cash": 789.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH DRN PLEURAL", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8245533", "type": "CDM"}], "standard_charges": [{"gross_charge": 10281.0, "discounted_cash": 7710.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ECHO INTRACARDIAC", "code_information": [{"code": "C1759", "type": "HCPCS"}, {"code": "8240106", "type": "CDM"}], "standard_charges": [{"gross_charge": 22680.0, "discounted_cash": 17010.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ELECTROPHSLGY DIAGN", "code_information": [{"code": "C1730", "type": "HCPCS"}, {"code": "8056033", "type": "CDM"}], "standard_charges": [{"gross_charge": 15377.0, "discounted_cash": 11532.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH EMBOLECTOMY", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8056318", "type": "CDM"}], "standard_charges": [{"gross_charge": 2085.0, "discounted_cash": 1563.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH EP COOL TIP", "code_information": [{"code": "C2630", "type": "HCPCS"}, {"code": "8240094", "type": "CDM"}], "standard_charges": [{"gross_charge": 27637.0, "discounted_cash": 20727.75, "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": 7797.0, "discounted_cash": 5847.75, "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": 26477.0, "discounted_cash": 19857.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH EP FARAWAVE", "code_information": [{"code": "C1733", "type": "HCPCS"}, {"code": "8050020", "type": "CDM"}], "standard_charges": [{"gross_charge": 86483.0, "discounted_cash": 64862.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH EP FC BS WEBSTER", "code_information": [{"code": "C1730", "type": "HCPCS"}, {"code": "8245560", "type": "CDM"}], "standard_charges": [{"gross_charge": 2793.0, "discounted_cash": 2094.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH EP FIX BRDVKNG QUAD", "code_information": [{"code": "C1730", "type": "HCPCS"}, {"code": "8240813", "type": "CDM"}], "standard_charges": [{"gross_charge": 4626.0, "discounted_cash": 3469.5, "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": 2717.0, "discounted_cash": 2037.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH EP STEER EPT-DX BS", "code_information": [{"code": "C1730", "type": "HCPCS"}, {"code": "8245632", "type": "CDM"}], "standard_charges": [{"gross_charge": 9467.0, "discounted_cash": 7100.25, "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": 5229.0, "discounted_cash": 3921.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH ESOPHAGEAL MAPPING", "code_information": [{"code": "C1732", "type": "HCPCS"}, {"code": "8056344", "type": "CDM"}], "standard_charges": [{"gross_charge": 3919.0, "discounted_cash": 2939.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH FGRTY EMBLA", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8056373", "type": "CDM"}], "standard_charges": [{"gross_charge": 3871.0, "discounted_cash": 2903.25, "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": 7897.0, "discounted_cash": 5922.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH GD ACUITY PRO INNER", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056441", "type": "CDM"}], "standard_charges": [{"gross_charge": 2134.0, "discounted_cash": 1600.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH GD ATTAIN SELII SUR", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056431", "type": "CDM"}], "standard_charges": [{"gross_charge": 2325.0, "discounted_cash": 1743.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH GLIDE", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056439", "type": "CDM"}], "standard_charges": [{"gross_charge": 2007.0, "discounted_cash": 1505.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH GROSHONG LG", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8056450", "type": "CDM"}], "standard_charges": [{"gross_charge": 4082.0, "discounted_cash": 3061.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH GUIDING", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056037", "type": "CDM"}], "standard_charges": [{"gross_charge": 3514.0, "discounted_cash": 2635.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH GUIDING", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8240096", "type": "CDM"}], "standard_charges": [{"gross_charge": 2475.0, "discounted_cash": 1856.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH GUIDING 2", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8240097", "type": "CDM"}], "standard_charges": [{"gross_charge": 13890.0, "discounted_cash": 10417.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH GUIDING 3", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8240099", "type": "CDM"}], "standard_charges": [{"gross_charge": 2613.0, "discounted_cash": 1959.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH GUIDING ATTAIN MP", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8245706", "type": "CDM"}], "standard_charges": [{"gross_charge": 3706.0, "discounted_cash": 2779.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH HEMODIAL LONG TERM", "code_information": [{"code": "C1750", "type": "HCPCS"}, {"code": "8240098", "type": "CDM"}], "standard_charges": [{"gross_charge": 2940.0, "discounted_cash": 2205.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH HEMODIAL SHORT TERM", "code_information": [{"code": "C1752", "type": "HCPCS"}, {"code": "8240102", "type": "CDM"}], "standard_charges": [{"gross_charge": 2252.0, "discounted_cash": 1689.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH HICKMAN", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8056470", "type": "CDM"}], "standard_charges": [{"gross_charge": 9710.0, "discounted_cash": 7282.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH HSG", "code_information": [{"code": "C2628", "type": "HCPCS"}, {"code": "8056486", "type": "CDM"}], "standard_charges": [{"gross_charge": 1187.0, "discounted_cash": 890.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH INF CLEARWAY", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "4031426", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10117.0, "discounted_cash": 7587.75, "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": 2955.0, "discounted_cash": 2216.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH INF PICC SL PWR", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8245754", "type": "CDM"}], "standard_charges": [{"gross_charge": 2798.0, "discounted_cash": 2098.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH INF PICC TL PWR", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8240043", "type": "CDM"}], "standard_charges": [{"gross_charge": 3061.0, "discounted_cash": 2295.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH INF SGL LMN", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8056496", "type": "CDM"}], "standard_charges": [{"gross_charge": 486.0, "discounted_cash": 364.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH INF UNIFUS ANGIODYN", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8245780", "type": "CDM"}], "standard_charges": [{"gross_charge": 1937.0, "discounted_cash": 1452.75, "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": 1316.0, "discounted_cash": 987.0, "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": 1316.0, "discounted_cash": 987.0, "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": 2267.0, "discounted_cash": 1700.25, "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": 2267.0, "discounted_cash": 1700.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH INTRACRAN SUPPRT NAVIEN", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056528", "type": "CDM"}], "standard_charges": [{"gross_charge": 14748.0, "discounted_cash": 11061.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH INTRASPINAL", "code_information": [{"code": "C1755", "type": "HCPCS"}, {"code": "8058052", "type": "CDM"}], "standard_charges": [{"gross_charge": 13088.0, "discounted_cash": 9816.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH IVUS PLATINUM ST", "code_information": [{"code": "C1753", "type": "HCPCS"}, {"code": "8056541", "type": "CDM"}], "standard_charges": [{"gross_charge": 4779.0, "discounted_cash": 3584.25, "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": 39910.0, "discounted_cash": 29932.5, "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": 39910.0, "discounted_cash": 29932.5, "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": 54830.0, "discounted_cash": 41122.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH L HRT ARTERY/VENTR", "code_information": [{"code": "93458", "type": "CPT"}, {"code": "4613458", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 54830.0, "discounted_cash": 41122.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH LSR ATHER TURBO-PWR", "code_information": [{"code": "C1885", "type": "HCPCS"}, {"code": "8056572", "type": "CDM"}], "standard_charges": [{"gross_charge": 26136.0, "discounted_cash": 19602.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH LSR SPECTRANTC EXTR", "code_information": [{"code": "C1885", "type": "HCPCS"}, {"code": "8240164", "type": "CDM"}], "standard_charges": [{"gross_charge": 19926.0, "discounted_cash": 14944.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH LT HRT W/LTVENT", "code_information": [{"code": "93452", "type": "CPT"}, {"code": "4613452", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 40116.0, "discounted_cash": 30087.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH LT HRT W/LTVENT", "code_information": [{"code": "93452", "type": "CPT"}, {"code": "4613452", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 40116.0, "discounted_cash": 30087.0, "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": 16030.0, "discounted_cash": 12022.5, "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": 16030.0, "discounted_cash": 12022.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH LUMBOPERITO", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8056591", "type": "CDM"}], "standard_charges": [{"gross_charge": 51324.0, "discounted_cash": 38493.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH MAPPING OCTARAY NAV", "code_information": [{"code": "C1732", "type": "HCPCS"}, {"code": "8056398", "type": "CDM"}], "standard_charges": [{"gross_charge": 22104.0, "discounted_cash": 16578.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH MULT LUM AR", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8056588", "type": "CDM"}], "standard_charges": [{"gross_charge": 2469.0, "discounted_cash": 1851.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH MULT LUM CV", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8056590", "type": "CDM"}], "standard_charges": [{"gross_charge": 1663.0, "discounted_cash": 1247.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH MUSHROOM", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8056595", "type": "CDM"}], "standard_charges": [{"gross_charge": 1150.0, "discounted_cash": 862.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH NEPHROSTOMY", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8056615", "type": "CDM"}], "standard_charges": [{"gross_charge": 2327.0, "discounted_cash": 1745.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH OCCLUSION", "code_information": [{"code": "C2628", "type": "HCPCS"}, {"code": "8240115", "type": "CDM"}], "standard_charges": [{"gross_charge": 2814.0, "discounted_cash": 2110.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH P-DIAL SAPHIRE", "code_information": [{"code": "C1750", "type": "HCPCS"}, {"code": "4031481", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5898.0, "discounted_cash": 4423.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PERIPH IVL SHOCKWAVE", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056908", "type": "CDM"}], "standard_charges": [{"gross_charge": 25183.0, "discounted_cash": 18887.25, "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": 2888.0, "discounted_cash": 2166.0, "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": 4474.0, "discounted_cash": 3355.5, "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": 3622.0, "discounted_cash": 2716.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PICC SL MORPHEUS CT", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8245941", "type": "CDM"}], "standard_charges": [{"gross_charge": 2126.0, "discounted_cash": 1594.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PICC SL NEONATAL", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8245942", "type": "CDM"}], "standard_charges": [{"gross_charge": 488.0, "discounted_cash": 366.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PLC CORONRY ART INC INTRA", "code_information": [{"code": "C7557", "type": "HCPCS"}, {"code": "4617557", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 293.0, "discounted_cash": 219.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PLC CORONRY ART INC INTRA", "code_information": [{"code": "C7557", "type": "HCPCS"}, {"code": "4617557", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 293.0, "discounted_cash": 219.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PORTACATH", "code_information": [{"code": "C1788", "type": "HCPCS"}, {"code": "8056660", "type": "CDM"}], "standard_charges": [{"gross_charge": 3871.0, "discounted_cash": 2903.25, "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": 3771.0, "discounted_cash": 2828.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PRPH DIL POLARCATH", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8240045", "type": "CDM"}], "standard_charges": [{"gross_charge": 16038.0, "discounted_cash": 12028.5, "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": 2887.0, "discounted_cash": 2165.25, "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": 2871.0, "discounted_cash": 2153.25, "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": 3356.0, "discounted_cash": 2517.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTA CHOCOLATE BLN", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056671", "type": "CDM"}], "standard_charges": [{"gross_charge": 6906.0, "discounted_cash": 5179.5, "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": 3037.0, "discounted_cash": 2277.75, "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": 3019.0, "discounted_cash": 2264.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTA DIL ATLAS GOLD", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8058259", "type": "CDM"}], "standard_charges": [{"gross_charge": 3176.0, "discounted_cash": 2382.0, "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": 2256.0, "discounted_cash": 1692.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTA DIL CONQUEST", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8240059", "type": "CDM"}], "standard_charges": [{"gross_charge": 2728.0, "discounted_cash": 2046.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTA DIL ULTRAVERSE", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8245961", "type": "CDM"}], "standard_charges": [{"gross_charge": 2003.0, "discounted_cash": 1502.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTA DRUG COATED BLN", "code_information": [{"code": "C2623", "type": "HCPCS"}, {"code": "8056881", "type": "CDM"}], "standard_charges": [{"gross_charge": 20120.0, "discounted_cash": 15090.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTA DRUG COATED BLN", "code_information": [{"code": "C2623", "type": "HCPCS"}, {"code": "8056886", "type": "CDM"}], "standard_charges": [{"gross_charge": 9632.0, "discounted_cash": 7224.0, "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": 17508.0, "discounted_cash": 13131.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTA EVERCROSS BLN", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056663", "type": "CDM"}], "standard_charges": [{"gross_charge": 1056.0, "discounted_cash": 792.0, "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": 8651.0, "discounted_cash": 6488.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTA MUSTANG BLLN", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056664", "type": "CDM"}], "standard_charges": [{"gross_charge": 1101.0, "discounted_cash": 825.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTA OPTIPLAST XT5", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8245967", "type": "CDM"}], "standard_charges": [{"gross_charge": 3871.0, "discounted_cash": 2903.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTA PACIFIC XTREME", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056662", "type": "CDM"}], "standard_charges": [{"gross_charge": 3454.0, "discounted_cash": 2590.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTA SV FOX", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8245969", "type": "CDM"}], "standard_charges": [{"gross_charge": 7292.0, "discounted_cash": 5469.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTCA APEX OTW BLN", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056666", "type": "CDM"}], "standard_charges": [{"gross_charge": 4957.0, "discounted_cash": 3717.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTCA APEX RX BLN", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056667", "type": "CDM"}], "standard_charges": [{"gross_charge": 839.0, "discounted_cash": 629.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTCA DIL CHARGER", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8240839", "type": "CDM"}], "standard_charges": [{"gross_charge": 1860.0, "discounted_cash": 1395.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTCA DIL DURA STAR", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8245970", "type": "CDM"}], "standard_charges": [{"gross_charge": 3793.0, "discounted_cash": 2844.75, "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": 839.0, "discounted_cash": 629.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH PTCA MAVERICK OTW", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8240846", "type": "CDM"}], "standard_charges": [{"gross_charge": 4862.0, "discounted_cash": 3646.5, "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": 6709.0, "discounted_cash": 5031.75, "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": 72227.0, "discounted_cash": 54170.25, "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": 72227.0, "discounted_cash": 54170.25, "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": 59916.0, "discounted_cash": 44937.0, "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": 59916.0, "discounted_cash": 44937.0, "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": 44895.0, "discounted_cash": 33671.25, "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": 44895.0, "discounted_cash": 33671.25, "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": 45249.0, "discounted_cash": 33936.75, "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": 45249.0, "discounted_cash": 33936.75, "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": 37996.0, "discounted_cash": 28497.0, "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": 37996.0, "discounted_cash": 28497.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH REACT 71", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8058269", "type": "CDM"}], "standard_charges": [{"gross_charge": 24039.0, "discounted_cash": 18029.25, "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": 28750.0, "discounted_cash": 21562.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH REPERFUS ASPIRATION", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056689", "type": "CDM"}], "standard_charges": [{"gross_charge": 8391.0, "discounted_cash": 6293.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH REPERFUS INTRACRAN", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "4031510", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 13187.0, "discounted_cash": 9890.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH RIGHT HEART", "code_information": [{"code": "93451", "type": "CPT"}, {"code": "4613451", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 29830.0, "discounted_cash": 22372.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH RIGHT HEART", "code_information": [{"code": "93451", "type": "CPT"}, {"code": "4613451", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 29830.0, "discounted_cash": 22372.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH SHOCKWAVE C2", "code_information": [{"code": "C1761", "type": "HCPCS"}, {"code": "8056916", "type": "CDM"}], "standard_charges": [{"gross_charge": 51230.0, "discounted_cash": 38422.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH SHOCKWAVE E8", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056919", "type": "CDM"}], "standard_charges": [{"gross_charge": 48103.0, "discounted_cash": 36077.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH SHOCKWAVE M5 +IVL", "code_information": [{"code": "C1761", "type": "HCPCS"}, {"code": "8056917", "type": "CDM"}], "standard_charges": [{"gross_charge": 37605.0, "discounted_cash": 28203.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH SINUS GUIDE", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056701", "type": "CDM"}], "standard_charges": [{"gross_charge": 4714.0, "discounted_cash": 3535.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH SINUS IRRG VORTEX 2", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8056699", "type": "CDM"}], "standard_charges": [{"gross_charge": 2771.0, "discounted_cash": 2078.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH SUPPORT RUBICON", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056737", "type": "CDM"}], "standard_charges": [{"gross_charge": 1468.0, "discounted_cash": 1101.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH SUPRAPUBC/CYSTOSCOP", "code_information": [{"code": "C2627", "type": "HCPCS"}, {"code": "8240119", "type": "CDM"}], "standard_charges": [{"gross_charge": 3366.0, "discounted_cash": 2524.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH THORACIC", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8056780", "type": "CDM"}], "standard_charges": [{"gross_charge": 365.0, "discounted_cash": 273.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH THORACIC ANY 2", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8056779", "type": "CDM"}], "standard_charges": [{"gross_charge": 392.0, "discounted_cash": 294.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH THROMB/EMBOLECT 4", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8240109", "type": "CDM"}], "standard_charges": [{"gross_charge": 14516.0, "discounted_cash": 10887.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH THROMB/EMBOLECTMY 2", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8240091", "type": "CDM"}], "standard_charges": [{"gross_charge": 2469.0, "discounted_cash": 1851.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH THROMB/EMBOLECTMY 3", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8240093", "type": "CDM"}], "standard_charges": [{"gross_charge": 8043.0, "discounted_cash": 6032.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH THROMB/EMBOLECTOMY", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8240121", "type": "CDM"}], "standard_charges": [{"gross_charge": 5430.0, "discounted_cash": 4072.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH THROMBECTOMY", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8056687", "type": "CDM"}], "standard_charges": [{"gross_charge": 22721.0, "discounted_cash": 17040.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH THROMBEX PMT 6F 120", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8246010", "type": "CDM"}], "standard_charges": [{"gross_charge": 14562.0, "discounted_cash": 10921.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH TRAY DIALYSIS", "code_information": [{"code": "C1752", "type": "HCPCS"}, {"code": "8081016", "type": "CDM"}], "standard_charges": [{"gross_charge": 3543.0, "discounted_cash": 2657.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH TRI-LOBE BALLOON", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056804", "type": "CDM"}], "standard_charges": [{"gross_charge": 8093.0, "discounted_cash": 6069.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH TRIP-LUMEN", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8056805", "type": "CDM"}], "standard_charges": [{"gross_charge": 2486.0, "discounted_cash": 1864.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH URETERAL", "code_information": [{"code": "C1758", "type": "HCPCS"}, {"code": "8041250", "type": "CDM"}], "standard_charges": [{"gross_charge": 142.0, "discounted_cash": 106.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH URETERAL", "code_information": [{"code": "C1758", "type": "HCPCS"}, {"code": "8041251", "type": "CDM"}], "standard_charges": [{"gross_charge": 129.0, "discounted_cash": 96.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH URETERAL", "code_information": [{"code": "C1758", "type": "HCPCS"}, {"code": "8240131", "type": "CDM"}], "standard_charges": [{"gross_charge": 617.0, "discounted_cash": 462.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH URETERAL DL", "code_information": [{"code": "C1758", "type": "HCPCS"}, {"code": "8246027", "type": "CDM"}], "standard_charges": [{"gross_charge": 1448.0, "discounted_cash": 1086.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH URTRL FLEXIMA", "code_information": [{"code": "C1758", "type": "HCPCS"}, {"code": "8246050", "type": "CDM"}], "standard_charges": [{"gross_charge": 461.0, "discounted_cash": 345.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH US IVAS AVANAR F/X", "code_information": [{"code": "C1753", "type": "HCPCS"}, {"code": "8240855", "type": "CDM"}], "standard_charges": [{"gross_charge": 16093.0, "discounted_cash": 12069.75, "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": 24903.0, "discounted_cash": 18677.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH US SOUNDSTAR ECO", "code_information": [{"code": "C1759", "type": "HCPCS"}, {"code": "8058288", "type": "CDM"}], "standard_charges": [{"gross_charge": 17920.0, "discounted_cash": 13440.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH VALVULOPLSTY BLLN", "code_information": [{"code": "C1726", "type": "HCPCS"}, {"code": "8056819", "type": "CDM"}], "standard_charges": [{"gross_charge": 7538.0, "discounted_cash": 5653.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH VALVULPLSTY PERFUSN", "code_information": [{"code": "C1726", "type": "HCPCS"}, {"code": "8056827", "type": "CDM"}], "standard_charges": [{"gross_charge": 13997.0, "discounted_cash": 10497.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH VENTR", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8141275", "type": "CDM"}], "standard_charges": [{"gross_charge": 2105.0, "discounted_cash": 1578.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH VSL SIZING PERFORMA", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8246060", "type": "CDM"}], "standard_charges": [{"gross_charge": 2071.0, "discounted_cash": 1553.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CATH WIRE INFU PROSTREAM", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8056497", "type": "CDM"}], "standard_charges": [{"gross_charge": 2672.0, "discounted_cash": 2004.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CATHETER IVUS", "code_information": [{"code": "C1753", "type": "HCPCS"}, {"code": "8056542", "type": "CDM"}], "standard_charges": [{"gross_charge": 8768.0, "discounted_cash": 6576.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CBC AUTO W/O DIFF", "code_information": [{"code": "85027", "type": "CPT"}, {"code": "4100056", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 286.0, "discounted_cash": 214.5, "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": 45.0, "discounted_cash": 33.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CBC AUTO W/O DIFF", "code_information": [{"code": "85027", "type": "CPT"}, {"code": "4170056", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 225.0, "discounted_cash": 168.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CBC AUTO W/O DIFF", "code_information": [{"code": "85027", "type": "CPT"}, {"code": "7255027", "type": "CDM"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "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": 400.0, "discounted_cash": 300.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CBC WITH AUTO DIFF", "code_information": [{"code": "85025", "type": "CPT"}, {"code": "4125028", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CBC WITH AUTO DIFF", "code_information": [{"code": "85025", "type": "CPT"}, {"code": "4175028", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 315.0, "discounted_cash": 236.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CBC WITH AUTO DIFF", "code_information": [{"code": "85025", "type": "CPT"}, {"code": "7255028", "type": "CDM"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CBL ORTHO W CRIMP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131515", "type": "CDM"}], "standard_charges": [{"gross_charge": 3735.21, "discounted_cash": 2801.41, "setting": "both", "billing_class": "facility"}]}, {"description": "CBLE FIX BN SLEVE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131514", "type": "CDM"}], "standard_charges": [{"gross_charge": 10225.0, "discounted_cash": 7668.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CDOPA/LDOPA/ENTAC 100 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312038", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CDOPA/LDOPA/ENTAC 100 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312038", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "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": 16.0, "discounted_cash": 12.0, "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": 16.0, "discounted_cash": 12.0, "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": 241.0, "discounted_cash": 180.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 241.0, "discounted_cash": 180.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFACLOR250/5 75ML PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314545", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1187.0, "discounted_cash": 890.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFACLOR250/5 75ML PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314545", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1187.0, "discounted_cash": 890.25, "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": 208.0, "discounted_cash": 156.0, "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": 208.0, "discounted_cash": 156.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "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": 23.0, "discounted_cash": 17.25, "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": 23.0, "discounted_cash": 17.25, "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": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFDINIR 250/5 5ML PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314578", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 75.0, "discounted_cash": 56.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFDINIR 250/5 5ML PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314578", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 75.0, "discounted_cash": 56.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFDINIR 250/5 60ML PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314581", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 384.0, "discounted_cash": 288.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFDINIR 250/5 60ML PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314581", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 384.0, "discounted_cash": 288.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFDINIR 300MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302100", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 295.0, "discounted_cash": 221.25, "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": 295.0, "discounted_cash": 221.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFDR125MG/5ML 60ML PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302101", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFDR125MG/5ML 60ML PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302101", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFEPIME PED PER 1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5318994", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 34.0, "discounted_cash": 25.5, "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": 34.0, "discounted_cash": 25.5, "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": 75.0, "discounted_cash": 56.25, "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": 75.0, "discounted_cash": 56.25, "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": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFIXIME 200/5 5ML PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314598", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 207.0, "discounted_cash": 155.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFIXIME 200/5 5ML PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314598", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 207.0, "discounted_cash": 155.25, "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": 438.0, "discounted_cash": 328.5, "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": 438.0, "discounted_cash": 328.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFOXITIN PER 1GM IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0694", "type": "HCPCS"}, {"code": "5319049", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFOXITIN PER 1GM IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0694", "type": "HCPCS"}, {"code": "5319049", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "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": 101.0, "discounted_cash": 75.75, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 101.0, "discounted_cash": 75.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFPODOXIME 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302124", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 292.0, "discounted_cash": 219.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFPODOXIME 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302124", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 292.0, "discounted_cash": 219.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFPODOXIME100/5 100MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314556", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 62.0, "discounted_cash": 46.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFPODOXIME100/5 100MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314556", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 62.0, "discounted_cash": 46.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFPODOXIME50/5 100ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314555", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 718.0, "discounted_cash": 538.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFPODOXIME50/5 100ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314555", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 718.0, "discounted_cash": 538.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFPROZIL 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302119", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 178.0, "discounted_cash": 133.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFPROZIL 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302119", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 178.0, "discounted_cash": 133.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFPROZIL 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302114", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFPROZIL 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302114", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFPROZIL125/5 100ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314586", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFPROZIL125/5 100ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314586", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFPROZIL250/5 100ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314588", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1250.0, "discounted_cash": 937.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFPROZIL250/5 100ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314588", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1250.0, "discounted_cash": 937.5, "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": 10.0, "discounted_cash": 7.5, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 10.0, "discounted_cash": 7.5, "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": 353.0, "discounted_cash": 264.75, "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": 353.0, "discounted_cash": 264.75, "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": 0.01, "discounted_cash": 0.01, "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": 0.01, "discounted_cash": 0.01, "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": 146.0, "discounted_cash": 109.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFTAZIDIME PER 500MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0713", "type": "HCPCS"}, {"code": "5319060", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 146.0, "discounted_cash": 109.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFTOLOZ/TAZOBACT 75MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0695", "type": "HCPCS"}, {"code": "5319074", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "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": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFTRIAX PER250MG IVPBIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0696", "type": "HCPCS"}, {"code": "5319091", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "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": 39.0, "discounted_cash": 29.25, "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": 201.0, "discounted_cash": 150.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFTRIAXONE PER 250MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0696", "type": "HCPCS"}, {"code": "5319082", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 201.0, "discounted_cash": 150.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFUROXIME 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302121", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFUROXIME 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302121", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFUROXIME 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302122", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 62.0, "discounted_cash": 46.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CEFUROXIME 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302122", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 62.0, "discounted_cash": 46.5, "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": 62.0, "discounted_cash": 46.5, "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": 62.0, "discounted_cash": 46.5, "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": 193.0, "discounted_cash": 144.75, "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": 193.0, "discounted_cash": 144.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CELECOXIB 400MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302132", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CELECOXIB 400MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302132", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "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": 192.0, "discounted_cash": 144.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CELL COUNT MISC BODY FLD", "code_information": [{"code": "89050", "type": "CPT"}, {"code": "4179050", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 151.0, "discounted_cash": 113.25, "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": 385.0, "discounted_cash": 288.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CELL COUNT MISC W/DIFF", "code_information": [{"code": "89051", "type": "CPT"}, {"code": "4179051", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 303.0, "discounted_cash": 227.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CEMNT BN PLN FL MCPT CAP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011845", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3301.0, "discounted_cash": 2475.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CEMT BN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131520", "type": "CDM"}], "standard_charges": [{"gross_charge": 3599.0, "discounted_cash": 2699.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CEMT BN 2", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131521", "type": "CDM"}], "standard_charges": [{"gross_charge": 2388.0, "discounted_cash": 1791.0, "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": 3148.0, "discounted_cash": 2361.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CEMT BN INJECT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8173508", "type": "CDM"}], "standard_charges": [{"gross_charge": 25646.0, "discounted_cash": 19234.5, "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": 911.0, "discounted_cash": 683.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CEMT BN PL HALF STRYKER", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011010", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8359.0, "discounted_cash": 6269.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CEMT BN W/ANTIBIOTIC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131522", "type": "CDM"}], "standard_charges": [{"gross_charge": 3599.0, "discounted_cash": 2699.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CEMT PERC DELIVERY SYS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131527", "type": "CDM"}], "standard_charges": [{"gross_charge": 5943.0, "discounted_cash": 4457.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CEMT RSTR SET", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8173565", "type": "CDM"}], "standard_charges": [{"gross_charge": 3599.0, "discounted_cash": 2699.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CEMT SURG SIMP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8173570", "type": "CDM"}], "standard_charges": [{"gross_charge": 2808.0, "discounted_cash": 2106.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CEPBA GENE ANALYSIS", "code_information": [{"code": "81218", "type": "CPT"}, {"code": "7270013", "type": "CDM"}], "standard_charges": [{"gross_charge": 1336.0, "discounted_cash": 1002.0, "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": 10.0, "discounted_cash": 7.5, "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": 10.0, "discounted_cash": 7.5, "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": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CEPHALEXIN 500MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302208", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CEPHALEXIN125/5 100 PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314564", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 266.0, "discounted_cash": 199.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CEPHALEXIN125/5 100 PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314564", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 266.0, "discounted_cash": 199.5, "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": 3.0, "discounted_cash": 2.25, "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": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CERTOLIZUMAB PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0717", "type": "HCPCS"}, {"code": "5319199", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CERTOLIZUMAB PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0717", "type": "HCPCS"}, {"code": "5319199", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CERULOPLASMIN", "code_information": [{"code": "82390", "type": "CPT"}, {"code": "4172390", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 248.0, "discounted_cash": 186.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CERULOPLASMIN", "code_information": [{"code": "82390", "type": "CPT"}, {"code": "7002390", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CERULOPLASMIN", "code_information": [{"code": "82390", "type": "CPT"}, {"code": "7252390", "type": "CDM"}], "standard_charges": [{"gross_charge": 315.0, "discounted_cash": 236.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CERV SEMIRIG ADJ MLD CHN", "code_information": [{"code": "L0150", "type": "HCPCS"}, {"code": "8130075", "type": "CDM"}], "standard_charges": [{"gross_charge": 473.0, "discounted_cash": 354.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CERVICAL MYELO LUMB INJ", "code_information": [{"code": "4902301", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4577.0, "discounted_cash": 3432.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CERVICAL MYELO LUMB INJ", "code_information": [{"code": "4912301", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7034.0, "discounted_cash": 5275.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CETIRIZINE 1MG/ML 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314594", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 179.0, "discounted_cash": 134.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CETIRIZINE 1MG/ML 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314594", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 179.0, "discounted_cash": 134.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CETRIZINE/PSEUDOEP XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302247", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CETRIZINE/PSEUDOEP XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302247", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "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": 677.0, "discounted_cash": 507.75, "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": 677.0, "discounted_cash": 507.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CETYLPYRDN/BENZ 1 EA LZ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5302250", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 10.0, "discounted_cash": 7.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CETYLPYRDN/BENZ 1 EA LZ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5302250", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 10.0, "discounted_cash": 7.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CETYLPYRDN/BENZ 18 PK LZ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5302158", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CETYLPYRDN/BENZ 18 PK LZ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5302158", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CEVIMELINE 30MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302255", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CEVIMELINE 30MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302255", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CFTR COMMON VARIANTS/2", "code_information": [{"code": "81220", "type": "CPT"}, {"code": "7259204", "type": "CDM"}], "standard_charges": [{"gross_charge": 719.0, "discounted_cash": 539.25, "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": 6948.0, "discounted_cash": 5211.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHANGE BILIARY DRAIN CTH", "code_information": [{"code": "4917515", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 533.0, "discounted_cash": 399.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHANGE CYSTO TB SMPL", "code_information": [{"code": "4912040", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2032.0, "discounted_cash": 1524.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHANGE NEPHROSTOMY TUBE", "code_information": [{"code": "4917520", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2829.0, "discounted_cash": 2121.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHANGE PERC DRAIN CATH", "code_information": [{"code": "75984", "type": "CPT"}, {"code": "4915985", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1455.0, "discounted_cash": 1091.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHANGE URETER STENT PERC", "code_information": [{"code": "4917526", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7790.0, "discounted_cash": 5842.5, "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": 68.0, "discounted_cash": 51.0, "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": 68.0, "discounted_cash": 51.0, "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": 20.0, "discounted_cash": 15.0, "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": 20.0, "discounted_cash": 15.0, "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": 28.0, "discounted_cash": 21.0, "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": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHEM CAUTERY OF TISSUE", "code_information": [{"code": "6904010", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 617.0, "discounted_cash": 462.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHEM CAUTERY OF TISSUE", "code_information": [{"code": "6904010", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 617.0, "discounted_cash": 462.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHEMILUMINESCENT ASY/2", "code_information": [{"code": "82397", "type": "CPT"}, {"code": "7252397", "type": "CDM"}], "standard_charges": [{"gross_charge": 171.0, "discounted_cash": 128.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHEMILUMINESCENT ASY/3", "code_information": [{"code": "82397", "type": "CPT"}, {"code": "7252398", "type": "CDM"}], "standard_charges": [{"gross_charge": 735.0, "discounted_cash": 551.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHEMILUMINESCENT ASY/4", "code_information": [{"code": "82397", "type": "CPT"}, {"code": "7252402", "type": "CDM"}], "standard_charges": [{"gross_charge": 199.0, "discounted_cash": 149.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHEMILUMINESCENT ASY/6", "code_information": [{"code": "82397", "type": "CPT"}, {"code": "7253558", "type": "CDM"}], "standard_charges": [{"gross_charge": 196.0, "discounted_cash": 147.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHEMILUMNESCENT ASY", "code_information": [{"code": "82397", "type": "CPT"}, {"code": "7252396", "type": "CDM"}], "standard_charges": [{"gross_charge": 249.0, "discounted_cash": 186.75, "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": 1781.0, "discounted_cash": 1335.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHEMO INF EA ADD HR", "code_information": [{"code": "96415", "type": "CPT"}, {"code": "4546415", "type": "CDM"}, {"code": "335", "type": "RC"}], "standard_charges": [{"gross_charge": 388.0, "discounted_cash": 291.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHEMO INF SEQ ADD DRUG", "code_information": [{"code": "96417", "type": "CPT"}, {"code": "4546417", "type": "CDM"}, {"code": "335", "type": "RC"}], "standard_charges": [{"gross_charge": 462.0, "discounted_cash": 346.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHEMO IV <=1H INIT", "code_information": [{"code": "96413", "type": "CPT"}, {"code": "4546413", "type": "CDM"}, {"code": "335", "type": "RC"}], "standard_charges": [{"gross_charge": 432.0, "discounted_cash": 324.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHEMO SQ/IM HORMONAL", "code_information": [{"code": "96402", "type": "CPT"}, {"code": "4546402", "type": "CDM"}, {"code": "331", "type": "RC"}], "standard_charges": [{"gross_charge": 667.0, "discounted_cash": 500.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHEMO SQ/IM NONHORMONAL", "code_information": [{"code": "96401", "type": "CPT"}, {"code": "4546401", "type": "CDM"}, {"code": "331", "type": "RC"}], "standard_charges": [{"gross_charge": 667.0, "discounted_cash": 500.25, "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": 671.0, "discounted_cash": 503.25, "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": 671.0, "discounted_cash": 503.25, "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": 671.0, "discounted_cash": 503.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHEST 1 VIEW", "code_information": [{"code": "71045", "type": "CPT"}, {"code": "5121045", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 671.0, "discounted_cash": 503.25, "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": 967.0, "discounted_cash": 725.25, "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": 967.0, "discounted_cash": 725.25, "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": 967.0, "discounted_cash": 725.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHEST 2 VIEWS", "code_information": [{"code": "71046", "type": "CPT"}, {"code": "5121046", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 967.0, "discounted_cash": 725.25, "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": 488.0, "discounted_cash": 366.0, "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": 488.0, "discounted_cash": 366.0, "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": 488.0, "discounted_cash": 366.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHEST 3 VIEWS", "code_information": [{"code": "71047", "type": "CPT"}, {"code": "5121047", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 488.0, "discounted_cash": 366.0, "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": 824.0, "discounted_cash": 618.0, "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": 976.0, "discounted_cash": 732.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHIKUNGUNYA AB", "code_information": [{"code": "86790", "type": "CPT"}, {"code": "7256799", "type": "CDM"}], "standard_charges": [{"gross_charge": 295.0, "discounted_cash": 221.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLAMYDIA AB", "code_information": [{"code": "86631", "type": "CPT"}, {"code": "7026903", "type": "CDM"}], "standard_charges": [{"gross_charge": 130.0, "discounted_cash": 97.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLAMYDIA AB/2", "code_information": [{"code": "86631", "type": "CPT"}, {"code": "7006616", "type": "CDM"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 83.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLAMYDIA AB/3", "code_information": [{"code": "86631", "type": "CPT"}, {"code": "7006637", "type": "CDM"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 83.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLAMYDIA AB/5", "code_information": [{"code": "86631", "type": "CPT"}, {"code": "7006639", "type": "CDM"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 83.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLAMYDIA AB/5", "code_information": [{"code": "86631", "type": "CPT"}, {"code": "7256903", "type": "CDM"}], "standard_charges": [{"gross_charge": 210.0, "discounted_cash": 157.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLAMYDIA AB/7", "code_information": [{"code": "86631", "type": "CPT"}, {"code": "7006918", "type": "CDM"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 83.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLAMYDIA AB/9", "code_information": [{"code": "86631", "type": "CPT"}, {"code": "7006946", "type": "CDM"}], "standard_charges": [{"gross_charge": 179.0, "discounted_cash": 134.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLAMYDIA AMP PROBE", "code_information": [{"code": "87491", "type": "CPT"}, {"code": "4107492", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 776.0, "discounted_cash": 582.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLAMYDIA AMP PROBE", "code_information": [{"code": "87491", "type": "CPT"}, {"code": "4177492", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 610.0, "discounted_cash": 457.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLAMYDIA AMP PROBE", "code_information": [{"code": "87491", "type": "CPT"}, {"code": "7007492", "type": "CDM"}], "standard_charges": [{"gross_charge": 464.0, "discounted_cash": 348.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLAMYDIA AMP PROBE/2", "code_information": [{"code": "87491", "type": "CPT"}, {"code": "7257492", "type": "CDM"}], "standard_charges": [{"gross_charge": 622.0, "discounted_cash": 466.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLAMYDIA DIRECT PRB", "code_information": [{"code": "87490", "type": "CPT"}, {"code": "7007179", "type": "CDM"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLAMYDIA DIRECT PRB/2", "code_information": [{"code": "87490", "type": "CPT"}, {"code": "7257179", "type": "CDM"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLAMYDIA IA", "code_information": [{"code": "87320", "type": "CPT"}, {"code": "4106313", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 293.0, "discounted_cash": 219.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLAMYDIA IA", "code_information": [{"code": "87320", "type": "CPT"}, {"code": "4176313", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 231.0, "discounted_cash": 173.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLAMYDIA IGM", "code_information": [{"code": "86632", "type": "CPT"}, {"code": "7256629", "type": "CDM"}], "standard_charges": [{"gross_charge": 234.0, "discounted_cash": 175.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLAMYDIA IGM/2", "code_information": [{"code": "86632", "type": "CPT"}, {"code": "7006629", "type": "CDM"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 83.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLAMYDIA IGM/2", "code_information": [{"code": "86632", "type": "CPT"}, {"code": "7256632", "type": "CDM"}], "standard_charges": [{"gross_charge": 244.0, "discounted_cash": 183.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLAMYDIA IGM/3", "code_information": [{"code": "86632", "type": "CPT"}, {"code": "7006632", "type": "CDM"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 83.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLAMYDIA IGM/4", "code_information": [{"code": "86632", "type": "CPT"}, {"code": "7006945", "type": "CDM"}], "standard_charges": [{"gross_charge": 179.0, "discounted_cash": 134.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLAMYDIA PNEUM AMP PRB", "code_information": [{"code": "87486", "type": "CPT"}, {"code": "7257488", "type": "CDM"}], "standard_charges": [{"gross_charge": 194.0, "discounted_cash": 145.5, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 93.0, "discounted_cash": 69.75, "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": 93.0, "discounted_cash": 69.75, "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": 16.0, "discounted_cash": 12.0, "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": 16.0, "discounted_cash": 12.0, "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": 23.0, "discounted_cash": 17.25, "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": 23.0, "discounted_cash": 17.25, "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": 19.0, "discounted_cash": 14.25, "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": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORDIAZEPOXUPTO100MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1990", "type": "HCPCS"}, {"code": "5319205", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 116.0, "discounted_cash": 87.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORDIAZEPOXUPTO100MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1990", "type": "HCPCS"}, {"code": "5319205", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 116.0, "discounted_cash": 87.0, "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": 55.0, "discounted_cash": 41.25, "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": 55.0, "discounted_cash": 41.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORHEXIDINE 15ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314638", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "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": 168.0, "discounted_cash": 126.0, "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": 168.0, "discounted_cash": 126.0, "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": 21.0, "discounted_cash": 15.75, "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": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORIDE", "code_information": [{"code": "82435", "type": "CPT"}, {"code": "4172439", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORIDE", "code_information": [{"code": "82435", "type": "CPT"}, {"code": "7002439", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "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": 75.0, "discounted_cash": 56.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORIDE OTHER SOURCE/2", "code_information": [{"code": "82438", "type": "CPT"}, {"code": "7252439", "type": "CDM"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORIDE OTHER SOURCE/3", "code_information": [{"code": "82438", "type": "CPT"}, {"code": "7002442", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 156.0, "discounted_cash": 117.0, "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": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORIDE URINE/2", "code_information": [{"code": "82436", "type": "CPT"}, {"code": "4172436", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 98.0, "discounted_cash": 73.5, "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": 0.14, "discounted_cash": 0.11, "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": 0.14, "discounted_cash": 0.11, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLOROTHIAZID PER500MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1205", "type": "HCPCS"}, {"code": "5319262", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3883.0, "discounted_cash": 2912.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLOROTHIAZID PER500MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1205", "type": "HCPCS"}, {"code": "5319262", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 3883.0, "discounted_cash": 2912.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLOROTHIAZIDE CMPD LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314673", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLOROTHIAZIDE CMPD LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314673", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "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": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 160.0, "discounted_cash": 120.0, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 160.0, "discounted_cash": 120.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORPROMAZIN 30/1 120LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314663", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 944.0, "discounted_cash": 708.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORPROMAZIN 30/1 120LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314663", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 944.0, "discounted_cash": 708.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORPROMAZINE 10/5 30LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314666", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1049.0, "discounted_cash": 786.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORPROMAZINE 10/5 30LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314666", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1049.0, "discounted_cash": 786.75, "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": 33.0, "discounted_cash": 24.75, "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": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORPROMAZINE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302590", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORPROMAZINE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302590", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORPROMAZINE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302594", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "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": 19.0, "discounted_cash": 14.25, "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": 20.0, "discounted_cash": 15.0, "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": 20.0, "discounted_cash": 15.0, "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": 19.0, "discounted_cash": 14.25, "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": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORPROPAMIDE 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302641", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORPROPAMIDE 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302641", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORTHALIDONE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302664", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 7.0, "discounted_cash": 5.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORTHALIDONE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302664", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 7.0, "discounted_cash": 5.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORTHALIDONE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302668", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORTHALIDONE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302668", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORTHIAZIDE250 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314671", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHLORTHIAZIDE250 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314671", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHOLANGIO INTRAOP S&I INIT", "code_information": [{"code": "74300", "type": "CPT"}, {"code": "4904300", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2181.0, "discounted_cash": 1635.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHOLANGIO+INJ EXIST CTH", "code_information": [{"code": "4907531", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2277.0, "discounted_cash": 1707.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHOLANGIO+INJ EXIST CTH", "code_information": [{"code": "4917531", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1604.0, "discounted_cash": 1203.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHOLANGIO+INJ NEW", "code_information": [{"code": "4917532", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3734.0, "discounted_cash": 2800.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHOLESTEROL", "code_information": [{"code": "84311", "type": "CPT"}, {"code": "4176366", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHOLESTEROL", "code_information": [{"code": "84311", "type": "CPT"}, {"code": "7258432", "type": "CDM"}], "standard_charges": [{"gross_charge": 89.0, "discounted_cash": 66.75, "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": 133.0, "discounted_cash": 99.75, "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": 58.0, "discounted_cash": 43.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHOLESTEROL HDL", "code_information": [{"code": "83718", "type": "CPT"}, {"code": "4172477", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 105.0, "discounted_cash": 78.75, "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": 106.0, "discounted_cash": 79.5, "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": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHOLESTEROL TOTAL", "code_information": [{"code": "82465", "type": "CPT"}, {"code": "4172465", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHOLESTEROL TOTAL", "code_information": [{"code": "82465", "type": "CPT"}, {"code": "7002465", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "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": 45.0, "discounted_cash": 33.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHOLESTYRAMINE 4GM PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314680", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 45.0, "discounted_cash": 33.75, "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": 204.0, "discounted_cash": 153.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 204.0, "discounted_cash": 153.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CHOLINE/MAG SAL 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302718", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHOLINE/MAG SAL 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302718", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHOLINE/MAG SAL 750MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302719", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHOLINE/MAG SAL 750MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302719", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHOLINESTERASE PSEUDO", "code_information": [{"code": "82480", "type": "CPT"}, {"code": "7252480", "type": "CDM"}], "standard_charges": [{"gross_charge": 137.0, "discounted_cash": 102.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHOLINESTERASE RBC", "code_information": [{"code": "82482", "type": "CPT"}, {"code": "7252482", "type": "CDM"}], "standard_charges": [{"gross_charge": 98.0, "discounted_cash": 73.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHRM ANAL 15-20 CELL W/BND", "code_information": [{"code": "88262", "type": "CPT"}, {"code": "7028255", "type": "CDM"}], "standard_charges": [{"gross_charge": 6093.0, "discounted_cash": 4569.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHRM ANAL 15-20 CELL W/BND", "code_information": [{"code": "88262", "type": "CPT"}, {"code": "7270073", "type": "CDM"}], "standard_charges": [{"gross_charge": 557.0, "discounted_cash": 417.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHRM ANAL 15-20 CELL W/BND/2", "code_information": [{"code": "88262", "type": "CPT"}, {"code": "7258257", "type": "CDM"}], "standard_charges": [{"gross_charge": 659.0, "discounted_cash": 494.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHRM ANAL 15-20 CELL W/BND/4", "code_information": [{"code": "88262", "type": "CPT"}, {"code": "7258255", "type": "CDM"}], "standard_charges": [{"gross_charge": 1499.0, "discounted_cash": 1124.25, "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": 1545.0, "discounted_cash": 1158.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHRM ANAL 45 CELL W/BND", "code_information": [{"code": "88263", "type": "CPT"}, {"code": "7250010", "type": "CDM"}], "standard_charges": [{"gross_charge": 829.0, "discounted_cash": 621.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHROM/MASS SPEC NES QL", "code_information": [{"code": "82542", "type": "CPT"}, {"code": "7142544", "type": "CDM"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHROM/MASS SPEC NES QL/2", "code_information": [{"code": "82542", "type": "CPT"}, {"code": "7002481", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 403.0, "discounted_cash": 302.25, "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": 1379.0, "discounted_cash": 1034.25, "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": 1070.0, "discounted_cash": 802.5, "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": 935.0, "discounted_cash": 701.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CHROMATOGRPHY QUAN NES/2", "code_information": [{"code": "82542", "type": "CPT"}, {"code": "7251284", "type": "CDM"}], "standard_charges": [{"gross_charge": 1177.0, "discounted_cash": 882.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHROMIUM/2", "code_information": [{"code": "82495", "type": "CPT"}, {"code": "7252495", "type": "CDM"}], "standard_charges": [{"gross_charge": 157.0, "discounted_cash": 117.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CHROMO ADD KARYOTYPES EA", "code_information": [{"code": "88280", "type": "CPT"}, {"code": "7270075", "type": "CDM"}], "standard_charges": [{"gross_charge": 211.0, "discounted_cash": 158.25, "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": 542.0, "discounted_cash": 406.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CHYLOMICRONS", "code_information": [{"code": "84999", "type": "CPT"}, {"code": "7252504", "type": "CDM"}], "standard_charges": [{"gross_charge": 241.0, "discounted_cash": 180.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CICLOPIROX .77% 30GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334849", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CICLOPIROX .77% 30GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334849", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CICLOPIROX 1% 120ML SH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334839", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 762.0, "discounted_cash": 571.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CICLOPIROX 1% 120ML SH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334839", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 762.0, "discounted_cash": 571.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CIDOFOVIR PER 375MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0740", "type": "HCPCS"}, {"code": "5319365", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 17053.0, "discounted_cash": 12789.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CIDOFOVIR PER 375MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0740", "type": "HCPCS"}, {"code": "5319365", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 17053.0, "discounted_cash": 12789.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CILOSTAZOL 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302731", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 192.0, "discounted_cash": 144.0, "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": 192.0, "discounted_cash": 144.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CIMETIDINE 200MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5302741", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CIMETIDINE 200MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5302741", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CIMETIDINE PER 300MG IJ", "code_information": [{"code": "S0023", "type": "HCPCS"}, {"code": "5319377", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 253.0, "discounted_cash": 189.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CINACALCET 30MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302762", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 367.0, "discounted_cash": 275.25, "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": 367.0, "discounted_cash": 275.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CIPROFLOX 250/5 100 PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314713", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1141.0, "discounted_cash": 855.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CIPROFLOX 250/5 100 PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314713", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1141.0, "discounted_cash": 855.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CIPROFLOX PER200MG PMXIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0744", "type": "HCPCS"}, {"code": "5319388", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CIPROFLOX PER200MG PMXIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0744", "type": "HCPCS"}, {"code": "5319388", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CIPROFLOX/DEXM 7.5ML OT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330543", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 480.0, "discounted_cash": 360.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CIPROFLOX/DEXM 7.5ML OT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330543", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 480.0, "discounted_cash": 360.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CIPROFLOXACIN .3% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330547", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 656.0, "discounted_cash": 492.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CIPROFLOXACIN .3% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330547", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 656.0, "discounted_cash": 492.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CIPROFLOXACIN 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302775", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CIPROFLOXACIN 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302775", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CIPROFLOXACIN 500MGTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302776", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CIPROFLOXACIN 500MGTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302776", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 114.0, "discounted_cash": 85.5, "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": 114.0, "discounted_cash": 85.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CIPROFLOXACIN.3%3.5GM OO", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330549", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 870.0, "discounted_cash": 652.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CIPROFLOXACIN.3%3.5GM OO", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330549", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 870.0, "discounted_cash": 652.5, "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": 687.0, "discounted_cash": 515.25, "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": 687.0, "discounted_cash": 515.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CIRC ASSIST INT", "code_information": [{"code": "92970", "type": "CPT"}, {"code": "4612970", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 10314.0, "discounted_cash": 7735.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CIRCUMCISION", "code_information": [{"code": "3110150", "type": "CDM"}, {"code": "723", "type": "RC"}], "standard_charges": [{"gross_charge": 1209.0, "discounted_cash": 906.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CISATRACURM 2MG/ML 5MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5319391", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 716.0, "discounted_cash": 537.0, "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": 108.0, "discounted_cash": 81.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CISTERNOGRAM", "code_information": [{"code": "78630", "type": "CPT"}, {"code": "5208630", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 2002.0, "discounted_cash": 1501.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CITALOPRAM 10/5 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314731", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CITALOPRAM 10/5 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314731", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": 12.0, "discounted_cash": 9.0, "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": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CITRATE/2", "code_information": [{"code": "82507", "type": "CPT"}, {"code": "7002509", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 207.0, "discounted_cash": 155.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CK MB FRACTION", "code_information": [{"code": "82553", "type": "CPT"}, {"code": "4102553", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 600.0, "discounted_cash": 450.0, "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": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CK MB FRACTION", "code_information": [{"code": "82553", "type": "CPT"}, {"code": "4172553", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CK MB FRACTION", "code_information": [{"code": "82553", "type": "CPT"}, {"code": "7252553", "type": "CDM"}], "standard_charges": [{"gross_charge": 98.0, "discounted_cash": 73.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CLARITHROMY125/5 100PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314755", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1365.0, "discounted_cash": 1023.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLARITHROMY125/5 100PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314755", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1365.0, "discounted_cash": 1023.75, "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": 1139.0, "discounted_cash": 854.25, "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": 1139.0, "discounted_cash": 854.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLARITHROMYCI 250/5 PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314758", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 388.0, "discounted_cash": 291.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLARITHROMYCI 250/5 PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314758", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 388.0, "discounted_cash": 291.0, "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": 118.0, "discounted_cash": 88.5, "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": 118.0, "discounted_cash": 88.5, "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": 368.0, "discounted_cash": 276.0, "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": 368.0, "discounted_cash": 276.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLARITHROMYCIN500MGXR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302782", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 349.0, "discounted_cash": 261.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLARITHROMYCIN500MGXR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302782", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 349.0, "discounted_cash": 261.75, "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": 1292.0, "discounted_cash": 969.0, "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": 1292.0, "discounted_cash": 969.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLAVICLE COMPLETE", "code_information": [{"code": "73000", "type": "CPT"}, {"code": "5113000", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1292.0, "discounted_cash": 969.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLAVICLE COMPLETE", "code_information": [{"code": "73000", "type": "CPT"}, {"code": "5123000", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1292.0, "discounted_cash": 969.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLINDAMYCIN 1% 60ML TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334867", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 528.0, "discounted_cash": 396.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLINDAMYCIN 1% 60ML TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334867", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 528.0, "discounted_cash": 396.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLINDAMYCIN 100MG V SU", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338255", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1053.0, "discounted_cash": 789.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLINDAMYCIN 100MG V SU", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338255", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1053.0, "discounted_cash": 789.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLINDAMYCIN 150MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302814", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "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": 114.0, "discounted_cash": 85.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 114.0, "discounted_cash": 85.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CLINDAMYCIN 75/5 100PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314770", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 229.0, "discounted_cash": 171.75, "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": 229.0, "discounted_cash": 171.75, "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": 134.0, "discounted_cash": 100.5, "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": 134.0, "discounted_cash": 100.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 87.75, "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": 117.0, "discounted_cash": 87.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLIP ANEURANEUR", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8141285", "type": "CDM"}], "standard_charges": [{"gross_charge": 13855.0, "discounted_cash": 10391.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLMP CRANIAL TITANIUM", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8192009", "type": "CDM"}], "standard_charges": [{"gross_charge": 3507.0, "discounted_cash": 2630.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOBAZAM 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302851", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOBAZAM 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302851", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "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": 412.0, "discounted_cash": 309.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 412.0, "discounted_cash": 309.0, "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": 12.0, "discounted_cash": 9.0, "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": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOMIPRAMINE 75MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302892", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOMIPRAMINE 75MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302892", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "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": 10.0, "discounted_cash": 7.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 10.0, "discounted_cash": 7.5, "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": 10.0, "discounted_cash": 7.5, "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": 10.0, "discounted_cash": 7.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CLONIDINE", "code_information": [{"code": "80375", "type": "CPT"}, {"code": "7252544", "type": "CDM"}], "standard_charges": [{"gross_charge": 483.0, "discounted_cash": 362.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLONIDINE .1MG XR TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334897", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 729.0, "discounted_cash": 546.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLONIDINE .1MG XR TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334897", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 729.0, "discounted_cash": 546.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLONIDINE .2MG XR TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334899", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 692.0, "discounted_cash": 519.0, "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": 692.0, "discounted_cash": 519.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 825.0, "discounted_cash": 618.75, "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": 825.0, "discounted_cash": 618.75, "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": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLONIDINE 0.1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302941", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLONIDINE 0.2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302945", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLONIDINE 0.2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302945", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLONIDINE 0.3MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302949", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 10.0, "discounted_cash": 7.5, "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": 10.0, "discounted_cash": 7.5, "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": 3.0, "discounted_cash": 2.25, "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": 3.0, "discounted_cash": 2.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1602.0, "discounted_cash": 1201.5, "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": 1602.0, "discounted_cash": 1201.5, "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": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOPIDOGREL 300MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302970", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "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": 3.0, "discounted_cash": 2.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "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": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLORAZEPATE 3.75MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5302976", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "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": 14.0, "discounted_cash": 10.5, "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": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOSTRIDIUM IA", "code_information": [{"code": "87324", "type": "CPT"}, {"code": "4105006", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 277.0, "discounted_cash": 207.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOSTRIDIUM IA", "code_information": [{"code": "87324", "type": "CPT"}, {"code": "4175006", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 218.0, "discounted_cash": 163.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOSTRIDIUM IA", "code_information": [{"code": "87324", "type": "CPT"}, {"code": "7255006", "type": "CDM"}], "standard_charges": [{"gross_charge": 114.0, "discounted_cash": 85.5, "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": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FACTOR II PRTHRMBN", "code_information": [{"code": "85210", "type": "CPT"}, {"code": "4175210", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 83.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FACTOR II PRTHRMBN", "code_information": [{"code": "85210", "type": "CPT"}, {"code": "7005210", "type": "CDM"}], "standard_charges": [{"gross_charge": 1158.0, "discounted_cash": 868.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FACTOR II PRTHRMBN", "code_information": [{"code": "85210", "type": "CPT"}, {"code": "7255210", "type": "CDM"}], "standard_charges": [{"gross_charge": 142.0, "discounted_cash": 106.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FACTOR V (LABILE)", "code_information": [{"code": "85220", "type": "CPT"}, {"code": "4175221", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 427.0, "discounted_cash": 320.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FACTOR V (LABILE)", "code_information": [{"code": "85220", "type": "CPT"}, {"code": "7005220", "type": "CDM"}], "standard_charges": [{"gross_charge": 319.0, "discounted_cash": 239.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FACTOR V (LABILE)", "code_information": [{"code": "85220", "type": "CPT"}, {"code": "7255220", "type": "CDM"}], "standard_charges": [{"gross_charge": 543.0, "discounted_cash": 407.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FACTOR VII(STABLE)", "code_information": [{"code": "85230", "type": "CPT"}, {"code": "4175230", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 491.0, "discounted_cash": 368.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FACTOR VII(STABLE)", "code_information": [{"code": "85230", "type": "CPT"}, {"code": "7005230", "type": "CDM"}], "standard_charges": [{"gross_charge": 319.0, "discounted_cash": 239.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FACTOR VII(STABLE)", "code_information": [{"code": "85230", "type": "CPT"}, {"code": "7255230", "type": "CDM"}], "standard_charges": [{"gross_charge": 623.0, "discounted_cash": 467.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FCTR IX(PTC/XMAS)", "code_information": [{"code": "85250", "type": "CPT"}, {"code": "4175250", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 427.0, "discounted_cash": 320.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FCTR IX(PTC/XMAS)", "code_information": [{"code": "85250", "type": "CPT"}, {"code": "7005250", "type": "CDM"}], "standard_charges": [{"gross_charge": 749.0, "discounted_cash": 561.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FCTR IX(PTC/XMAS)", "code_information": [{"code": "85250", "type": "CPT"}, {"code": "7255250", "type": "CDM"}], "standard_charges": [{"gross_charge": 543.0, "discounted_cash": 407.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FCTR VIII RELATE AG", "code_information": [{"code": "85244", "type": "CPT"}, {"code": "7005231", "type": "CDM"}], "standard_charges": [{"gross_charge": 1158.0, "discounted_cash": 868.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FCTR VIII RELATE AG", "code_information": [{"code": "85244", "type": "CPT"}, {"code": "7258524", "type": "CDM"}], "standard_charges": [{"gross_charge": 1497.0, "discounted_cash": 1122.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FCTR VIII(AHG)1 STG", "code_information": [{"code": "85240", "type": "CPT"}, {"code": "4175240", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 427.0, "discounted_cash": 320.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FCTR VIII(AHG)1 STG", "code_information": [{"code": "85240", "type": "CPT"}, {"code": "7005240", "type": "CDM"}], "standard_charges": [{"gross_charge": 1158.0, "discounted_cash": 868.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FCTR VIII(AHG)1 STG", "code_information": [{"code": "85240", "type": "CPT"}, {"code": "7255240", "type": "CDM"}], "standard_charges": [{"gross_charge": 543.0, "discounted_cash": 407.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FCTR X(STUART-PRWR)", "code_information": [{"code": "85260", "type": "CPT"}, {"code": "4175260", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 98.0, "discounted_cash": 73.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FCTR X(STUART-PRWR)", "code_information": [{"code": "85260", "type": "CPT"}, {"code": "7005260", "type": "CDM"}], "standard_charges": [{"gross_charge": 319.0, "discounted_cash": 239.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FCTR X(STUART-PRWR)", "code_information": [{"code": "85260", "type": "CPT"}, {"code": "7255260", "type": "CDM"}], "standard_charges": [{"gross_charge": 124.0, "discounted_cash": 93.0, "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": 347.0, "discounted_cash": 260.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FCTR XI(PTA)", "code_information": [{"code": "85270", "type": "CPT"}, {"code": "4175270", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 427.0, "discounted_cash": 320.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FCTR XI(PTA)", "code_information": [{"code": "85270", "type": "CPT"}, {"code": "7005270", "type": "CDM"}], "standard_charges": [{"gross_charge": 319.0, "discounted_cash": 239.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FCTR XI(PTA)", "code_information": [{"code": "85270", "type": "CPT"}, {"code": "7255270", "type": "CDM"}], "standard_charges": [{"gross_charge": 543.0, "discounted_cash": 407.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FCTR XII(HAGEMANN)", "code_information": [{"code": "85280", "type": "CPT"}, {"code": "4175280", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 491.0, "discounted_cash": 368.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FCTR XII(HAGEMANN)", "code_information": [{"code": "85280", "type": "CPT"}, {"code": "7005280", "type": "CDM"}], "standard_charges": [{"gross_charge": 319.0, "discounted_cash": 239.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FCTR XII(HAGEMANN)", "code_information": [{"code": "85280", "type": "CPT"}, {"code": "7255280", "type": "CDM"}], "standard_charges": [{"gross_charge": 623.0, "discounted_cash": 467.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOT FCTR XIII(FBRN STB)", "code_information": [{"code": "85290", "type": "CPT"}, {"code": "7005290", "type": "CDM"}], "standard_charges": [{"gross_charge": 412.0, "discounted_cash": 309.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOTRIMAZ/BETAMET 15GMCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334893", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "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": 26.0, "discounted_cash": 19.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOTRIMAZ/BETAMET 30MLLT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334892", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 173.0, "discounted_cash": 129.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOTRIMAZ/BETAMET 30MLLT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334892", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 173.0, "discounted_cash": 129.75, "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": 129.0, "discounted_cash": 96.75, "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": 129.0, "discounted_cash": 96.75, "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": 49.0, "discounted_cash": 36.75, "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": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOTRIMAZOLE 1% 30GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334874", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOTRIMAZOLE 1% 30GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334874", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "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": 19.0, "discounted_cash": 14.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 142.0, "discounted_cash": 106.5, "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": 142.0, "discounted_cash": 106.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOTRIMAZOLE1%45GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334883", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 114.0, "discounted_cash": 85.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOTRIMAZOLE1%45GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334883", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 114.0, "discounted_cash": 85.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOZAPINE", "code_information": [{"code": "80159", "type": "CPT"}, {"code": "7250062", "type": "CDM"}], "standard_charges": [{"gross_charge": 391.0, "discounted_cash": 293.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOZAPINE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303017", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 97.0, "discounted_cash": 72.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOZAPINE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303017", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 97.0, "discounted_cash": 72.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOZAPINE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303016", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CLOZAPINE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303016", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CMP EP ABL INTRA AFIB PVI EP3D", "code_information": [{"code": "93656", "type": "CPT"}, {"code": "4613663", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 71245.0, "discounted_cash": 53433.75, "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": 71245.0, "discounted_cash": 53433.75, "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": 20772.0, "discounted_cash": 15579.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CMP FEM UNCTD SPHERE MEDACT CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013450", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 18043.0, "discounted_cash": 13532.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CMP FEM UNCTD SPHERE MEDACT CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013458", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 54500.0, "discounted_cash": 40875.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CMP HMRL STM FR SHLD ARTHRO CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013304", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 21966.0, "discounted_cash": 16474.5, "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": 5222.0, "discounted_cash": 3916.5, "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": 6362.0, "discounted_cash": 4771.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CMV QUANT", "code_information": [{"code": "87497", "type": "CPT"}, {"code": "7007498", "type": "CDM"}], "standard_charges": [{"gross_charge": 2108.0, "discounted_cash": 1581.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CMV QUANT/2", "code_information": [{"code": "87497", "type": "CPT"}, {"code": "7257497", "type": "CDM"}], "standard_charges": [{"gross_charge": 694.0, "discounted_cash": 520.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CNS PATHOGENS 12-25", "code_information": [{"code": "87483", "type": "CPT"}, {"code": "4177483", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 2082.0, "discounted_cash": 1561.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CNS PATHOGENS 12-25", "code_information": [{"code": "87483", "type": "CPT"}, {"code": "7257483", "type": "CDM"}], "standard_charges": [{"gross_charge": 2648.0, "discounted_cash": 1986.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CNSLT/RPT REFRD MATERIAL", "code_information": [{"code": "88323", "type": "CPT"}, {"code": "7098323", "type": "CDM"}], "standard_charges": [{"gross_charge": 243.0, "discounted_cash": 182.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CNSLT/RPT REFRD SLIDES", "code_information": [{"code": "88321", "type": "CPT"}, {"code": "7098321", "type": "CDM"}], "standard_charges": [{"gross_charge": 388.0, "discounted_cash": 291.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COAG TIME OTHER METHODS", "code_information": [{"code": "85348", "type": "CPT"}, {"code": "4105168", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COAGULATION TIME ACTIVTD", "code_information": [{"code": "85347", "type": "CPT"}, {"code": "4105347", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 277.0, "discounted_cash": 207.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COAGULATION TIME ACTIVTD", "code_information": [{"code": "85347", "type": "CPT"}, {"code": "4175347", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 218.0, "discounted_cash": 163.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COAGULATION TIME ACTIVTD/2", "code_information": [{"code": "85347", "type": "CPT"}, {"code": "4100382", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "COCAINE", "code_information": [{"code": "80353", "type": "CPT"}, {"code": "7052520", "type": "CDM"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COCAINE", "code_information": [{"code": "80353", "type": "CPT"}, {"code": "7252520", "type": "CDM"}], "standard_charges": [{"gross_charge": 222.0, "discounted_cash": 166.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COCAINE 4% 4ML TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5327318", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 244.0, "discounted_cash": 183.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COCAINE/2", "code_information": [{"code": "80353", "type": "CPT"}, {"code": "7002520", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 201.0, "discounted_cash": 150.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COCCIDIOIDES ANTIBODY/2", "code_information": [{"code": "86635", "type": "CPT"}, {"code": "4176636", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COCCIDIOIDES ANTIBODY/2", "code_information": [{"code": "86635", "type": "CPT"}, {"code": "7256172", "type": "CDM"}], "standard_charges": [{"gross_charge": 82.0, "discounted_cash": 61.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COCCIDIOIDES ANTIBODY/4", "code_information": [{"code": "86635", "type": "CPT"}, {"code": "7006172", "type": "CDM"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 105.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COIL EMB PERIPH COMPLEX", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8187026", "type": "CDM"}], "standard_charges": [{"gross_charge": 11557.0, "discounted_cash": 8667.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COIL EMBOLIC", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8031745", "type": "CDM"}], "standard_charges": [{"gross_charge": 1442.0, "discounted_cash": 1081.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COIL EMBOLIC DETACH", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8060300", "type": "CDM"}], "standard_charges": [{"gross_charge": 25768.0, "discounted_cash": 19326.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COIL EMBOLIC DETACH 2", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8060301", "type": "CDM"}], "standard_charges": [{"gross_charge": 17703.0, "discounted_cash": 13277.25, "setting": "both", "billing_class": "facility"}]}, {"description": "COIL PV DIAMOND", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "4021018", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5918.0, "discounted_cash": 4438.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COIL PV PLATINUM", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "4021019", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2329.0, "discounted_cash": 1746.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COLCHICINE .6MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303042", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COLCHICINE .6MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303042", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COLD AGGLUTINATN TITER", "code_information": [{"code": "86157", "type": "CPT"}, {"code": "4106015", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 301.0, "discounted_cash": 225.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COLD AGGLUTINATN TITER", "code_information": [{"code": "86157", "type": "CPT"}, {"code": "4176015", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 237.0, "discounted_cash": 177.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COLD AGGLUTINATN TITER", "code_information": [{"code": "86157", "type": "CPT"}, {"code": "7256015", "type": "CDM"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "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": 77.0, "discounted_cash": 57.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "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": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COLESTIPOL 1GM TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303044", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 45.0, "discounted_cash": 33.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COLESTIPOL 1GM TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303044", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 45.0, "discounted_cash": 33.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COLESTIPOL 5GM PK", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314848", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COLESTIPOL 5GM PK", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314848", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "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": 900.0, "discounted_cash": 675.0, "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": 900.0, "discounted_cash": 675.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COLLAGEN CROSS LINKS", "code_information": [{"code": "82523", "type": "CPT"}, {"code": "7252523", "type": "CDM"}], "standard_charges": [{"gross_charge": 694.0, "discounted_cash": 520.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COLLAGEN CROSS LINKS/6", "code_information": [{"code": "82523", "type": "CPT"}, {"code": "7258252", "type": "CDM"}], "standard_charges": [{"gross_charge": 245.0, "discounted_cash": 183.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COLLAGEN MIC SHT70X35 EA", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5336612", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 594.0, "discounted_cash": 445.5, "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": 1013.0, "discounted_cash": 759.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COLLAGENASE250U/GM15GMOI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5334957", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1130.0, "discounted_cash": 847.5, "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": 1130.0, "discounted_cash": 847.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COLLAR MIAMI J", "code_information": [{"code": "L0174", "type": "HCPCS"}, {"code": "8114198", "type": "CDM"}], "standard_charges": [{"gross_charge": 392.0, "discounted_cash": 294.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COLLODION FLEX 120ML TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5334963", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 256.0, "discounted_cash": 192.0, "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": 2756.0, "discounted_cash": 2067.0, "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": 2756.0, "discounted_cash": 2067.0, "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": 1988.0, "discounted_cash": 1491.0, "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": 1988.0, "discounted_cash": 1491.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COLONIC LAVAGE 1L PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314380", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 174.0, "discounted_cash": 130.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COLONIC LAVAGE 1L PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314380", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 174.0, "discounted_cash": 130.5, "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": 619.0, "discounted_cash": 464.25, "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": 619.0, "discounted_cash": 464.25, "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": 63889.0, "discounted_cash": 47916.75, "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": 18543.0, "discounted_cash": 13907.25, "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": 71306.0, "discounted_cash": 53479.5, "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": 24731.0, "discounted_cash": 18548.25, "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": 71245.0, "discounted_cash": 53433.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COMP FEM COATD ATTUNE DEPUY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012818", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16758.0, "discounted_cash": 12568.5, "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": 20358.0, "discounted_cash": 15268.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COMP FEM UNCT FLX ATT DPY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012810", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 14946.0, "discounted_cash": 11209.5, "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": 20930.0, "discounted_cash": 15697.5, "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": 16618.0, "discounted_cash": 12463.5, "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": 17923.0, "discounted_cash": 13442.25, "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": 47359.0, "discounted_cash": 35519.25, "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": 950.0, "discounted_cash": 712.5, "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": 82.0, "discounted_cash": 61.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COMP METABOLIC PANEL", "code_information": [{"code": "80053", "type": "CPT"}, {"code": "4170111", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 747.0, "discounted_cash": 560.25, "setting": "both", "billing_class": "facility"}]}, {"description": "COMP METABOLIC PANEL", "code_information": [{"code": "80053", "type": "CPT"}, {"code": "7250113", "type": "CDM"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COMP REV MATERIAL", "code_information": [{"code": "88325", "type": "CPT"}, {"code": "7098326", "type": "CDM"}], "standard_charges": [{"gross_charge": 958.0, "discounted_cash": 718.5, "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": 349.0, "discounted_cash": 261.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COMP TST EA ELECTRONIC", "code_information": [{"code": "86923", "type": "CPT"}, {"code": "4176923", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 274.0, "discounted_cash": 205.5, "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": 351.0, "discounted_cash": 263.25, "setting": "both", "billing_class": "facility"}]}, {"description": "COMP TST EA UT AHG TECH", "code_information": [{"code": "86922", "type": "CPT"}, {"code": "4176212", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 276.0, "discounted_cash": 207.0, "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": 675.0, "discounted_cash": 506.25, "setting": "both", "billing_class": "facility"}]}, {"description": "COMP TST EA UT INCUB TCH", "code_information": [{"code": "86921", "type": "CPT"}, {"code": "4176211", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 87.0, "discounted_cash": 65.25, "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": 398.0, "discounted_cash": 298.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COMP TST EA UT SPIN TECH", "code_information": [{"code": "86920", "type": "CPT"}, {"code": "4176210", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 313.0, "discounted_cash": 234.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPLEMENT AG EA", "code_information": [{"code": "86160", "type": "CPT"}, {"code": "4106159", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 57.0, "discounted_cash": 42.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPLEMENT AG EA", "code_information": [{"code": "86160", "type": "CPT"}, {"code": "4176159", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 198.0, "discounted_cash": 148.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPLEMENT AG EA", "code_information": [{"code": "86160", "type": "CPT"}, {"code": "7256136", "type": "CDM"}], "standard_charges": [{"gross_charge": 252.0, "discounted_cash": 189.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPLEMENT AG EA/10", "code_information": [{"code": "86160", "type": "CPT"}, {"code": "7006161", "type": "CDM"}], "standard_charges": [{"gross_charge": 611.0, "discounted_cash": 458.25, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPLEMENT AG EA/10", "code_information": [{"code": "86160", "type": "CPT"}, {"code": "7256332", "type": "CDM"}], "standard_charges": [{"gross_charge": 283.0, "discounted_cash": 212.25, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPLEMENT AG EA/11", "code_information": [{"code": "86160", "type": "CPT"}, {"code": "7006332", "type": "CDM"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 105.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPLEMENT AG EA/11", "code_information": [{"code": "86160", "type": "CPT"}, {"code": "7256333", "type": "CDM"}], "standard_charges": [{"gross_charge": 504.0, "discounted_cash": 378.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPLEMENT AG EA/12", "code_information": [{"code": "86160", "type": "CPT"}, {"code": "7006333", "type": "CDM"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 105.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPLEMENT AG EA/12", "code_information": [{"code": "86160", "type": "CPT"}, {"code": "7256334", "type": "CDM"}], "standard_charges": [{"gross_charge": 507.0, "discounted_cash": 380.25, "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": 57.0, "discounted_cash": 42.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPLEMENT AG EA/2", "code_information": [{"code": "86160", "type": "CPT"}, {"code": "7006142", "type": "CDM"}], "standard_charges": [{"gross_charge": 602.0, "discounted_cash": 451.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPLEMENT AG EA/3", "code_information": [{"code": "86160", "type": "CPT"}, {"code": "4176333", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 296.0, "discounted_cash": 222.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPLEMENT AG EA/3", "code_information": [{"code": "86160", "type": "CPT"}, {"code": "7256157", "type": "CDM"}], "standard_charges": [{"gross_charge": 377.0, "discounted_cash": 282.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPLEMENT AG EA/5", "code_information": [{"code": "86160", "type": "CPT"}, {"code": "7256161", "type": "CDM"}], "standard_charges": [{"gross_charge": 438.0, "discounted_cash": 328.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPLEMENT TOTAL CH50", "code_information": [{"code": "86162", "type": "CPT"}, {"code": "7006162", "type": "CDM"}], "standard_charges": [{"gross_charge": 219.0, "discounted_cash": 164.25, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPLEMENT TOTAL CH50", "code_information": [{"code": "86162", "type": "CPT"}, {"code": "7256162", "type": "CDM"}], "standard_charges": [{"gross_charge": 948.0, "discounted_cash": 711.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPLEMNT FUNCT ACTIV EA", "code_information": [{"code": "86161", "type": "CPT"}, {"code": "7258308", "type": "CDM"}], "standard_charges": [{"gross_charge": 177.0, "discounted_cash": 132.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPNENT HUM STM FRE DEPUY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013173", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 15638.0, "discounted_cash": 11728.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPONENT ARTICULAR CAPITATE", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8131548", "type": "CDM"}], "standard_charges": [{"gross_charge": 57345.0, "discounted_cash": 43008.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COMPONENT FEM COAT DEPUY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012808", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 14946.0, "discounted_cash": 11209.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CONCENTRATION INF AGENT/3", "code_information": [{"code": "87015", "type": "CPT"}, {"code": "4107019", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 171.0, "discounted_cash": 128.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CONCENTRATION INF AGENT/4", "code_information": [{"code": "87015", "type": "CPT"}, {"code": "7257017", "type": "CDM"}], "standard_charges": [{"gross_charge": 89.0, "discounted_cash": 66.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CONCENTRATION INF AGENT/7", "code_information": [{"code": "87015", "type": "CPT"}, {"code": "7257212", "type": "CDM"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "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": 157.0, "discounted_cash": 117.75, "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": 157.0, "discounted_cash": 117.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CONJ ESTROGEN .3MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303065", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 82.0, "discounted_cash": 61.5, "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": 82.0, "discounted_cash": 61.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CONJ ESTROGEN .45MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303066", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CONJ ESTROGEN .45MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303066", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CONJ ESTROGEN .625MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303069", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "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": 83.0, "discounted_cash": 62.25, "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": 156.0, "discounted_cash": 117.0, "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": 156.0, "discounted_cash": 117.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1659.0, "discounted_cash": 1244.25, "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": 1659.0, "discounted_cash": 1244.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CONJUGAT ESTRGN42.5GMVCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5334999", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1049.0, "discounted_cash": 786.75, "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": 1049.0, "discounted_cash": 786.75, "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": 1.0, "discounted_cash": 0.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CONNECTOR NERVE AXOGUARD", "code_information": [{"code": "C1763", "type": "HCPCS"}, {"code": "4021024", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 20449.0, "discounted_cash": 15336.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CONSULT/FROZEN ADD", "code_information": [{"code": "88332", "type": "CPT"}, {"code": "4170040", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 421.0, "discounted_cash": 315.75, "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": 535.0, "discounted_cash": 401.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CONSULT/FROZEN SEC", "code_information": [{"code": "88331", "type": "CPT"}, {"code": "4170039", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 607.0, "discounted_cash": 455.25, "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": 772.0, "discounted_cash": 579.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CONT AER MED OBSTR 1STHR", "code_information": [{"code": "94644", "type": "CPT"}, {"code": "3114644", "type": "CDM"}, {"code": "410", "type": "RC"}], "standard_charges": [{"gross_charge": 667.0, "discounted_cash": 500.25, "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": 667.0, "discounted_cash": 500.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CONT AER MED OBSTR ADDHR", "code_information": [{"code": "94645", "type": "CPT"}, {"code": "3114645", "type": "CDM"}, {"code": "410", "type": "RC"}], "standard_charges": [{"gross_charge": 507.0, "discounted_cash": 380.25, "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": 507.0, "discounted_cash": 380.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CONTRST EVAL EXISTNG CVD", "code_information": [{"code": "4916598", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 944.0, "discounted_cash": 708.0, "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": 3680.0, "discounted_cash": 2760.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CONVRT NEPHOST TO URETER", "code_information": [{"code": "4910434", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7644.0, "discounted_cash": 5733.0, "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": 380.0, "discounted_cash": 285.0, "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": 242.0, "discounted_cash": 181.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COOMBS DIRECT EA", "code_information": [{"code": "86880", "type": "CPT"}, {"code": "4176031", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 299.0, "discounted_cash": 224.25, "setting": "both", "billing_class": "facility"}]}, {"description": "COOMBS DIRECT EA", "code_information": [{"code": "86880", "type": "CPT"}, {"code": "7196031", "type": "CDM"}], "standard_charges": [{"gross_charge": 101.0, "discounted_cash": 75.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COOMBS INDIRECT EA", "code_information": [{"code": "86885", "type": "CPT"}, {"code": "4129618", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 675.0, "discounted_cash": 506.25, "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": 747.0, "discounted_cash": 560.25, "setting": "both", "billing_class": "facility"}]}, {"description": "COOMBS INDIRECT EA AB TITR", "code_information": [{"code": "86886", "type": "CPT"}, {"code": "4176027", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 685.44, "discounted_cash": 514.08, "setting": "both", "billing_class": "facility"}]}, {"description": "COOMBS INDIRECT EA AB TITR", "code_information": [{"code": "86886", "type": "CPT"}, {"code": "7196027", "type": "CDM"}], "standard_charges": [{"gross_charge": 157.0, "discounted_cash": 117.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COPPER", "code_information": [{"code": "82525", "type": "CPT"}, {"code": "7002525", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 83.25, "setting": "both", "billing_class": "facility"}]}, {"description": "COPPER CL .4MG/1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5319517", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COPPER/2", "code_information": [{"code": "82525", "type": "CPT"}, {"code": "7002526", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COPPER/3", "code_information": [{"code": "82525", "type": "CPT"}, {"code": "7252525", "type": "CDM"}], "standard_charges": [{"gross_charge": 222.0, "discounted_cash": 166.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COPPER/4", "code_information": [{"code": "82525", "type": "CPT"}, {"code": "7252526", "type": "CDM"}], "standard_charges": [{"gross_charge": 148.0, "discounted_cash": 111.0, "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": 4120.0, "discounted_cash": 3090.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COR ANGPLSTY INIT", "code_information": [{"code": "92920", "type": "CPT"}, {"code": "4612919", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 37268.0, "discounted_cash": 27951.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COR ATHER STNT APLST ADD", "code_information": [{"code": "92934", "type": "CPT"}, {"code": "4612934", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 5513.0, "discounted_cash": 4134.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COR ATHERECT APLAS ADD", "code_information": [{"code": "92925", "type": "CPT"}, {"code": "4612925", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 4549.0, "discounted_cash": 3411.75, "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": 37268.0, "discounted_cash": 27951.0, "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": 6339.0, "discounted_cash": 4754.25, "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": 49501.0, "discounted_cash": 37125.75, "setting": "both", "billing_class": "facility"}]}, {"description": "COR THROMBLYS-INTRA COR", "code_information": [{"code": "92975", "type": "CPT"}, {"code": "4612975", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 6417.0, "discounted_cash": 4812.75, "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": 824.0, "discounted_cash": 618.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CORTISOL FREE", "code_information": [{"code": "82530", "type": "CPT"}, {"code": "7002534", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 192.0, "discounted_cash": 144.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CORTISOL FREE/2", "code_information": [{"code": "82530", "type": "CPT"}, {"code": "7252534", "type": "CDM"}], "standard_charges": [{"gross_charge": 300.0, "discounted_cash": 225.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CORTISOL FREE/3", "code_information": [{"code": "82530", "type": "CPT"}, {"code": "7002536", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 192.0, "discounted_cash": 144.0, "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": 251.0, "discounted_cash": 188.25, "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": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CORTISOL TOTAL", "code_information": [{"code": "82533", "type": "CPT"}, {"code": "4172533", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 197.0, "discounted_cash": 147.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CORTISOL TOTAL", "code_information": [{"code": "82533", "type": "CPT"}, {"code": "7252522", "type": "CDM"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "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": 396.0, "discounted_cash": 297.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CORTISOL TOTAL/2", "code_information": [{"code": "82533", "type": "CPT"}, {"code": "4172534", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 311.0, "discounted_cash": 233.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CORTISOL TOTAL/2", "code_information": [{"code": "82533", "type": "CPT"}, {"code": "7002533", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 157.0, "discounted_cash": 117.75, "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": 277.0, "discounted_cash": 207.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CORTISOL TOTAL/3", "code_information": [{"code": "82533", "type": "CPT"}, {"code": "4172535", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 218.0, "discounted_cash": 163.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CORTISOL TOTAL/4", "code_information": [{"code": "82533", "type": "CPT"}, {"code": "7252533", "type": "CDM"}], "standard_charges": [{"gross_charge": 457.0, "discounted_cash": 342.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CORTISONE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303089", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "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": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CORTROSYN PER.25MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0834", "type": "HCPCS"}, {"code": "5319575", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 983.0, "discounted_cash": 737.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CORTROSYN PER.25MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0834", "type": "HCPCS"}, {"code": "5319575", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 983.0, "discounted_cash": 737.25, "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": 542.0, "discounted_cash": 406.5, "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": 542.0, "discounted_cash": 406.5, "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": 355.0, "discounted_cash": 266.25, "setting": "both", "billing_class": "facility"}]}, {"description": "COVID 19", "code_information": [{"code": "U0002", "type": "HCPCS"}, {"code": "4170001", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 280.0, "discounted_cash": 210.0, "setting": "both", "billing_class": "facility"}]}, {"description": "COVID 19", "code_information": [{"code": "U0002", "type": "HCPCS"}, {"code": "7250043", "type": "CDM"}], "standard_charges": [{"gross_charge": 222.0, "discounted_cash": 166.5, "setting": "both", "billing_class": "facility"}]}, {"description": "COVID 19 CDC", "code_information": [{"code": "U0001", "type": "HCPCS"}, {"code": "7080012", "type": "CDM"}], "standard_charges": [{"gross_charge": 0.01, "discounted_cash": 0.01, "setting": "both", "billing_class": "facility"}]}, {"description": "CP ACE CTD DUAL MOB MEDACTA CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013436", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11429.0, "discounted_cash": 8571.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CPAP INITIAL", "code_information": [{"code": "94660", "type": "CPT"}, {"code": "5500600", "type": "CDM"}, {"code": "410", "type": "RC"}], "standard_charges": [{"gross_charge": 1824.0, "discounted_cash": 1368.0, "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": 1824.0, "discounted_cash": 1368.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CPAP NEONATAL SUBSEQ", "code_information": [{"code": "94660", "type": "CPT"}, {"code": "3110599", "type": "CDM"}, {"code": "410", "type": "RC"}], "standard_charges": [{"gross_charge": 1824.0, "discounted_cash": 1368.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CPAP-INITIAL", "code_information": [{"code": "94660", "type": "CPT"}, {"code": "3110160", "type": "CDM"}, {"code": "410", "type": "RC"}], "standard_charges": [{"gross_charge": 2161.0, "discounted_cash": 1620.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CPM/PE/PYRIL PED 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316249", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 58.0, "discounted_cash": 43.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CPM/PE/PYRIL PED 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316249", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 58.0, "discounted_cash": 43.5, "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": 2189.0, "discounted_cash": 1641.75, "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": 2189.0, "discounted_cash": 1641.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CPR CARDIOPULM RESUSC", "code_information": [{"code": "92950", "type": "CPT"}, {"code": "6100535", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 2189.0, "discounted_cash": 1641.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CPR CARDIOPULM RESUSC", "code_information": [{"code": "92950", "type": "CPT"}, {"code": "6110535", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 2189.0, "discounted_cash": 1641.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATINE", "code_information": [{"code": "82540", "type": "CPT"}, {"code": "7252540", "type": "CDM"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATINE KINASE ISONZ", "code_information": [{"code": "82552", "type": "CPT"}, {"code": "4122552", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATINE KINASE ISONZ", "code_information": [{"code": "82552", "type": "CPT"}, {"code": "7002552", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 147.0, "discounted_cash": 110.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATINE KINASE ISONZ", "code_information": [{"code": "82552", "type": "CPT"}, {"code": "7252552", "type": "CDM"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "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": 327.0, "discounted_cash": 245.25, "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": 45.0, "discounted_cash": 33.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATINE KINASE TOTAL", "code_information": [{"code": "82550", "type": "CPT"}, {"code": "4172550", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 257.0, "discounted_cash": 192.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATINE KINASE TOTAL", "code_information": [{"code": "82550", "type": "CPT"}, {"code": "7002550", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 58.0, "discounted_cash": 43.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATINE KINASE TOTAL", "code_information": [{"code": "82550", "type": "CPT"}, {"code": "7252550", "type": "CDM"}], "standard_charges": [{"gross_charge": 128.0, "discounted_cash": 96.0, "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": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATININE BLOOD", "code_information": [{"code": "82565", "type": "CPT"}, {"code": "4172565", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATININE BLOOD", "code_information": [{"code": "82565", "type": "CPT"}, {"code": "4182565", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}], "modifiers": "QW"}, {"description": "CREATININE BLOOD", "code_information": [{"code": "82565", "type": "CPT"}, {"code": "7252565", "type": "CDM"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 87.75, "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": 68.0, "discounted_cash": 51.0, "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": 266.0, "discounted_cash": 199.5, "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": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATININE CLEARANCE", "code_information": [{"code": "82575", "type": "CPT"}, {"code": "4172575", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 209.0, "discounted_cash": 156.75, "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": 29.0, "discounted_cash": 21.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATININE OTHR SRCE", "code_information": [{"code": "82570", "type": "CPT"}, {"code": "4172570", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 23.0, "discounted_cash": 17.25, "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": 116.0, "discounted_cash": 87.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATININE OTHR SRCE/2", "code_information": [{"code": "82570", "type": "CPT"}, {"code": "4172571", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 91.0, "discounted_cash": 68.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATININE OTHR SRCE/2", "code_information": [{"code": "82570", "type": "CPT"}, {"code": "7252570", "type": "CDM"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "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": 244.0, "discounted_cash": 183.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATININE OTHR SRCE/3", "code_information": [{"code": "82570", "type": "CPT"}, {"code": "4172573", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 192.0, "discounted_cash": 144.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATININE OTHR SRCE/3", "code_information": [{"code": "82570", "type": "CPT"}, {"code": "7252571", "type": "CDM"}], "standard_charges": [{"gross_charge": 62.0, "discounted_cash": 46.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CREATININE OTHR SRCE/5", "code_information": [{"code": "82570", "type": "CPT"}, {"code": "7252574", "type": "CDM"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "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": 4385.0, "discounted_cash": 3288.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CRITHIDIA IFA", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "7256221", "type": "CDM"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "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": 268.0, "discounted_cash": 201.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CROMOLYN .8MG 14.2GM IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330571", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1633.0, "discounted_cash": 1224.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CROMOLYN .8MG 14.2GM IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330571", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1633.0, "discounted_cash": 1224.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CROMOLYN .8MG 8.1GM IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330570", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1210.0, "discounted_cash": 907.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CROMOLYN .8MG 8.1GM IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330570", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1210.0, "discounted_cash": 907.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CRP HI SENSITIVITY", "code_information": [{"code": "86141", "type": "CPT"}, {"code": "4106140", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 209.0, "discounted_cash": 156.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CRP HI SENSITIVITY", "code_information": [{"code": "86141", "type": "CPT"}, {"code": "4176141", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 165.0, "discounted_cash": 123.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CRP HI SENSITIVITY", "code_information": [{"code": "86141", "type": "CPT"}, {"code": "7256363", "type": "CDM"}], "standard_charges": [{"gross_charge": 245.0, "discounted_cash": 183.75, "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": 464.0, "discounted_cash": 348.0, "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": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CRYOCRIT QUAL/SEMI QNT/3", "code_information": [{"code": "82595", "type": "CPT"}, {"code": "7002598", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 432.0, "discounted_cash": 324.0, "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": 788.0, "discounted_cash": 591.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CRYOFIBRINOGEN", "code_information": [{"code": "82585", "type": "CPT"}, {"code": "7252585", "type": "CDM"}], "standard_charges": [{"gross_charge": 123.0, "discounted_cash": 92.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CRYPTOCOCCUS NEO IA", "code_information": [{"code": "87327", "type": "CPT"}, {"code": "4106420", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 276.0, "discounted_cash": 207.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CRYPTOCOCCUS NEO IA", "code_information": [{"code": "87327", "type": "CPT"}, {"code": "4175318", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 217.0, "discounted_cash": 162.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CRYPTOSPORIDIUM IA", "code_information": [{"code": "87328", "type": "CPT"}, {"code": "4107329", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 225.0, "discounted_cash": 168.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CRYPTOSPORIDIUM IA", "code_information": [{"code": "87328", "type": "CPT"}, {"code": "4177329", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 177.0, "discounted_cash": 132.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CRYPTOSPORIDIUM IA", "code_information": [{"code": "87328", "type": "CPT"}, {"code": "7257330", "type": "CDM"}], "standard_charges": [{"gross_charge": 147.0, "discounted_cash": 110.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CRYST ID BODY FLD EX URN", "code_information": [{"code": "89060", "type": "CPT"}, {"code": "4170010", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CRYST ID BODY FLD EX URN", "code_information": [{"code": "89060", "type": "CPT"}, {"code": "4179363", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CRYST ID BODY FLD EX URN", "code_information": [{"code": "89060", "type": "CPT"}, {"code": "7259367", "type": "CDM"}], "standard_charges": [{"gross_charge": 41.0, "discounted_cash": 30.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CRYST ID BODY FLD EX URN/2", "code_information": [{"code": "89060", "type": "CPT"}, {"code": "4309060", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CSF SHUNT EVALUATION", "code_information": [{"code": "78645", "type": "CPT"}, {"code": "5208645", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 3366.0, "discounted_cash": 2524.5, "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": 11329.0, "discounted_cash": 8496.75, "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": 11329.0, "discounted_cash": 8496.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT ABD & PELVIS W/CM", "code_information": [{"code": "74177", "type": "CPT"}, {"code": "5124177", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 11329.0, "discounted_cash": 8496.75, "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": 6220.0, "discounted_cash": 4665.0, "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": 6220.0, "discounted_cash": 4665.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CT ABD & PELVIS W/O CM", "code_information": [{"code": "74176", "type": "CPT"}, {"code": "5124174", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 6220.0, "discounted_cash": 4665.0, "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": 15450.0, "discounted_cash": 11587.5, "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": 15450.0, "discounted_cash": 11587.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT ABD & PELVIS WO/W CM", "code_information": [{"code": "74178", "type": "CPT"}, {"code": "5124178", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 15450.0, "discounted_cash": 11587.5, "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": 5247.0, "discounted_cash": 3935.25, "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": 5247.0, "discounted_cash": 3935.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CT ABDOMEN W/ CM", "code_information": [{"code": "74160", "type": "CPT"}, {"code": "5124160", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 5247.0, "discounted_cash": 3935.25, "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": 4011.0, "discounted_cash": 3008.25, "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": 4011.0, "discounted_cash": 3008.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CT ABDOMEN W/O CM", "code_information": [{"code": "74150", "type": "CPT"}, {"code": "5124150", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 4011.0, "discounted_cash": 3008.25, "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": 5353.0, "discounted_cash": 4014.75, "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": 5353.0, "discounted_cash": 4014.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT ABDOMEN WO/W CM", "code_information": [{"code": "74170", "type": "CPT"}, {"code": "5124170", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 5353.0, "discounted_cash": 4014.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT CARD SCORING WO CONT", "code_information": [{"code": "75571", "type": "CPT"}, {"code": "5056500", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 2783.0, "discounted_cash": 2087.25, "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": 3545.0, "discounted_cash": 2658.75, "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": 1511.0, "discounted_cash": 1133.25, "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": 5211.0, "discounted_cash": 3908.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CT GUIDE RAD THERAPY FL", "code_information": [{"code": "77014", "type": "CPT"}, {"code": "5056370", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 1460.0, "discounted_cash": 1095.0, "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": 1460.0, "discounted_cash": 1095.0, "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": 3430.0, "discounted_cash": 2572.5, "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": 3430.0, "discounted_cash": 2572.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT HEAD/BRAIN W CONTRAST", "code_information": [{"code": "70460", "type": "CPT"}, {"code": "5120460", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 3430.0, "discounted_cash": 2572.5, "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": 4751.0, "discounted_cash": 3563.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CT HEAD/BRAIN WO CONTRST", "code_information": [{"code": "70450", "type": "CPT"}, {"code": "5110450", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 4751.0, "discounted_cash": 3563.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CT HEAD/BRAIN WO CONTRST", "code_information": [{"code": "70450", "type": "CPT"}, {"code": "5120450", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 4751.0, "discounted_cash": 3563.25, "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": 6274.0, "discounted_cash": 4705.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT HEAD/BRAIN WO/W CONTR", "code_information": [{"code": "70470", "type": "CPT"}, {"code": "5110470", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 6274.0, "discounted_cash": 4705.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT HEAD/BRAIN WO/W CONTR", "code_information": [{"code": "70470", "type": "CPT"}, {"code": "5120470", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 6274.0, "discounted_cash": 4705.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT HRT CONGENITAL W CONT", "code_information": [{"code": "75573", "type": "CPT"}, {"code": "5050214", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 5745.0, "discounted_cash": 4308.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT HRT STRUCT MORPH W CM", "code_information": [{"code": "75572", "type": "CPT"}, {"code": "5050213", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 3318.0, "discounted_cash": 2488.5, "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": 3430.0, "discounted_cash": 2572.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT LOWER EXTRMTY W/ CM", "code_information": [{"code": "73701", "type": "CPT"}, {"code": "5113701", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 3430.0, "discounted_cash": 2572.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT LOWER EXTRMTY W/ CM", "code_information": [{"code": "73701", "type": "CPT"}, {"code": "5123701", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 3430.0, "discounted_cash": 2572.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT LOWER EXTRMTY W/O CM", "code_information": [{"code": "73700", "type": "CPT"}, {"code": "5053700", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 4380.0, "discounted_cash": 3285.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CT LOWER EXTRMTY W/O CM", "code_information": [{"code": "73700", "type": "CPT"}, {"code": "5113700", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 4380.0, "discounted_cash": 3285.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CT LOWER EXTRMTY W/O CM", "code_information": [{"code": "73700", "type": "CPT"}, {"code": "5123700", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 4380.0, "discounted_cash": 3285.0, "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": 4555.0, "discounted_cash": 3416.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CT LOWER EXTRMTY WO/W CM", "code_information": [{"code": "73702", "type": "CPT"}, {"code": "5123702", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 4555.0, "discounted_cash": 3416.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CT LTD OR LOC F/U STUDY", "code_information": [{"code": "76380", "type": "CPT"}, {"code": "5056505", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 2157.0, "discounted_cash": 1617.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT LTD OR LOC F/U STUDY", "code_information": [{"code": "76380", "type": "CPT"}, {"code": "5116380", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 2157.0, "discounted_cash": 1617.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT LTD OR LOC F/U STUDY", "code_information": [{"code": "76380", "type": "CPT"}, {"code": "5126380", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 2157.0, "discounted_cash": 1617.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT LUNG SCREENING", "code_information": [{"code": "71271", "type": "CPT"}, {"code": "5051275", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 2157.0, "discounted_cash": 1617.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT LUNG SCREENING", "code_information": [{"code": "71271", "type": "CPT"}, {"code": "5110493", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 2157.0, "discounted_cash": 1617.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT LUNG SCREENING", "code_information": [{"code": "71271", "type": "CPT"}, {"code": "5120471", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 2157.0, "discounted_cash": 1617.75, "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": 3828.0, "discounted_cash": 2871.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CT MAXILLOFACIAL W/CM", "code_information": [{"code": "70487", "type": "CPT"}, {"code": "5110587", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 3828.0, "discounted_cash": 2871.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CT MAXILLOFACIAL W/CM", "code_information": [{"code": "70487", "type": "CPT"}, {"code": "5120485", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 3828.0, "discounted_cash": 2871.0, "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": 4207.0, "discounted_cash": 3155.25, "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": 4207.0, "discounted_cash": 3155.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CT MAXILLOFACIAL W/O CM", "code_information": [{"code": "70486", "type": "CPT"}, {"code": "5120489", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 4207.0, "discounted_cash": 3155.25, "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": 5282.0, "discounted_cash": 3961.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT MAXILLOFACIAL WO/W CM", "code_information": [{"code": "70488", "type": "CPT"}, {"code": "5120483", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 5282.0, "discounted_cash": 3961.5, "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": 5990.0, "discounted_cash": 4492.5, "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": 5990.0, "discounted_cash": 4492.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT ORB/EAR/FOSSA W/CM", "code_information": [{"code": "70481", "type": "CPT"}, {"code": "5120481", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 5990.0, "discounted_cash": 4492.5, "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": 5734.0, "discounted_cash": 4300.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT ORB/EAR/FOSSA W/O CM", "code_information": [{"code": "70480", "type": "CPT"}, {"code": "5110480", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 5734.0, "discounted_cash": 4300.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT ORB/EAR/FOSSA W/O CM", "code_information": [{"code": "70480", "type": "CPT"}, {"code": "5120480", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 5734.0, "discounted_cash": 4300.5, "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": 8735.0, "discounted_cash": 6551.25, "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": 8735.0, "discounted_cash": 6551.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CT ORB/EAR/FOSSA WO/W CM", "code_information": [{"code": "70482", "type": "CPT"}, {"code": "5120482", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 8735.0, "discounted_cash": 6551.25, "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": 3597.0, "discounted_cash": 2697.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT PELVIS W/O CONTRAST", "code_information": [{"code": "72192", "type": "CPT"}, {"code": "5112192", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 3597.0, "discounted_cash": 2697.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT PELVIS W/O CONTRAST", "code_information": [{"code": "72192", "type": "CPT"}, {"code": "5122192", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 3597.0, "discounted_cash": 2697.75, "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": 5376.0, "discounted_cash": 4032.0, "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": 5376.0, "discounted_cash": 4032.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CT PELVIS WITH CONTRAST", "code_information": [{"code": "72193", "type": "CPT"}, {"code": "5122193", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 5376.0, "discounted_cash": 4032.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CT PELVIS WO/W CM", "code_information": [{"code": "72194", "type": "CPT"}, {"code": "5052194", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 5988.0, "discounted_cash": 4491.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CT PELVIS WO/W CM", "code_information": [{"code": "72194", "type": "CPT"}, {"code": "5122194", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 5988.0, "discounted_cash": 4491.0, "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": 4765.0, "discounted_cash": 3573.75, "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": 4765.0, "discounted_cash": 3573.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SFT TISS NECK WO/W CM", "code_information": [{"code": "70492", "type": "CPT"}, {"code": "5120492", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 4765.0, "discounted_cash": 3573.75, "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": 4207.0, "discounted_cash": 3155.25, "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": 4207.0, "discounted_cash": 3155.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SINUS W/O CONTRAST", "code_information": [{"code": "70486", "type": "CPT"}, {"code": "5120486", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 4207.0, "discounted_cash": 3155.25, "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": 3828.0, "discounted_cash": 2871.0, "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": 3828.0, "discounted_cash": 2871.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SINUS WITH CONTRAST", "code_information": [{"code": "70487", "type": "CPT"}, {"code": "5120487", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 3828.0, "discounted_cash": 2871.0, "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": 5282.0, "discounted_cash": 3961.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SINUS WO/W CONTRAST", "code_information": [{"code": "70488", "type": "CPT"}, {"code": "5120488", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 5282.0, "discounted_cash": 3961.5, "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": 4997.0, "discounted_cash": 3747.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SOFT TISS NECK W CM", "code_information": [{"code": "70491", "type": "CPT"}, {"code": "5110491", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 4997.0, "discounted_cash": 3747.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SOFT TISS NECK W CM", "code_information": [{"code": "70491", "type": "CPT"}, {"code": "5120491", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 4997.0, "discounted_cash": 3747.75, "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": 3269.0, "discounted_cash": 2451.75, "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": 3269.0, "discounted_cash": 2451.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SOFT TISS NECK WO CM", "code_information": [{"code": "70490", "type": "CPT"}, {"code": "5120490", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 3269.0, "discounted_cash": 2451.75, "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": 4699.0, "discounted_cash": 3524.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SPINE CERVICAL W/CM", "code_information": [{"code": "72126", "type": "CPT"}, {"code": "5112126", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 4699.0, "discounted_cash": 3524.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SPINE CERVICAL W/CM", "code_information": [{"code": "72126", "type": "CPT"}, {"code": "5122126", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 4699.0, "discounted_cash": 3524.25, "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": 4290.0, "discounted_cash": 3217.5, "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": 4290.0, "discounted_cash": 3217.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SPINE CERVICAL W/O CM", "code_information": [{"code": "72125", "type": "CPT"}, {"code": "5122125", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 4290.0, "discounted_cash": 3217.5, "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": 6710.0, "discounted_cash": 5032.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SPINE CERVICL WO/W CM", "code_information": [{"code": "72127", "type": "CPT"}, {"code": "5122127", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 6710.0, "discounted_cash": 5032.5, "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": 4699.0, "discounted_cash": 3524.25, "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": 4699.0, "discounted_cash": 3524.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SPINE LUMBAR W/CM", "code_information": [{"code": "72132", "type": "CPT"}, {"code": "5122132", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 4699.0, "discounted_cash": 3524.25, "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": 4290.0, "discounted_cash": 3217.5, "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": 4290.0, "discounted_cash": 3217.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SPINE LUMBAR W/O CM", "code_information": [{"code": "72131", "type": "CPT"}, {"code": "5122131", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 4290.0, "discounted_cash": 3217.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SPINE LUMBAR WO/W CM", "code_information": [{"code": "72133", "type": "CPT"}, {"code": "5052133", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 5497.0, "discounted_cash": 4122.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SPINE LUMBAR WO/W CM", "code_information": [{"code": "72133", "type": "CPT"}, {"code": "5112133", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 5497.0, "discounted_cash": 4122.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SPINE LUMBAR WO/W CM", "code_information": [{"code": "72133", "type": "CPT"}, {"code": "5122133", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 5497.0, "discounted_cash": 4122.75, "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": 4280.0, "discounted_cash": 3210.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SPINE THORACIC W/CM", "code_information": [{"code": "72129", "type": "CPT"}, {"code": "5122129", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 4280.0, "discounted_cash": 3210.0, "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": 3430.0, "discounted_cash": 2572.5, "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": 3430.0, "discounted_cash": 2572.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SPINE THORACIC W/O CM", "code_information": [{"code": "72128", "type": "CPT"}, {"code": "5122128", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 3430.0, "discounted_cash": 2572.5, "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": 6710.0, "discounted_cash": 5032.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT SPINE THORACIC WO/W", "code_information": [{"code": "72130", "type": "CPT"}, {"code": "5122130", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 6710.0, "discounted_cash": 5032.5, "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": 4891.0, "discounted_cash": 3668.25, "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": 4891.0, "discounted_cash": 3668.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CT THORAX W/O CONTRAST", "code_information": [{"code": "71250", "type": "CPT"}, {"code": "5121250", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 4891.0, "discounted_cash": 3668.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CT THORAX WITH CONTRAST", "code_information": [{"code": "71260", "type": "CPT"}, {"code": "5051260", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 4502.0, "discounted_cash": 3376.5, "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": 4502.0, "discounted_cash": 3376.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT THORAX WITH CONTRAST", "code_information": [{"code": "71260", "type": "CPT"}, {"code": "5121260", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 4502.0, "discounted_cash": 3376.5, "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": 6155.0, "discounted_cash": 4616.25, "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": 6155.0, "discounted_cash": 4616.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CT THORAX WO/W CONTRAST", "code_information": [{"code": "71270", "type": "CPT"}, {"code": "5121270", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 6155.0, "discounted_cash": 4616.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CT UPPER EXTRMTY W/ CM", "code_information": [{"code": "73201", "type": "CPT"}, {"code": "5053201", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 5756.0, "discounted_cash": 4317.0, "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": 5756.0, "discounted_cash": 4317.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CT UPPER EXTRMTY W/ CM", "code_information": [{"code": "73201", "type": "CPT"}, {"code": "5127320", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 5756.0, "discounted_cash": 4317.0, "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": 4285.0, "discounted_cash": 3213.75, "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": 4285.0, "discounted_cash": 3213.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CT UPPER EXTRMTY W/O CM", "code_information": [{"code": "73200", "type": "CPT"}, {"code": "5123200", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 4285.0, "discounted_cash": 3213.75, "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": 8134.0, "discounted_cash": 6100.5, "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": 7474.0, "discounted_cash": 5605.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CT UPPER EXTRMTY WO/W CM", "code_information": [{"code": "73202", "type": "CPT"}, {"code": "5123202", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 8134.0, "discounted_cash": 6100.5, "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": 6421.0, "discounted_cash": 4815.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA ABD LE RO W CONT ONL", "code_information": [{"code": "75635", "type": "CPT"}, {"code": "5125636", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 6421.0, "discounted_cash": 4815.75, "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": 6421.0, "discounted_cash": 4815.75, "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": 6170.0, "discounted_cash": 4627.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA ABD W CONTRAST ONLY", "code_information": [{"code": "74175", "type": "CPT"}, {"code": "5114175", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 6881.0, "discounted_cash": 5160.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA ABD W CONTRAST ONLY", "code_information": [{"code": "74175", "type": "CPT"}, {"code": "5124176", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 6170.0, "discounted_cash": 4627.5, "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": 8318.0, "discounted_cash": 6238.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA ABD/PEL W CONTRAST", "code_information": [{"code": "74174", "type": "CPT"}, {"code": "5114173", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 9314.0, "discounted_cash": 6985.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA ABD/PEL W CONTRAST", "code_information": [{"code": "74174", "type": "CPT"}, {"code": "5124172", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 9331.0, "discounted_cash": 6998.25, "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": 7505.0, "discounted_cash": 5628.75, "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": 8901.0, "discounted_cash": 6675.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA ABD/PEL WO/W CM", "code_information": [{"code": "74174", "type": "CPT"}, {"code": "5124173", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 8901.0, "discounted_cash": 6675.75, "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": 7271.0, "discounted_cash": 5453.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA ABDOMEN WO/W CM", "code_information": [{"code": "74175", "type": "CPT"}, {"code": "5124175", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 8621.0, "discounted_cash": 6465.75, "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": 7899.0, "discounted_cash": 5924.25, "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": 7686.0, "discounted_cash": 5764.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA CHEST (NONCOR) WO/W", "code_information": [{"code": "71275", "type": "CPT"}, {"code": "5121276", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 8608.0, "discounted_cash": 6456.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA CHEST W CONTRST ONLY", "code_information": [{"code": "71275", "type": "CPT"}, {"code": "5111274", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 7899.0, "discounted_cash": 5924.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA CHEST W CONTRST ONLY", "code_information": [{"code": "71275", "type": "CPT"}, {"code": "5121275", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 7899.0, "discounted_cash": 5924.25, "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": 7814.0, "discounted_cash": 5860.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA HEAD W CONTRAST ONLY", "code_information": [{"code": "70496", "type": "CPT"}, {"code": "5120496", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 7814.0, "discounted_cash": 5860.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA HEAD WO/W CONTRAST", "code_information": [{"code": "70496", "type": "CPT"}, {"code": "5050500", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 7814.0, "discounted_cash": 5860.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA HEAD WO/W CONTRAST", "code_information": [{"code": "70496", "type": "CPT"}, {"code": "5120497", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 7814.0, "discounted_cash": 5860.5, "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": 6780.0, "discounted_cash": 5085.0, "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": 7707.0, "discounted_cash": 5780.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA LOW EXT W CNTRST ONL", "code_information": [{"code": "73706", "type": "CPT"}, {"code": "5123707", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 7707.0, "discounted_cash": 5780.25, "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": 7707.0, "discounted_cash": 5780.25, "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": 7525.0, "discounted_cash": 5643.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA NECK W CONTRAST ONLY", "code_information": [{"code": "70498", "type": "CPT"}, {"code": "5120498", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 7525.0, "discounted_cash": 5643.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA NECK WO/W CONTRAST", "code_information": [{"code": "70498", "type": "CPT"}, {"code": "5050502", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 7525.0, "discounted_cash": 5643.75, "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": 8621.0, "discounted_cash": 6465.75, "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": 8621.0, "discounted_cash": 6465.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA PELVIS WO/W CONTRAST", "code_information": [{"code": "72191", "type": "CPT"}, {"code": "5122191", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 7926.0, "discounted_cash": 5944.5, "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": 6170.0, "discounted_cash": 4627.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CTA PELVS W CONTRST ONLY", "code_information": [{"code": "72191", "type": "CPT"}, {"code": "5122190", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 7499.0, "discounted_cash": 5624.25, "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": 9196.0, "discounted_cash": 6897.0, "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": 9196.0, "discounted_cash": 6897.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CULT AMPLIFIED PROBE EA", "code_information": [{"code": "87150", "type": "CPT"}, {"code": "4108715", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 293.0, "discounted_cash": 219.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CULT ANAEROBIC ANY EX BLD", "code_information": [{"code": "87075", "type": "CPT"}, {"code": "4177075", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 444.0, "discounted_cash": 333.0, "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": 614.0, "discounted_cash": 460.5, "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": 677.0, "discounted_cash": 507.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CULT DIR PRB EA ORGANISM", "code_information": [{"code": "87149", "type": "CPT"}, {"code": "4177149", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 532.0, "discounted_cash": 399.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CULT FUNGI ID MOLD EA", "code_information": [{"code": "87107", "type": "CPT"}, {"code": "4177107", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 135.0, "discounted_cash": 101.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CULT FUNGI ID MOLD EA", "code_information": [{"code": "87107", "type": "CPT"}, {"code": "7007111", "type": "CDM"}], "standard_charges": [{"gross_charge": 197.0, "discounted_cash": 147.75, "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": 172.0, "discounted_cash": 129.0, "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": 238.0, "discounted_cash": 178.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CULT FUNGI ID YEAST EA", "code_information": [{"code": "87106", "type": "CPT"}, {"code": "4177106", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 187.0, "discounted_cash": 140.25, "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": 131.0, "discounted_cash": 98.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CULT ID SEQUENCING EA/2", "code_information": [{"code": "87153", "type": "CPT"}, {"code": "7258716", "type": "CDM"}], "standard_charges": [{"gross_charge": 586.0, "discounted_cash": 439.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CULT MYCOBACTERIAL EA ISOL", "code_information": [{"code": "87118", "type": "CPT"}, {"code": "7257119", "type": "CDM"}], "standard_charges": [{"gross_charge": 207.0, "discounted_cash": 155.25, "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": 187.0, "discounted_cash": 140.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CULT STOOL ADD PATH EA", "code_information": [{"code": "87046", "type": "CPT"}, {"code": "4177048", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 147.0, "discounted_cash": 110.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CULT STOOL ADD PATH EA/2", "code_information": [{"code": "87046", "type": "CPT"}, {"code": "4107046", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 157.0, "discounted_cash": 117.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CULT STOOL ADD PATH EA/2", "code_information": [{"code": "87046", "type": "CPT"}, {"code": "4177046", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 123.0, "discounted_cash": 92.25, "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": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CULT STOOL ADD PATH EA/4", "code_information": [{"code": "87046", "type": "CPT"}, {"code": "4177057", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 98.0, "discounted_cash": 73.5, "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": 209.0, "discounted_cash": 156.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE AEROBIC DEF ID", "code_information": [{"code": "87077", "type": "CPT"}, {"code": "4178707", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 165.0, "discounted_cash": 123.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE AEROBIC DEF ID", "code_information": [{"code": "87077", "type": "CPT"}, {"code": "7008707", "type": "CDM"}], "standard_charges": [{"gross_charge": 319.0, "discounted_cash": 239.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE AEROBIC DEF ID", "code_information": [{"code": "87077", "type": "CPT"}, {"code": "7257078", "type": "CDM"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 87.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE AEROBIC DEF ID/2", "code_information": [{"code": "87077", "type": "CPT"}, {"code": "7257074", "type": "CDM"}], "standard_charges": [{"gross_charge": 207.0, "discounted_cash": 155.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE AEROBIC DEF ID/3", "code_information": [{"code": "87077", "type": "CPT"}, {"code": "7258707", "type": "CDM"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "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": 559.0, "discounted_cash": 419.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE AFB", "code_information": [{"code": "87116", "type": "CPT"}, {"code": "4177116", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 134.0, "discounted_cash": 100.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE AFB", "code_information": [{"code": "87116", "type": "CPT"}, {"code": "7257116", "type": "CDM"}], "standard_charges": [{"gross_charge": 171.0, "discounted_cash": 128.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE AFB/2", "code_information": [{"code": "87116", "type": "CPT"}, {"code": "4107134", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 157.0, "discounted_cash": 117.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE AFB/2", "code_information": [{"code": "87116", "type": "CPT"}, {"code": "4177134", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 123.0, "discounted_cash": 92.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE ANAEROBIC DEF ID", "code_information": [{"code": "87076", "type": "CPT"}, {"code": "4177062", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 197.0, "discounted_cash": 147.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE ANAEROBIC DEF ID/2", "code_information": [{"code": "87076", "type": "CPT"}, {"code": "4107076", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE ANAEROBIC DEF ID/2", "code_information": [{"code": "87076", "type": "CPT"}, {"code": "7257076", "type": "CDM"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "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": 271.0, "discounted_cash": 203.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4177022", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 388.0, "discounted_cash": 291.0, "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": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/11", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "7007162", "type": "CDM"}], "standard_charges": [{"gross_charge": 363.0, "discounted_cash": 272.25, "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": 359.0, "discounted_cash": 269.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/13", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4177071", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 282.0, "discounted_cash": 211.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/14", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4107068", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 359.0, "discounted_cash": 269.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/14", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4177073", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 282.0, "discounted_cash": 211.5, "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": 401.0, "discounted_cash": 300.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/15", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4127070", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/15", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4177074", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 316.0, "discounted_cash": 237.0, "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": 401.0, "discounted_cash": 300.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/16", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4177078", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 316.0, "discounted_cash": 237.0, "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": 535.0, "discounted_cash": 401.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/2", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4177024", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 421.0, "discounted_cash": 315.75, "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": 604.0, "discounted_cash": 453.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/20", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4177085", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 475.0, "discounted_cash": 356.25, "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": 401.0, "discounted_cash": 300.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/22", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4177162", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 316.0, "discounted_cash": 237.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/25", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4107133", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 535.0, "discounted_cash": 401.25, "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": 114.0, "discounted_cash": 85.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/3", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4177043", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "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": 531.0, "discounted_cash": 398.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/5", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4177056", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 418.0, "discounted_cash": 313.5, "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": 657.0, "discounted_cash": 492.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/6", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4177064", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 517.0, "discounted_cash": 387.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/7", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4177065", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/7", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "7257090", "type": "CDM"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACT OTH SOURCE/8", "code_information": [{"code": "87070", "type": "CPT"}, {"code": "4177066", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 564.0, "discounted_cash": 423.0, "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": 717.0, "discounted_cash": 537.75, "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": 314.0, "discounted_cash": 235.5, "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": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACTERIAL SCREEN", "code_information": [{"code": "87081", "type": "CPT"}, {"code": "4177039", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 247.0, "discounted_cash": 185.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACTERIAL SCREEN", "code_information": [{"code": "87081", "type": "CPT"}, {"code": "7007039", "type": "CDM"}], "standard_charges": [{"gross_charge": 275.0, "discounted_cash": 206.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACTERIAL SCREEN", "code_information": [{"code": "87081", "type": "CPT"}, {"code": "7257038", "type": "CDM"}], "standard_charges": [{"gross_charge": 208.0, "discounted_cash": 156.0, "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": 179.0, "discounted_cash": 134.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACTERIAL SCREEN/2", "code_information": [{"code": "87081", "type": "CPT"}, {"code": "4177044", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 130.0, "discounted_cash": 97.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACTERIAL SCREEN/2", "code_information": [{"code": "87081", "type": "CPT"}, {"code": "7017038", "type": "CDM"}], "standard_charges": [{"gross_charge": 607.0, "discounted_cash": 455.25, "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": 290.0, "discounted_cash": 217.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACTERIAL SCREEN/5", "code_information": [{"code": "87081", "type": "CPT"}, {"code": "4177099", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 210.0, "discounted_cash": 157.5, "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": 190.0, "discounted_cash": 142.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACTERIAL SCREEN/6", "code_information": [{"code": "87081", "type": "CPT"}, {"code": "7258708", "type": "CDM"}], "standard_charges": [{"gross_charge": 129.0, "discounted_cash": 96.75, "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": 189.0, "discounted_cash": 141.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BACTERIAL SCREEN/7", "code_information": [{"code": "87081", "type": "CPT"}, {"code": "4177164", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 148.0, "discounted_cash": 111.0, "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": 719.0, "discounted_cash": 539.25, "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": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE BLOOD", "code_information": [{"code": "87040", "type": "CPT"}, {"code": "4177040", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 566.0, "discounted_cash": 424.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE CHLAMYDIA", "code_information": [{"code": "87110", "type": "CPT"}, {"code": "4177110", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 110.0, "discounted_cash": 82.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE CHLAMYDIA", "code_information": [{"code": "87110", "type": "CPT"}, {"code": "7007110", "type": "CDM"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE CHLAMYDIA", "code_information": [{"code": "87110", "type": "CPT"}, {"code": "7257110", "type": "CDM"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 105.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE FUNGI BLOOD", "code_information": [{"code": "87103", "type": "CPT"}, {"code": "4107103", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 146.0, "discounted_cash": 109.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE FUNGI BLOOD", "code_information": [{"code": "87103", "type": "CPT"}, {"code": "4177103", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 115.0, "discounted_cash": 86.25, "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": 473.0, "discounted_cash": 354.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE FUNGI OTHER", "code_information": [{"code": "87102", "type": "CPT"}, {"code": "4177102", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 372.0, "discounted_cash": 279.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE MYCOPLASMA ANY", "code_information": [{"code": "87109", "type": "CPT"}, {"code": "7007109", "type": "CDM"}], "standard_charges": [{"gross_charge": 865.0, "discounted_cash": 648.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE MYCOPLASMA ANY", "code_information": [{"code": "87109", "type": "CPT"}, {"code": "7257109", "type": "CDM"}], "standard_charges": [{"gross_charge": 649.0, "discounted_cash": 486.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE MYCOPLASMA ANY/2", "code_information": [{"code": "87109", "type": "CPT"}, {"code": "7008710", "type": "CDM"}], "standard_charges": [{"gross_charge": 356.0, "discounted_cash": 267.0, "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": 957.0, "discounted_cash": 717.75, "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": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE STOOL", "code_information": [{"code": "87045", "type": "CPT"}, {"code": "4177055", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 753.0, "discounted_cash": 564.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE STOOL", "code_information": [{"code": "87045", "type": "CPT"}, {"code": "7257045", "type": "CDM"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE TYPNG FLUORO EA", "code_information": [{"code": "87140", "type": "CPT"}, {"code": "7257140", "type": "CDM"}], "standard_charges": [{"gross_charge": 82.0, "discounted_cash": 61.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE TYPNG OTHER MTHD", "code_information": [{"code": "87158", "type": "CPT"}, {"code": "7257158", "type": "CDM"}], "standard_charges": [{"gross_charge": 207.0, "discounted_cash": 155.25, "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": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE TYPNG SEROLOGIC/3", "code_information": [{"code": "87147", "type": "CPT"}, {"code": "4177148", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 49.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE URINE COLONY CT", "code_information": [{"code": "87086", "type": "CPT"}, {"code": "4107086", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 403.0, "discounted_cash": 302.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE URINE COLONY CT", "code_information": [{"code": "87086", "type": "CPT"}, {"code": "4127086", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE URINE COLONY CT", "code_information": [{"code": "87086", "type": "CPT"}, {"code": "4177086", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 318.0, "discounted_cash": 238.5, "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": 178.0, "discounted_cash": 133.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CULTURE URINE IDENT", "code_information": [{"code": "87088", "type": "CPT"}, {"code": "4177088", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 140.0, "discounted_cash": 105.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CUP ACE BMNTM PRSFT PLS DPY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012803", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9964.0, "discounted_cash": 7473.0, "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": 8152.0, "discounted_cash": 6114.0, "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": 12028.0, "discounted_cash": 9021.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CUP ACETABULR UNCOAT DEPUY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012802", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8152.0, "discounted_cash": 6114.0, "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": 18644.0, "discounted_cash": 13983.0, "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": 22855.0, "discounted_cash": 17141.25, "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": 10826.0, "discounted_cash": 8119.5, "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": 12282.0, "discounted_cash": 9211.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CUP STEM HUM MONOBLK DJO CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013432", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10460.0, "discounted_cash": 7845.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CV CATH OH IABP", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056937", "type": "CDM"}], "standard_charges": [{"gross_charge": 10245.0, "discounted_cash": 7683.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CVP MULTILUMEN", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8031975", "type": "CDM"}], "standard_charges": [{"gross_charge": 2629.0, "discounted_cash": 1971.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYANIDE", "code_information": [{"code": "82600", "type": "CPT"}, {"code": "7002600", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CYANIDE (HYDROCOBL)KT IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5319670", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3084.0, "discounted_cash": 2313.0, "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": 58.0, "discounted_cash": 43.5, "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": 58.0, "discounted_cash": 43.5, "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": 368.0, "discounted_cash": 276.0, "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": 106.0, "discounted_cash": 79.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CYANOCOBLMN(VIT B12)", "code_information": [{"code": "82607", "type": "CPT"}, {"code": "4172611", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 290.0, "discounted_cash": 217.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CYANOCOBLMN(VIT B12)", "code_information": [{"code": "82607", "type": "CPT"}, {"code": "7252611", "type": "CDM"}], "standard_charges": [{"gross_charge": 192.0, "discounted_cash": 144.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYC CITRULLINATED PEP AB", "code_information": [{"code": "86200", "type": "CPT"}, {"code": "7003596", "type": "CDM"}], "standard_charges": [{"gross_charge": 788.0, "discounted_cash": 591.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYC CITRULLINATED PEP AB", "code_information": [{"code": "86200", "type": "CPT"}, {"code": "7253596", "type": "CDM"}], "standard_charges": [{"gross_charge": 492.0, "discounted_cash": 369.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYCLOBENZAPRINE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303254", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "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": 21.0, "discounted_cash": 15.75, "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": 45.0, "discounted_cash": 33.75, "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": 13.0, "discounted_cash": 9.75, "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": 178.0, "discounted_cash": 133.5, "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": 4.0, "discounted_cash": 3.0, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "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": 179.0, "discounted_cash": 134.25, "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": 179.0, "discounted_cash": 134.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "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": 431.0, "discounted_cash": 323.25, "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": 431.0, "discounted_cash": 323.25, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CYCLOSPORINE", "code_information": [{"code": "80158", "type": "CPT"}, {"code": "7002613", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 271.0, "discounted_cash": 203.25, "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": 101.0, "discounted_cash": 75.75, "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": 101.0, "discounted_cash": 75.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYCLOSPORINE.05% .4ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330610", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 180.0, "discounted_cash": 135.0, "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": 180.0, "discounted_cash": 135.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYCLOSPORINE/2", "code_information": [{"code": "80158", "type": "CPT"}, {"code": "7252613", "type": "CDM"}], "standard_charges": [{"gross_charge": 571.0, "discounted_cash": 428.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CYCLOSPORINE100MG/1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7502", "type": "HCPCS"}, {"code": "5314875", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2688.0, "discounted_cash": 2016.0, "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": 2688.0, "discounted_cash": 2016.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYP2CA9 COMMON VARIANTS", "code_information": [{"code": "81225", "type": "CPT"}, {"code": "7251225", "type": "CDM"}], "standard_charges": [{"gross_charge": 2957.0, "discounted_cash": 2217.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYP2D6 COMMON VARIANTS", "code_information": [{"code": "81226", "type": "CPT"}, {"code": "7251226", "type": "CDM"}], "standard_charges": [{"gross_charge": 1065.0, "discounted_cash": 798.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYPROHEPTADINE 4MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303304", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "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": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CYSTATIN C", "code_information": [{"code": "82610", "type": "CPT"}, {"code": "7258261", "type": "CDM"}], "standard_charges": [{"gross_charge": 680.0, "discounted_cash": 510.0, "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": 1134.0, "discounted_cash": 850.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTAL WND 2-LYR 7CMX10CM SQ CM", "code_information": [{"code": "Q4166", "type": "HCPCS"}, {"code": "4027989", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTAL WND 2-LYR 7CMX10CM SQ CM", "code_information": [{"code": "Q4166", "type": "HCPCS"}, {"code": "4027989", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "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": 77.0, "discounted_cash": 57.75, "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": 77.0, "discounted_cash": 57.75, "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": 12.0, "discounted_cash": 9.0, "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": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTO C/V BETHESDA", "code_information": [{"code": "88164", "type": "CPT"}, {"code": "4308164", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 172.0, "discounted_cash": 129.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTO C/V PREP AUTO", "code_information": [{"code": "88175", "type": "CPT"}, {"code": "7258817", "type": "CDM"}], "standard_charges": [{"gross_charge": 204.0, "discounted_cash": 153.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTO C/V PREP SCREEN", "code_information": [{"code": "88142", "type": "CPT"}, {"code": "4308142", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 292.0, "discounted_cash": 219.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTO C/V PREP SCREEN", "code_information": [{"code": "88142", "type": "CPT"}, {"code": "7258142", "type": "CDM"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 105.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTO CONSLT INITIAL SITE", "code_information": [{"code": "88333", "type": "CPT"}, {"code": "4170041", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 180.0, "discounted_cash": 135.0, "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": 3397.0, "discounted_cash": 2547.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTO CONSULT EA ADD SITE", "code_information": [{"code": "88334", "type": "CPT"}, {"code": "4170042", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 176.0, "discounted_cash": 132.0, "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": 223.0, "discounted_cash": 167.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTO FLD AUTO/MAN", "code_information": [{"code": "G0143", "type": "HCPCS"}, {"code": "4300143", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 277.0, "discounted_cash": 207.75, "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": 675.0, "discounted_cash": 506.25, "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": 102.0, "discounted_cash": 76.5, "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": 881.0, "discounted_cash": 660.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTO FNA WITHOUT IMAGING", "code_information": [{"code": "4308169", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 468.0, "discounted_cash": 351.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTO PRESERV FLD AUTO TL", "code_information": [{"code": "88142", "type": "CPT"}, {"code": "4170016", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 230.0, "discounted_cash": 172.5, "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": 148.0, "discounted_cash": 111.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTO/MOLECULAR REPORT", "code_information": [{"code": "88291", "type": "CPT"}, {"code": "7270077", "type": "CDM"}], "standard_charges": [{"gross_charge": 130.0, "discounted_cash": 97.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTOGEN VARIANT CHROME", "code_information": [{"code": "81229", "type": "CPT"}, {"code": "7251229", "type": "CDM"}], "standard_charges": [{"gross_charge": 5899.0, "discounted_cash": 4424.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTOMEGALOVIRUS AB", "code_information": [{"code": "86644", "type": "CPT"}, {"code": "7006644", "type": "CDM"}], "standard_charges": [{"gross_charge": 157.0, "discounted_cash": 117.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTOMEGALOVIRUS AB IGM", "code_information": [{"code": "86645", "type": "CPT"}, {"code": "4176926", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 74.0, "discounted_cash": 55.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTOMEGALOVIRUS AB IGM", "code_information": [{"code": "86645", "type": "CPT"}, {"code": "7256645", "type": "CDM"}], "standard_charges": [{"gross_charge": 94.0, "discounted_cash": 70.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTOMEGALOVIRUS AB IGM/2", "code_information": [{"code": "86645", "type": "CPT"}, {"code": "7006645", "type": "CDM"}], "standard_charges": [{"gross_charge": 157.0, "discounted_cash": 117.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTOMEGALOVIRUS AB/2", "code_information": [{"code": "86644", "type": "CPT"}, {"code": "7256915", "type": "CDM"}], "standard_charges": [{"gross_charge": 305.0, "discounted_cash": 228.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTOMEGALOVIRUS AB/4", "code_information": [{"code": "86644", "type": "CPT"}, {"code": "7259425", "type": "CDM"}], "standard_charges": [{"gross_charge": 97.0, "discounted_cash": 72.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTOMEGALOVIRUS AB/5", "code_information": [{"code": "86644", "type": "CPT"}, {"code": "7009060", "type": "CDM"}], "standard_charges": [{"gross_charge": 157.0, "discounted_cash": 117.75, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTOMEGALOVIRUS AMP PRB", "code_information": [{"code": "87496", "type": "CPT"}, {"code": "7257500", "type": "CDM"}], "standard_charges": [{"gross_charge": 848.0, "discounted_cash": 636.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTOMEGALOVIRUS AMPL PRB/3", "code_information": [{"code": "87496", "type": "CPT"}, {"code": "7258756", "type": "CDM"}], "standard_charges": [{"gross_charge": 694.0, "discounted_cash": 520.5, "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": 495.0, "discounted_cash": 371.25, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTOPATH OTHER SOURCE", "code_information": [{"code": "88160", "type": "CPT"}, {"code": "4308160", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 168.0, "discounted_cash": 126.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTOPATH UNLISTED", "code_information": [{"code": "88199", "type": "CPT"}, {"code": "7008200", "type": "CDM"}], "standard_charges": [{"gross_charge": 2554.0, "discounted_cash": 1915.5, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTOPATH WASH/BRUSH/SM", "code_information": [{"code": "88104", "type": "CPT"}, {"code": "4308104", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 216.0, "discounted_cash": 162.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTOPATH WASH/BRUSH/SM/5", "code_information": [{"code": "88104", "type": "CPT"}, {"code": "4303434", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 364.0, "discounted_cash": 273.0, "setting": "both", "billing_class": "facility"}]}, {"description": "CYTOPTH CELL ENHANCE TEC", "code_information": [{"code": "88112", "type": "CPT"}, {"code": "4170015", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 311.0, "discounted_cash": 233.25, "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": 396.0, "discounted_cash": 297.0, "setting": "both", "billing_class": "facility"}]}, {"description": "D10 NACL 0.225 250ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412412", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 794.0, "discounted_cash": 595.5, "setting": "both", "billing_class": "facility"}]}, {"description": "D10 NACL 0.45 1000ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412415", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 295.0, "discounted_cash": 221.25, "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": 658.0, "discounted_cash": 493.5, "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": 340.0, "discounted_cash": 255.0, "setting": "both", "billing_class": "facility"}]}, {"description": "D10W 500ML IN 1L TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5413335", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 710.0, "discounted_cash": 532.5, "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": 546.0, "discounted_cash": 409.5, "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": 619.0, "discounted_cash": 464.25, "setting": "both", "billing_class": "facility"}]}, {"description": "D40W 500ML IN 1L TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5413375", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 1463.0, "discounted_cash": 1097.25, "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": 392.0, "discounted_cash": 294.0, "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": 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": 379.0, "discounted_cash": 284.25, "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": 379.0, "discounted_cash": 284.25, "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": 445.0, "discounted_cash": 333.75, "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": 520.0, "discounted_cash": 390.0, "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": 520.0, "discounted_cash": 390.0, "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": 524.0, "discounted_cash": 393.0, "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": 524.0, "discounted_cash": 393.0, "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": 33.0, "discounted_cash": 24.75, "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": 516.0, "discounted_cash": 387.0, "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": 516.0, "discounted_cash": 387.0, "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": 477.0, "discounted_cash": 357.75, "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": 477.0, "discounted_cash": 357.75, "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": 477.0, "discounted_cash": 357.75, "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": 540.0, "discounted_cash": 405.0, "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": 431.0, "discounted_cash": 323.25, "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": 611.0, "discounted_cash": 458.25, "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": 49.0, "discounted_cash": 36.75, "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": 642.0, "discounted_cash": 481.5, "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": 759.0, "discounted_cash": 569.25, "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": 759.0, "discounted_cash": 569.25, "setting": "both", "billing_class": "facility"}]}, {"description": "D5 NACL 0.9 500ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7042", "type": "HCPCS"}, {"code": "5412330", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "D5 NACL 0.9 500ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7042", "type": "HCPCS"}, {"code": "5412330", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "D5 NACL.45 KCL20 1L IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412310", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 942.0, "discounted_cash": 706.5, "setting": "both", "billing_class": "facility"}]}, {"description": "D5 NACL.45 KCL40 1L IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412320", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 584.0, "discounted_cash": 438.0, "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": 419.0, "discounted_cash": 314.25, "setting": "both", "billing_class": "facility"}]}, {"description": "D5 NACL.9 KCL40 1L IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412345", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "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": 590.0, "discounted_cash": 442.5, "setting": "both", "billing_class": "facility"}]}, {"description": "D5W 1000ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7070", "type": "HCPCS"}, {"code": "5412380", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 687.0, "discounted_cash": 515.25, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 687.0, "discounted_cash": 515.25, "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": 477.0, "discounted_cash": 357.75, "setting": "both", "billing_class": "facility"}]}, {"description": "D5W KCL 40 1000ML IVF", "code_information": [{"code": "S5012", "type": "HCPCS"}, {"code": "5412405", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 477.0, "discounted_cash": 357.75, "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": 746.0, "discounted_cash": 559.5, "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": 34.0, "discounted_cash": 25.5, "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": 34.0, "discounted_cash": 25.5, "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": 34.0, "discounted_cash": 25.5, "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": 34.0, "discounted_cash": 25.5, "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": 75.0, "discounted_cash": 56.25, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 75.0, "discounted_cash": 56.25, "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": 7980.0, "discounted_cash": 5985.0, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 7980.0, "discounted_cash": 5985.0, "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": 847.0, "discounted_cash": 635.25, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 847.0, "discounted_cash": 635.25, "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": 379.0, "discounted_cash": 284.25, "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": 379.0, "discounted_cash": 284.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 178.0, "discounted_cash": 133.5, "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": 178.0, "discounted_cash": 133.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DANTROLENE 100MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303425", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 192.0, "discounted_cash": 144.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DANTROLENE 100MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303425", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 192.0, "discounted_cash": 144.0, "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": 970.0, "discounted_cash": 727.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DANTROLENE 25MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303419", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DAPAGLIFLOZIN 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303431", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "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": 93.0, "discounted_cash": 69.75, "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": 68.0, "discounted_cash": 51.0, "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": 68.0, "discounted_cash": 51.0, "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": 19.0, "discounted_cash": 14.25, "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": 19.0, "discounted_cash": 14.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DAPSONE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303442", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DAPTOMYCIN PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0878", "type": "HCPCS"}, {"code": "5319759", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.53, "discounted_cash": 0.4, "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": 0.53, "discounted_cash": 0.4, "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": 2291.0, "discounted_cash": 1718.25, "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": 2291.0, "discounted_cash": 1718.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DARIFENACIN 15MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303446", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 407.0, "discounted_cash": 305.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DARIFENACIN 15MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303446", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 407.0, "discounted_cash": 305.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DARIFENACIN 7.5MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303445", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 226.0, "discounted_cash": 169.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DARIFENACIN 7.5MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303445", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 226.0, "discounted_cash": 169.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DART CHRONDRAL ARTHREX", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8246100", "type": "CDM"}], "standard_charges": [{"gross_charge": 1449.0, "discounted_cash": 1086.75, "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": 255.0, "discounted_cash": 191.25, "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": 255.0, "discounted_cash": 191.25, "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": 160.0, "discounted_cash": 120.0, "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": 160.0, "discounted_cash": 120.0, "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": 118.0, "discounted_cash": 88.5, "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": 118.0, "discounted_cash": 88.5, "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": 183.0, "discounted_cash": 137.25, "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": 183.0, "discounted_cash": 137.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DCLOT CVAD THROMBL AGNT", "code_information": [{"code": "4916593", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1733.0, "discounted_cash": 1299.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DCLOT CVAD THROMBL AGNT", "code_information": [{"code": "6296593", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1733.0, "discounted_cash": 1299.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRID SUBQ 1ST 20 SQ CM OR <", "code_information": [{"code": "6900040", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1843.0, "discounted_cash": 1382.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRID SUBQ 1ST 20 SQ CM OR <", "code_information": [{"code": "6900040", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 1843.0, "discounted_cash": 1382.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRIDE BONE 20SQ CM/<", "code_information": [{"code": "6900044", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1545.0, "discounted_cash": 1158.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRIDE BONE 20SQ CM/<", "code_information": [{"code": "6900044", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 1545.0, "discounted_cash": 1158.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRIDE BONE EA ADD 20SQ", "code_information": [{"code": "6900045", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1545.0, "discounted_cash": 1158.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRIDE BONE EA ADD 20SQ", "code_information": [{"code": "6900045", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 1545.0, "discounted_cash": 1158.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRIDE MSCL/FSCA 20SQCM", "code_information": [{"code": "6900042", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2872.0, "discounted_cash": 2154.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRIDE MSCL/FSCA 20SQCM", "code_information": [{"code": "6900042", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 2872.0, "discounted_cash": 2154.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRIDE MSCL/FSCA EA ADD", "code_information": [{"code": "6900043", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2872.0, "discounted_cash": 2154.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRIDE MSCL/FSCA EA ADD", "code_information": [{"code": "6900043", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 2872.0, "discounted_cash": 2154.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRIDE SUBQ EA ADD 20SQ", "code_information": [{"code": "6900041", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1843.0, "discounted_cash": 1382.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEBRIDE SUBQ EA ADD 20SQ", "code_information": [{"code": "6900041", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 1843.0, "discounted_cash": 1382.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DECALCIFICATION", "code_information": [{"code": "88311", "type": "CPT"}, {"code": "4170034", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 87.75, "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": 148.0, "discounted_cash": 111.0, "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": 146.0, "discounted_cash": 109.5, "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": 146.0, "discounted_cash": 109.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DEFERASIROX 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303481", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 601.0, "discounted_cash": 450.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DEFERASIROX 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303481", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 601.0, "discounted_cash": 450.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DEFEROXAMINE PER500MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0895", "type": "HCPCS"}, {"code": "5319794", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 865.0, "discounted_cash": 648.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DEFEROXAMINE PER500MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0895", "type": "HCPCS"}, {"code": "5319794", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 865.0, "discounted_cash": 648.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DEFIB INTICA NEO 7 HF-T 429552", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008463", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 149951.0, "discounted_cash": 112463.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEFIB MAXIMO II D284TRK", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4000220", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 200052.0, "discounted_cash": 150039.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DEFIB MAXIO II D284VRC", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4000219", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 100899.0, "discounted_cash": 75674.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEHYDROEPIANDRST SULFATE", "code_information": [{"code": "82627", "type": "CPT"}, {"code": "7002631", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 256.0, "discounted_cash": 192.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DEHYDROEPIANDRST SULFATE", "code_information": [{"code": "82627", "type": "CPT"}, {"code": "7252631", "type": "CDM"}], "standard_charges": [{"gross_charge": 524.0, "discounted_cash": 393.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DELIVERY COMPLEX", "code_information": [{"code": "3101212", "type": "CDM"}, {"code": "722", "type": "RC"}], "standard_charges": [{"gross_charge": 2510.0, "discounted_cash": 1882.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DELIVERY SIMPLE", "code_information": [{"code": "3101210", "type": "CDM"}, {"code": "722", "type": "RC"}], "standard_charges": [{"gross_charge": 2447.0, "discounted_cash": 1835.25, "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": 106.0, "discounted_cash": 79.5, "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": 106.0, "discounted_cash": 79.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 679.0, "discounted_cash": 509.25, "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": 679.0, "discounted_cash": 509.25, "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": 111.0, "discounted_cash": 83.25, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 83.25, "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": 224.0, "discounted_cash": 168.0, "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": 224.0, "discounted_cash": 168.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DERMAGRAFT PER SQ CM", "code_information": [{"code": "Q4106", "type": "HCPCS"}, {"code": "8246126", "type": "CDM"}], "standard_charges": [{"gross_charge": 177.0, "discounted_cash": 132.75, "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": 32.0, "discounted_cash": 24.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 45.0, "discounted_cash": 33.75, "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": 45.0, "discounted_cash": 33.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "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": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DESLORATADINE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303584", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 308.0, "discounted_cash": 231.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DESLORATADINE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303584", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 308.0, "discounted_cash": 231.0, "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": 627.0, "discounted_cash": 470.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DESMOPRESSIN .01%5ML SP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330641", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 627.0, "discounted_cash": 470.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DESMOPRESSIN .2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303586", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DESMOPRESSIN .2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303586", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "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": 138.0, "discounted_cash": 103.5, "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": 138.0, "discounted_cash": 103.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DESONIDE .05% 15GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335069", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 364.0, "discounted_cash": 273.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DESONIDE .05% 15GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335069", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 364.0, "discounted_cash": 273.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DESONIDE .05% 15GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335067", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 193.0, "discounted_cash": 144.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DESONIDE .05% 15GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335067", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 193.0, "discounted_cash": 144.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DESOXIMETASONE.05%60GMCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335111", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1143.0, "discounted_cash": 857.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DESOXIMETASONE.05%60GMCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335111", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1143.0, "discounted_cash": 857.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DESOXIMETASONE.25%15GMCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335093", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 455.0, "discounted_cash": 341.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DESOXIMETASONE.25%15GMCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335093", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 455.0, "discounted_cash": 341.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DESTR CELIAC PLEX W/AGNT", "code_information": [{"code": "5057610", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6024.0, "discounted_cash": 4518.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DESVENLAFAXINE 25MG XRTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303589", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 9.0, "discounted_cash": 6.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DESVENLAFAXINE 25MG XRTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303589", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 9.0, "discounted_cash": 6.75, "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": 75.0, "discounted_cash": 56.25, "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": 75.0, "discounted_cash": 56.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEV CAPIO SUTURE OPEN", "code_information": [{"code": "C2631", "type": "HCPCS"}, {"code": "8240916", "type": "CDM"}], "standard_charges": [{"gross_charge": 3788.0, "discounted_cash": 2841.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DEV CAPIO SUTURE STD", "code_information": [{"code": "C2631", "type": "HCPCS"}, {"code": "8240918", "type": "CDM"}], "standard_charges": [{"gross_charge": 1553.0, "discounted_cash": 1164.75, "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": 1740.0, "discounted_cash": 1305.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DEV LDLOCK SPECTRA518018", "code_information": [{"code": "C1773", "type": "HCPCS"}, {"code": "8240934", "type": "CDM"}], "standard_charges": [{"gross_charge": 6587.0, "discounted_cash": 4940.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEV LDLOCK SPECTRA518062", "code_information": [{"code": "C1773", "type": "HCPCS"}, {"code": "8240937", "type": "CDM"}], "standard_charges": [{"gross_charge": 7832.0, "discounted_cash": 5874.0, "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": 13496.0, "discounted_cash": 10122.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DEV RETRIEVAL INSERTABLE", "code_information": [{"code": "C1773", "type": "HCPCS"}, {"code": "8240139", "type": "CDM"}], "standard_charges": [{"gross_charge": 3140.0, "discounted_cash": 2355.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DEV TRNSVG SUTR CAPIO CL", "code_information": [{"code": "C2631", "type": "HCPCS"}, {"code": "8240942", "type": "CDM"}], "standard_charges": [{"gross_charge": 5813.0, "discounted_cash": 4359.75, "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": 1065.0, "discounted_cash": 798.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXA AXIAL SKELETON", "code_information": [{"code": "77080", "type": "CPT"}, {"code": "5116075", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1065.0, "discounted_cash": 798.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXA AXIAL SKELETON", "code_information": [{"code": "77080", "type": "CPT"}, {"code": "5127080", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1065.0, "discounted_cash": 798.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXA AXIAL W VERT FX ASMT", "code_information": [{"code": "77085", "type": "CPT"}, {"code": "5017085", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1515.0, "discounted_cash": 1136.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXA AXIAL W VERT FX ASMT", "code_information": [{"code": "77085", "type": "CPT"}, {"code": "5127085", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1515.0, "discounted_cash": 1136.25, "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": 399.0, "discounted_cash": 299.25, "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": 399.0, "discounted_cash": 299.25, "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": 165.0, "discounted_cash": 123.75, "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": 165.0, "discounted_cash": 123.75, "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": 350.0, "discounted_cash": 262.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 350.0, "discounted_cash": 262.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXAMETHASONE .5/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314908", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "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": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXAMETHASONE .5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303596", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXAMETHASONE .5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303596", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 16.0, "discounted_cash": 12.0, "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": 16.0, "discounted_cash": 12.0, "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": 12.0, "discounted_cash": 9.0, "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": 12.0, "discounted_cash": 9.0, "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": 1076.0, "discounted_cash": 807.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXMEDETOM 80MCG/20PMXIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5319878", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 69.0, "discounted_cash": 51.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXMEDETOMIDINE PER1MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5319879", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "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": 1541.0, "discounted_cash": 1155.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXMETHYLPHEN 20MG XRCP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327406", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 7.0, "discounted_cash": 5.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXMETHYLPHEN 20MG XRCP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327406", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 7.0, "discounted_cash": 5.25, "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": 469.0, "discounted_cash": 351.75, "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": 469.0, "discounted_cash": 351.75, "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": 3124.0, "discounted_cash": 2343.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXTRAN40NACL.9 500MLIVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7100", "type": "HCPCS"}, {"code": "5412075", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 3124.0, "discounted_cash": 2343.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXTROAMPHETAMIN 5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327407", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXTROAMPHETAMIN 5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327407", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "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": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DEXTROSE 10% 5ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5319897", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "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": 161.0, "discounted_cash": 120.75, "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": 2.0, "discounted_cash": 1.5, "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": 219.0, "discounted_cash": 164.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB ACTICOR 7 HF-T QP 429522", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4000082", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 130933.0, "discounted_cash": 98199.75, "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": 94814.0, "discounted_cash": 71110.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB ACTICOR HF-T CRT-DX 429523", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4000083", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 130933.0, "discounted_cash": 98199.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB AMPLIA MRI DTMB1D1", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4000086", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 232752.0, "discounted_cash": 174564.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB AMPLIA MRI DTMB1D4", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4000087", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 279542.0, "discounted_cash": 209656.5, "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": 279542.0, "discounted_cash": 209656.5, "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": 131572.0, "discounted_cash": 98679.0, "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": 242333.0, "discounted_cash": 181749.75, "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": 242333.0, "discounted_cash": 181749.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB CLARIA MRI DTMA1Q1", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008492", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 244113.0, "discounted_cash": 183084.75, "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": 244113.0, "discounted_cash": 183084.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB COBALT CRTD DTPB2Q1", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008289", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 196721.0, "discounted_cash": 147540.75, "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": 134083.0, "discounted_cash": 100562.25, "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": 102528.0, "discounted_cash": 76896.0, "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": 111145.0, "discounted_cash": 83358.75, "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": 111145.0, "discounted_cash": 83358.75, "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": 222486.0, "discounted_cash": 166864.5, "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": 90884.0, "discounted_cash": 68163.0, "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": 212555.0, "discounted_cash": 159416.25, "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": 110426.0, "discounted_cash": 82819.5, "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": 215543.0, "discounted_cash": 161657.25, "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": 184665.0, "discounted_cash": 138498.75, "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": 105960.0, "discounted_cash": 79470.0, "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": 113804.0, "discounted_cash": 85353.0, "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": 185110.0, "discounted_cash": 138832.5, "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": 145677.0, "discounted_cash": 109257.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB GALLANT CRT-D HF CDHFA300Q", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4000296", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 139551.0, "discounted_cash": 104663.25, "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": 139551.0, "discounted_cash": 104663.25, "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": 159456.0, "discounted_cash": 119592.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB ILESTO 7 DR-T 400447", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4008350", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 102849.0, "discounted_cash": 77136.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB ILESTO DRTDF4 405574", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4008365", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 102849.0, "discounted_cash": 77136.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB ILESTO HFTDF4 405577", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008366", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 127048.0, "discounted_cash": 95286.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB ILESTO VRTDF4 405580", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008367", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 93977.0, "discounted_cash": 70482.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB ILESTO7 VRTDX 383594", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008346", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 91153.0, "discounted_cash": 68364.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB ILESTO7 VRTDX 400029", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008351", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 102849.0, "discounted_cash": 77136.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB ILIVIA NEO 7 VR-T 429531", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4000081", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 108562.0, "discounted_cash": 81421.5, "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": 87228.0, "discounted_cash": 65421.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB ILIVIA PROMRI DR-T 404623", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4008339", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 114746.0, "discounted_cash": 86059.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB ILIVIA PROMRI QP 404621", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008386", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 130850.0, "discounted_cash": 98137.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB ILIVIA PROMRI VR-T 404625", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008338", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 94615.0, "discounted_cash": 70961.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB ILIVIA PROMRI VR-T 404626", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008387", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 88038.0, "discounted_cash": 66028.5, "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": 153266.0, "discounted_cash": 114949.5, "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": 155282.0, "discounted_cash": 116461.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB INCEPTA VR DF1 E161", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008311", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 109408.0, "discounted_cash": 82056.0, "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": 111360.0, "discounted_cash": 83520.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB INOGEN X4 CRTD G148", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008357", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 182553.0, "discounted_cash": 136914.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB INTICA 7 HF-T 404629", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008456", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 174128.0, "discounted_cash": 130596.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB INTICA 7 HF-T 429553", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008454", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 149951.0, "discounted_cash": 112463.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB INTICA NEO 7 VR-TDX 429559", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008470", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 108562.0, "discounted_cash": 81421.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB INTICA PROMRI DX 404633", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008457", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 114344.0, "discounted_cash": 85758.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB INTICA PROMRI HF-T 404627", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008455", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 130933.0, "discounted_cash": 98199.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB INVENTR HFT QP393012", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4000204", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 178061.0, "discounted_cash": 133545.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB INVENTR PROMR 399436", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008380", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 181594.0, "discounted_cash": 136195.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB INVENTRA 7 DX 399437", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008370", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 93826.0, "discounted_cash": 70369.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB IPERIA DRTDF1 392409", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4008382", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 175033.0, "discounted_cash": 131274.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB IPERIA PROMRI 392423", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4008379", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 175033.0, "discounted_cash": 131274.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB IPERIA PROMRI 393007", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008383", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 121573.0, "discounted_cash": 91179.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB IPERIA PROMRI 393009", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008384", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 178061.0, "discounted_cash": 133545.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB IPERIA VRT DX 393032", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008381", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 175033.0, "discounted_cash": 131274.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB ITREVA VRTDF4 393041", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008377", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 84363.0, "discounted_cash": 63272.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB ITREVIA DR-T 392412", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4008378", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 91958.0, "discounted_cash": 68968.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB ITREVIA DR-T 392426", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4008369", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 91958.0, "discounted_cash": 68968.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB ITREVIA HF-T 393014", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008373", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 197956.0, "discounted_cash": 148467.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB ITREVIA HF-T 393016", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008371", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 112686.0, "discounted_cash": 84514.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB ITREVIA HFTQP 401662", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008375", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 112686.0, "discounted_cash": 84514.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB ITREVIA VR-T 393040", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008376", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 142533.0, "discounted_cash": 106899.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB LUMAX 740DR-T MOBL", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4008393", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 102849.0, "discounted_cash": 77136.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB LUMAX 740DRT HM MNTR", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4008391", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 91153.0, "discounted_cash": 68364.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB LUMAX 740HFT BIV MOB", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008392", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 127048.0, "discounted_cash": 95286.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB LUMAX 740VRT DX GSM", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008396", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 102849.0, "discounted_cash": 77136.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB LUMAX 740VRT HM MNTR", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008390", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 149877.0, "discounted_cash": 112407.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB LUMAX SC 740 VRT MOB", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008394", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 157944.0, "discounted_cash": 118458.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB MOMENTUM CRT-D G124", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008460", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 130920.0, "discounted_cash": 98190.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB MOMENTUM EL DR D121", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4008461", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 109456.0, "discounted_cash": 82092.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB MOMENTUM EL VR D120", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008462", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 136830.0, "discounted_cash": 102622.5, "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": 170837.0, "discounted_cash": 128127.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB MOMENTUM X4 CRT-D G138", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008397", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 143335.0, "discounted_cash": 107501.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB PROMOTE ACCL 321536Q", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008407", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 141166.0, "discounted_cash": 105874.5, "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": 112125.0, "discounted_cash": 84093.75, "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": 195471.0, "discounted_cash": 146603.25, "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": 139753.0, "discounted_cash": 104814.75, "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": 122932.0, "discounted_cash": 92199.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB RESONATE CRT-D HF G547", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4000249", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 273918.0, "discounted_cash": 205438.5, "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": 113627.0, "discounted_cash": 85220.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB RESONATE EL DR D533", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4000248", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 232347.0, "discounted_cash": 174260.25, "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": 99764.0, "discounted_cash": 74823.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB RESONATE ICD VR HF D532", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4000250", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 214151.0, "discounted_cash": 160613.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB RESONATE X4 CRT-D G447", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4000233", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 146896.0, "discounted_cash": 110172.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB RIVACOR 7 DR-T 429534", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4000237", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 94814.0, "discounted_cash": 71110.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB RIVACOR 7 HF-T QP 429532", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4000236", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 130933.0, "discounted_cash": 98199.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB RIVACOR 7 VR-T 429536", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4000238", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 94814.0, "discounted_cash": 71110.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB SECURA VR DF4 204VRM", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008440", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 142779.0, "discounted_cash": 107084.25, "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": 138068.0, "discounted_cash": 103551.0, "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": 215956.0, "discounted_cash": 161967.0, "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": 139753.0, "discounted_cash": 104814.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB VIGILANT EL MRI VR D232", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4000174", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 112930.0, "discounted_cash": 84697.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB VIGILANT X4 CRT-D G247", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008496", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 153689.0, "discounted_cash": 115266.75, "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": 160875.0, "discounted_cash": 120656.25, "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": 91892.0, "discounted_cash": 68919.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB VIVA QD DF4 DTBB1QQ", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008485", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 152500.0, "discounted_cash": 114375.0, "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": 209249.0, "discounted_cash": 156936.75, "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": 160526.0, "discounted_cash": 120394.5, "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": 160526.0, "discounted_cash": 120394.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFB VIVA XT CRTD DTBA1D4", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008483", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 160526.0, "discounted_cash": 120394.5, "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": 198797.0, "discounted_cash": 149097.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB COBALT HF MRI DTPB2D1", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008287", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 137392.0, "discounted_cash": 103044.0, "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": 147094.0, "discounted_cash": 110320.5, "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": 246335.0, "discounted_cash": 184751.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB CONCERTO II CRT-D", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4000098", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 158065.0, "discounted_cash": 118548.75, "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": 171013.0, "discounted_cash": 128259.75, "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": 198838.0, "discounted_cash": 149128.5, "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": 189519.0, "discounted_cash": 142139.25, "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": 213922.0, "discounted_cash": 160441.5, "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": 171483.0, "discounted_cash": 128612.25, "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": 142616.0, "discounted_cash": 106962.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB DC LIVIAN HE H227", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4000130", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 233112.0, "discounted_cash": 174834.0, "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": 155579.0, "discounted_cash": 116684.25, "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": 133994.0, "discounted_cash": 100495.5, "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": 218678.0, "discounted_cash": 164008.5, "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": 194476.0, "discounted_cash": 145857.0, "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": 194476.0, "discounted_cash": 145857.0, "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": 203119.0, "discounted_cash": 152339.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB DC XELOS DR-T", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4000189", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 155579.0, "discounted_cash": 116684.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB DYNAGEN CRT-D G150", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4000123", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 197920.0, "discounted_cash": 148440.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB EMBLEM S-ICD A209", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008329", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 205698.0, "discounted_cash": 154273.5, "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": 124412.0, "discounted_cash": 93309.0, "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": 108762.0, "discounted_cash": 81571.5, "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": 128260.0, "discounted_cash": 96195.0, "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": 128260.0, "discounted_cash": 96195.0, "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": 112125.0, "discounted_cash": 84093.75, "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": 112125.0, "discounted_cash": 84093.75, "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": 121000.0, "discounted_cash": 90750.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB ILESTO 7 DRT 383562", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4008349", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 91153.0, "discounted_cash": 68364.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB ILESTO 7 HFT 383547", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008348", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 125034.0, "discounted_cash": 93775.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB ILESTO 7 HFT 400450", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008352", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 127048.0, "discounted_cash": 95286.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB ILESTO 7 VRT 400453", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008353", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 93977.0, "discounted_cash": 70482.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB ILIVIA NEO 7 DR-T 429529", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4000134", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 108562.0, "discounted_cash": 81421.5, "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": 117861.0, "discounted_cash": 88395.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB INOGEN CRT-D G140", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008364", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 182553.0, "discounted_cash": 136914.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB INOGEN EL DR D142", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4008362", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 173957.0, "discounted_cash": 130467.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB INOGEN EL VR D140", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008360", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 105568.0, "discounted_cash": 79176.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB INSYNC MAXIMO 7304", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4000202", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 214356.0, "discounted_cash": 160767.0, "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": 259733.0, "discounted_cash": 194799.75, "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": 168546.0, "discounted_cash": 126409.5, "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": 195079.0, "discounted_cash": 146309.25, "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": 175927.0, "discounted_cash": 131945.25, "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": 177345.0, "discounted_cash": 133008.75, "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": 144473.0, "discounted_cash": 108354.75, "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": 134786.0, "discounted_cash": 101089.5, "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": 135196.0, "discounted_cash": 101397.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB MAXIMO II D284DRG", "code_information": [{"code": "C1721", "type": "HCPCS"}, {"code": "4008401", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 111923.0, "discounted_cash": 83942.25, "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": 214304.0, "discounted_cash": 160728.0, "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": 165882.0, "discounted_cash": 124411.5, "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": 128260.0, "discounted_cash": 96195.0, "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": 226888.0, "discounted_cash": 170166.0, "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": 235534.0, "discounted_cash": 176650.5, "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": 171483.0, "discounted_cash": 128612.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB SC EPIC+ VR V196", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4000314", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 168478.0, "discounted_cash": 126358.5, "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": 146937.0, "discounted_cash": 110202.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB SC MAXIMO VR7232CX", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4000332", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 142616.0, "discounted_cash": 106962.0, "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 PROTECTA XT VR", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4008411", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 117764.0, "discounted_cash": 88323.0, "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": 211978.0, "discounted_cash": 158983.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB SC VITALTY 2 T177", "code_information": [{"code": "C1722", "type": "HCPCS"}, {"code": "4000348", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 172869.0, "discounted_cash": 129651.75, "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": 196018.0, "discounted_cash": 147013.5, "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": 121402.0, "discounted_cash": 91051.5, "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": 173433.0, "discounted_cash": 130074.75, "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": 203811.0, "discounted_cash": 152858.25, "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": 168349.0, "discounted_cash": 126261.75, "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": 141166.0, "discounted_cash": 105874.5, "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": 141166.0, "discounted_cash": 105874.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DFIB VIVA S CRTD DTBB1D1", "code_information": [{"code": "C1882", "type": "HCPCS"}, {"code": "4008480", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 155711.0, "discounted_cash": 116783.25, "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": 155711.0, "discounted_cash": 116783.25, "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": 15266.0, "discounted_cash": 11449.5, "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": 26029.0, "discounted_cash": 19521.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DIA-CIR THRO+PLST+IMG+S&I", "code_information": [{"code": "4616905", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 49006.0, "discounted_cash": 36754.5, "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": 49006.0, "discounted_cash": 36754.5, "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": 88094.0, "discounted_cash": 66070.5, "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": 23903.0, "discounted_cash": 17927.25, "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": 8301.0, "discounted_cash": 6225.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DIALYSATE 2000-2999ML PD", "code_information": [{"code": "A4722", "type": "HCPCS"}, {"code": "5412078", "type": "CDM"}, {"code": "270", "type": "RC"}], "standard_charges": [{"gross_charge": 192.0, "discounted_cash": 144.0, "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": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "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": 13.0, "discounted_cash": 9.75, "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": 13.0, "discounted_cash": 9.75, "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": 193.0, "discounted_cash": 144.75, "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": 193.0, "discounted_cash": 144.75, "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": 2944.0, "discounted_cash": 2208.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2944.0, "discounted_cash": 2208.0, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DIBUCAINE NUMBER", "code_information": [{"code": "82638", "type": "CPT"}, {"code": "7252638", "type": "CDM"}], "standard_charges": [{"gross_charge": 241.0, "discounted_cash": 180.75, "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": 436.0, "discounted_cash": 327.0, "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": 436.0, "discounted_cash": 327.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DICLOFENAC 1% 100GM GL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335212", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 514.0, "discounted_cash": 385.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DICLOFENAC 1% 100GM GL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335212", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 514.0, "discounted_cash": 385.5, "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": 76.0, "discounted_cash": 57.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DICLOFENAC 100MG XRTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303750", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 350.0, "discounted_cash": 262.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DICLOFENAC 100MG XRTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303750", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 350.0, "discounted_cash": 262.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DICLOFENAC NA 50MG XRTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303746", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DICLOFENAC NA 50MG XRTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303746", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DICLOFENAC NA 75MG XRTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303747", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DICLOFENAC NA 75MG XRTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303747", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "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": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DICYCLOMINE 10MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303820", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DICYCLOMINE 10MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303820", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "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": 13.0, "discounted_cash": 9.75, "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": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DICYCLOMINE UPTO 20MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0500", "type": "HCPCS"}, {"code": "5319981", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1147.0, "discounted_cash": 860.25, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1147.0, "discounted_cash": 860.25, "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": 70.0, "discounted_cash": 52.5, "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": "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": 467.0, "discounted_cash": 350.25, "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": 467.0, "discounted_cash": 350.25, "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": 726.0, "discounted_cash": 544.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DIFLUNISAL 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303894", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DIFLUNISAL 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303894", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DIFLUPREDNATE.05% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330763", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1462.0, "discounted_cash": 1096.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DIFLUPREDNATE.05% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330763", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1462.0, "discounted_cash": 1096.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DIG BREAST TOMO BILAT", "code_information": [{"code": "77062", "type": "CPT"}, {"code": "5017062", "type": "CDM"}, {"code": "401", "type": "RC"}], "standard_charges": [{"gross_charge": 284.0, "discounted_cash": 213.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DIG BREAST TOMO BILAT", "code_information": [{"code": "77062", "type": "CPT"}, {"code": "5127066", "type": "CDM"}, {"code": "401", "type": "RC"}], "standard_charges": [{"gross_charge": 210.0, "discounted_cash": 157.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DIG BREAST TOMO UNI", "code_information": [{"code": "77061", "type": "CPT"}, {"code": "5017061", "type": "CDM"}, {"code": "401", "type": "RC"}], "standard_charges": [{"gross_charge": 284.0, "discounted_cash": 213.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DIG BREAST TOMO UNI", "code_information": [{"code": "77061", "type": "CPT"}, {"code": "5127064", "type": "CDM"}, {"code": "401", "type": "RC"}], "standard_charges": [{"gross_charge": 230.0, "discounted_cash": 172.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 114.0, "discounted_cash": 85.5, "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": 114.0, "discounted_cash": 85.5, "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": 901.0, "discounted_cash": 675.75, "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": 901.0, "discounted_cash": 675.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DIGOXIN 0.125MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303944", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DIGOXIN 0.125MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303944", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "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": 31.0, "discounted_cash": 23.25, "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": 31.0, "discounted_cash": 23.25, "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": 7109.0, "discounted_cash": 5331.75, "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": 7109.0, "discounted_cash": 5331.75, "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": 436.0, "discounted_cash": 327.0, "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": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DIGOXIN TOTAL", "code_information": [{"code": "80162", "type": "CPT"}, {"code": "4172643", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 343.0, "discounted_cash": 257.25, "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": 189.0, "discounted_cash": 141.75, "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": 189.0, "discounted_cash": 141.75, "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": 98.0, "discounted_cash": 73.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 98.0, "discounted_cash": 73.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DIHYDROCOD/APAP/CAF TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303984", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 23.0, "discounted_cash": 17.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DIHYDROCOD/APAP/CAF TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303984", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 23.0, "discounted_cash": 17.25, "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": 929.0, "discounted_cash": 696.75, "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": 929.0, "discounted_cash": 696.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DIHYDROTESTOSTERONE", "code_information": [{"code": "82642", "type": "CPT"}, {"code": "7252641", "type": "CDM"}], "standard_charges": [{"gross_charge": 187.0, "discounted_cash": 140.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DIL BLN ESP/PYL/COL BIL", "code_information": [{"code": "C1726", "type": "HCPCS"}, {"code": "8174027", "type": "CDM"}], "standard_charges": [{"gross_charge": 1890.0, "discounted_cash": 1417.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DIL BLN ESPH/PYL/COL WG", "code_information": [{"code": "C1726", "type": "HCPCS"}, {"code": "8174026", "type": "CDM"}], "standard_charges": [{"gross_charge": 1875.0, "discounted_cash": 1406.25, "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": 6011.0, "discounted_cash": 4508.25, "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": 12439.0, "discounted_cash": 9329.25, "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": 84.0, "discounted_cash": 63.0, "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": 84.0, "discounted_cash": 63.0, "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": 131.0, "discounted_cash": 98.25, "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": 131.0, "discounted_cash": 98.25, "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": 130.0, "discounted_cash": 97.5, "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": 130.0, "discounted_cash": 97.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DILTIAZEM 300MG XR24 CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304046", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 180.0, "discounted_cash": 135.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DILTIAZEM 300MG XR24 CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304046", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 180.0, "discounted_cash": 135.0, "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": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DILTIAZEM 30MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304033", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DILTIAZEM 60MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304037", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 10.0, "discounted_cash": 7.5, "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": 10.0, "discounted_cash": 7.5, "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": 14.0, "discounted_cash": 10.5, "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": 14.0, "discounted_cash": 10.5, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "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": 0.49, "discounted_cash": 0.37, "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": 0.49, "discounted_cash": 0.37, "setting": "both", "billing_class": "facility"}]}, {"description": "DILTIAZEM PER 0.5MG PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1163", "type": "HCPCS"}, {"code": "5320069", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.85, "discounted_cash": 0.64, "setting": "both", "billing_class": "facility"}]}, {"description": "DILTIAZEM PER 0.5MG PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1163", "type": "HCPCS"}, {"code": "5320069", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 0.85, "discounted_cash": 0.64, "setting": "both", "billing_class": "facility"}]}, {"description": "DIMENHYDRINAT UPTO50MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1240", "type": "HCPCS"}, {"code": "5320070", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 348.0, "discounted_cash": 261.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DIMENHYDRINAT UPTO50MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1240", "type": "HCPCS"}, {"code": "5320070", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 348.0, "discounted_cash": 261.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DIMENHYDRINATE 50MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5304060", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DIMENHYDRINATE 50MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5304060", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DIMETHICONE 3% 120ML LT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335246", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 10.0, "discounted_cash": 7.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DIMETHICONE 3% 120ML LT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335246", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 10.0, "discounted_cash": 7.5, "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": 3728.0, "discounted_cash": 2796.0, "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": 3728.0, "discounted_cash": 2796.0, "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": 7706.0, "discounted_cash": 5779.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DINOPROSTONE.5MG/3GM VGL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335245", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2871.0, "discounted_cash": 2153.25, "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": 3.0, "discounted_cash": 2.25, "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": 3.0, "discounted_cash": 2.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 82.0, "discounted_cash": 61.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPHENHYDR UPTO 50MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1200", "type": "HCPCS"}, {"code": "5320117", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 82.0, "discounted_cash": 61.5, "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": "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": 14.0, "discounted_cash": 10.5, "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": 14.0, "discounted_cash": 10.5, "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": 19.0, "discounted_cash": 14.25, "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": 19.0, "discounted_cash": 14.25, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPHENOX/ATROP 2.5 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304098", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPHENOX/ATROP 2.5 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304098", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 367.0, "discounted_cash": 275.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 367.0, "discounted_cash": 275.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPHENYDRAMINE QUANT", "code_information": [{"code": "80375", "type": "CPT"}, {"code": "7252489", "type": "CDM"}], "standard_charges": [{"gross_charge": 194.0, "discounted_cash": 145.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPHTHER TET <7YR IJ", "code_information": [{"code": "90702", "type": "CPT"}, {"code": "5320139", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1070.0, "discounted_cash": 802.5, "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": 1070.0, "discounted_cash": 802.5, "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": 252.0, "discounted_cash": 189.0, "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": 252.0, "discounted_cash": 189.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPYRDAML/ASA200/25 XRCP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304123", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 173.0, "discounted_cash": 129.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPYRDAML/ASA200/25 XRCP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304123", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 173.0, "discounted_cash": 129.75, "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": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPYRIDAMOLE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304114", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DIPYRIDAMOLE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304118", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "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": 19.0, "discounted_cash": 14.25, "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": 21.0, "discounted_cash": 15.75, "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": 21.0, "discounted_cash": 15.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "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": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DIR RBC LEUKORED IRRAD", "code_information": [{"code": "P9040", "type": "HCPCS"}, {"code": "4506026", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 1418.0, "discounted_cash": 1063.5, "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": 4941.0, "discounted_cash": 3705.75, "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": 4941.0, "discounted_cash": 3705.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DISCOGRAPHY LUMBAR", "code_information": [{"code": "72295", "type": "CPT"}, {"code": "6932295", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 4941.0, "discounted_cash": 3705.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DISOPYRAMIDE", "code_information": [{"code": "80299", "type": "CPT"}, {"code": "7003903", "type": "CDM"}], "standard_charges": [{"gross_charge": 157.0, "discounted_cash": 117.75, "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": 34.0, "discounted_cash": 25.5, "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": 34.0, "discounted_cash": 25.5, "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": 84.0, "discounted_cash": 63.0, "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": 84.0, "discounted_cash": 63.0, "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": 94.0, "discounted_cash": 70.5, "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": 94.0, "discounted_cash": 70.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DISULFIRAM 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304178", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "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": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DIVALPROX NA 125MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312260", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DIVALPROX NA 250MG EC TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304191", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 106.0, "discounted_cash": 79.5, "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": 106.0, "discounted_cash": 79.5, "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": 102.0, "discounted_cash": 76.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 208.0, "discounted_cash": 156.0, "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": 208.0, "discounted_cash": 156.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DIVALPROX NA 500MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304195", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 178.0, "discounted_cash": 133.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 178.0, "discounted_cash": 133.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DNA ANTIBODY", "code_information": [{"code": "86215", "type": "CPT"}, {"code": "7006215", "type": "CDM"}], "standard_charges": [{"gross_charge": 177.0, "discounted_cash": 132.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DNA ANTIBODY", "code_information": [{"code": "86215", "type": "CPT"}, {"code": "7256217", "type": "CDM"}], "standard_charges": [{"gross_charge": 244.0, "discounted_cash": 183.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DNA ANTIBODY DBL STRAND", "code_information": [{"code": "86225", "type": "CPT"}, {"code": "4176225", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 237.0, "discounted_cash": 177.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DNA ANTIBODY DBL STRAND", "code_information": [{"code": "86225", "type": "CPT"}, {"code": "7256220", "type": "CDM"}], "standard_charges": [{"gross_charge": 301.0, "discounted_cash": 225.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DNA ANTIBODY SNGL STRAND", "code_information": [{"code": "86226", "type": "CPT"}, {"code": "7006225", "type": "CDM"}], "standard_charges": [{"gross_charge": 304.0, "discounted_cash": 228.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DNA ANTIBODY SNGL STRAND", "code_information": [{"code": "86226", "type": "CPT"}, {"code": "7256225", "type": "CDM"}], "standard_charges": [{"gross_charge": 276.0, "discounted_cash": 207.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DNA ANTIBODY/2", "code_information": [{"code": "86215", "type": "CPT"}, {"code": "7006217", "type": "CDM"}], "standard_charges": [{"gross_charge": 183.0, "discounted_cash": 137.25, "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": 403.0, "discounted_cash": 302.25, "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": 403.0, "discounted_cash": 302.25, "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": 402.0, "discounted_cash": 301.5, "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": 402.0, "discounted_cash": 301.5, "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": 322.0, "discounted_cash": 241.5, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 322.0, "discounted_cash": 241.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DOCOSANOL 10% 2GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335290", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DOCOSANOL 10% 2GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335290", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 3.0, "discounted_cash": 2.25, "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": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DOCUSATE 240MG CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5304203", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DOCUSATE 240MG CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5304203", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "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": 44.0, "discounted_cash": 33.0, "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": 44.0, "discounted_cash": 33.0, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "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": 44.0, "discounted_cash": 33.0, "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": 44.0, "discounted_cash": 33.0, "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": 468.0, "discounted_cash": 351.0, "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": 468.0, "discounted_cash": 351.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DOLUTEGRAVIR 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304258", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DOLUTEGRAVIR 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304258", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DOLUTEGRAVIR 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304259", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DOLUTEGRAVIR 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304259", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "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": 190.0, "discounted_cash": 142.5, "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": 190.0, "discounted_cash": 142.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DOME PATELLA", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137255", "type": "CDM"}], "standard_charges": [{"gross_charge": 1624.0, "discounted_cash": 1218.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DONEPEZIL 10MG DT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304255", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 330.0, "discounted_cash": 247.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DONEPEZIL 10MG DT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304255", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 330.0, "discounted_cash": 247.5, "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": 77.0, "discounted_cash": 57.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "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": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "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": 0.03, "discounted_cash": 0.02, "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": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DOPAMINE PER40MG IV IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1265", "type": "HCPCS"}, {"code": "5320210", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "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": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DOPAMINE PER40MG PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1265", "type": "HCPCS"}, {"code": "5320208", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DOPLR VELOC FETL MD CERE", "code_information": [{"code": "76821", "type": "CPT"}, {"code": "3126821", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1208.0, "discounted_cash": 906.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DOPLR VELOC FETL UMB ART", "code_information": [{"code": "76820", "type": "CPT"}, {"code": "3127682", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 823.0, "discounted_cash": 617.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DOPLR VELOC FETL UMB ART", "code_information": [{"code": "76820", "type": "CPT"}, {"code": "5067682", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 823.0, "discounted_cash": 617.25, "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": 293.0, "discounted_cash": 219.75, "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": 293.0, "discounted_cash": 219.75, "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": 293.0, "discounted_cash": 219.75, "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": 293.0, "discounted_cash": 219.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DOPPLER ECHO COLOR FLOW", "code_information": [{"code": "93325", "type": "CPT"}, {"code": "3127683", "type": "CDM"}, {"code": "483", "type": "RC"}], "standard_charges": [{"gross_charge": 1489.0, "discounted_cash": 1116.75, "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": 1489.0, "discounted_cash": 1116.75, "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": 1489.0, "discounted_cash": 1116.75, "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": 1210.0, "discounted_cash": 907.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DORAVIRINE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304300", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 154.0, "discounted_cash": 115.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DORAVIRINE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304300", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 154.0, "discounted_cash": 115.5, "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": 10.0, "discounted_cash": 7.5, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 10.0, "discounted_cash": 7.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 753.0, "discounted_cash": 564.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 753.0, "discounted_cash": 564.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DORZOLAMIDE 2% 10ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330786", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 719.0, "discounted_cash": 539.25, "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": 719.0, "discounted_cash": 539.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DORZOLAMIDE 2% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330785", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 467.0, "discounted_cash": 350.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DORZOLAMIDE 2% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330785", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 467.0, "discounted_cash": 350.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DORZOLAMIDE/TIMOLO10MLOS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330788", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1625.0, "discounted_cash": 1218.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DORZOLAMIDE/TIMOLO10MLOS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330788", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1625.0, "discounted_cash": 1218.75, "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": 592.0, "discounted_cash": 444.0, "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": 592.0, "discounted_cash": 444.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXAPRAM 20MG/ML 1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5320245", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 245.0, "discounted_cash": 183.75, "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": 2305.0, "discounted_cash": 1728.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXAZOSIN 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304336", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXAZOSIN 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304336", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXAZOSIN 8MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304338", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXAZOSIN 8MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304338", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXEPIN 10MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304342", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXEPIN 10MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304342", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "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": 10.0, "discounted_cash": 7.5, "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": 10.0, "discounted_cash": 7.5, "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": 10.0, "discounted_cash": 7.5, "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": 10.0, "discounted_cash": 7.5, "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": 16.0, "discounted_cash": 12.0, "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": 16.0, "discounted_cash": 12.0, "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": 114.0, "discounted_cash": 85.5, "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": 114.0, "discounted_cash": 85.5, "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": 14.0, "discounted_cash": 10.5, "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": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXORUBIC LIP PER10MGIJ", "code_information": [{"code": "Q2050", "type": "HCPCS"}, {"code": "5320277", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2524.0, "discounted_cash": 1893.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXORUBIC LIP PER10MGIJ", "code_information": [{"code": "Q2050", "type": "HCPCS"}, {"code": "5320277", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 2524.0, "discounted_cash": 1893.0, "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": 173.0, "discounted_cash": 129.75, "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": 173.0, "discounted_cash": 129.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DOXYCYCLINE 100MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304392", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "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": 409.0, "discounted_cash": 306.75, "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": 409.0, "discounted_cash": 306.75, "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": 0.4, "discounted_cash": 0.3, "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": 0.4, "discounted_cash": 0.3, "setting": "both", "billing_class": "facility"}]}, {"description": "DRAIN PERITONEAL ABSCESS", "code_information": [{"code": "4907586", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3144.0, "discounted_cash": 2358.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRAIN PERITONEAL ABSCESS", "code_information": [{"code": "5057586", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3144.0, "discounted_cash": 2358.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRAIN PERITONEAL ABSCESS", "code_information": [{"code": "5067590", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3144.0, "discounted_cash": 2358.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRGSCRN DIR OPT INST", "code_information": [{"code": "80306", "type": "CPT"}, {"code": "4170059", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DRGSCRN DIR OPT INST/3", "code_information": [{"code": "80306", "type": "CPT"}, {"code": "4100406", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DRGSCRN DIRCT OPT OBS", "code_information": [{"code": "80305", "type": "CPT"}, {"code": "4100403", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DRGSCRN DIRECT OPT OBS", "code_information": [{"code": "80305", "type": "CPT"}, {"code": "4170057", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRONABINOL 2.5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327430", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 379.0, "discounted_cash": 284.25, "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": 379.0, "discounted_cash": 284.25, "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": 34.0, "discounted_cash": 25.5, "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": 34.0, "discounted_cash": 25.5, "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": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DROPERIDOL UPTO 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1790", "type": "HCPCS"}, {"code": "5320305", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "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": 9666.0, "discounted_cash": 7249.5, "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": 4845.0, "discounted_cash": 3633.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DRS INTERCEED", "code_information": [{"code": "C1765", "type": "HCPCS"}, {"code": "8024553", "type": "CDM"}], "standard_charges": [{"gross_charge": 4508.0, "discounted_cash": 3381.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "4100100", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 292.0, "discounted_cash": 219.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "4170103", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 439.0, "discounted_cash": 329.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7250098", "type": "CDM"}], "standard_charges": [{"gross_charge": 558.0, "discounted_cash": 418.5, "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": 772.0, "discounted_cash": 579.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/10", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "4172055", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 607.0, "discounted_cash": 455.25, "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": 560.0, "discounted_cash": 420.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/12", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "4173016", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 441.0, "discounted_cash": 330.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/12", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7002560", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 157.0, "discounted_cash": 117.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/13", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7012661", "type": "CDM"}], "standard_charges": [{"gross_charge": 807.0, "discounted_cash": 605.25, "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": 560.0, "discounted_cash": 420.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/14", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7003731", "type": "CDM"}], "standard_charges": [{"gross_charge": 157.0, "discounted_cash": 117.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/14", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7250305", "type": "CDM"}], "standard_charges": [{"gross_charge": 396.0, "discounted_cash": 297.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/16", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7003927", "type": "CDM"}], "standard_charges": [{"gross_charge": 157.0, "discounted_cash": 117.75, "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": 560.0, "discounted_cash": 420.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/17", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7250310", "type": "CDM"}], "standard_charges": [{"gross_charge": 497.0, "discounted_cash": 372.75, "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": 560.0, "discounted_cash": 420.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/19", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7250312", "type": "CDM"}], "standard_charges": [{"gross_charge": 1036.0, "discounted_cash": 777.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/2", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "4100101", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 560.0, "discounted_cash": 420.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/2", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7002660", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 423.0, "discounted_cash": 317.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/2", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7250099", "type": "CDM"}], "standard_charges": [{"gross_charge": 292.0, "discounted_cash": 219.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/20", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7250313", "type": "CDM"}], "standard_charges": [{"gross_charge": 948.0, "discounted_cash": 711.0, "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": 560.0, "discounted_cash": 420.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/21", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7250318", "type": "CDM"}], "standard_charges": [{"gross_charge": 558.0, "discounted_cash": 418.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/23", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "4108030", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 431.0, "discounted_cash": 323.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/24", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7250327", "type": "CDM"}], "standard_charges": [{"gross_charge": 727.0, "discounted_cash": 545.25, "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": 499.0, "discounted_cash": 374.25, "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": 560.0, "discounted_cash": 420.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/3", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "4170301", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 441.0, "discounted_cash": 330.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/32", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7252184", "type": "CDM"}], "standard_charges": [{"gross_charge": 822.0, "discounted_cash": 616.5, "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": 447.0, "discounted_cash": 335.25, "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": 219.0, "discounted_cash": 164.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/4", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "4100154", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 271.0, "discounted_cash": 203.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/4", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7058011", "type": "CDM"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/45", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7256461", "type": "CDM"}], "standard_charges": [{"gross_charge": 276.0, "discounted_cash": 207.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/46", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7257262", "type": "CDM"}], "standard_charges": [{"gross_charge": 459.0, "discounted_cash": 344.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/51", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7258013", "type": "CDM"}], "standard_charges": [{"gross_charge": 558.0, "discounted_cash": 418.5, "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": 862.0, "discounted_cash": 646.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/53", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7258015", "type": "CDM"}], "standard_charges": [{"gross_charge": 558.0, "discounted_cash": 418.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/54", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "7259369", "type": "CDM"}], "standard_charges": [{"gross_charge": 582.0, "discounted_cash": 436.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DRUG TEST PRSMV CHEM ANLYZR/6", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "4170315", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 311.0, "discounted_cash": 233.25, "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": 396.0, "discounted_cash": 297.0, "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": 998.0, "discounted_cash": 748.5, "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": 431.0, "discounted_cash": 323.25, "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": 772.0, "discounted_cash": 579.0, "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": 415.0, "discounted_cash": 311.25, "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": 208.0, "discounted_cash": 156.0, "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": 208.0, "discounted_cash": 156.0, "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": 283.0, "discounted_cash": 212.25, "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": 283.0, "discounted_cash": 212.25, "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": 440.0, "discounted_cash": 330.0, "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": 440.0, "discounted_cash": 330.0, "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": 3.0, "discounted_cash": 2.25, "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": 3.0, "discounted_cash": 2.25, "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": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DULOXETINE 30MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304411", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "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": 3489.0, "discounted_cash": 2616.75, "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": 3489.0, "discounted_cash": 2616.75, "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": 3489.0, "discounted_cash": 2616.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DUPLEX CAROTID BI/COMP", "code_information": [{"code": "93880", "type": "CPT"}, {"code": "5123880", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 3489.0, "discounted_cash": 2616.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DUPLEX CAROTID UNI/LTD", "code_information": [{"code": "93882", "type": "CPT"}, {"code": "4636026", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 1477.0, "discounted_cash": 1107.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DUPLEX CAROTID UNI/LTD", "code_information": [{"code": "93882", "type": "CPT"}, {"code": "5066540", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 1477.0, "discounted_cash": 1107.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DUPLEX CAROTID UNI/LTD", "code_information": [{"code": "93882", "type": "CPT"}, {"code": "5116540", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 1477.0, "discounted_cash": 1107.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DUPLEX CAROTID UNI/LTD", "code_information": [{"code": "93882", "type": "CPT"}, {"code": "5123882", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 1477.0, "discounted_cash": 1107.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DUTASTERIDE .5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304415", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 192.0, "discounted_cash": 144.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DUTASTERIDE .5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304415", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 192.0, "discounted_cash": 144.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC ARTHERET DIRECTIONAL", "code_information": [{"code": "C1714", "type": "HCPCS"}, {"code": "8058299", "type": "CDM"}], "standard_charges": [{"gross_charge": 28046.0, "discounted_cash": 21034.5, "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": 20990.0, "discounted_cash": 15742.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC ATHERECT DIRECTIONAL", "code_information": [{"code": "C1714", "type": "HCPCS"}, {"code": "8058301", "type": "CDM"}], "standard_charges": [{"gross_charge": 28046.0, "discounted_cash": 21034.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC ATHERECT DIRECTONAL", "code_information": [{"code": "C1714", "type": "HCPCS"}, {"code": "8058300", "type": "CDM"}], "standard_charges": [{"gross_charge": 28046.0, "discounted_cash": 21034.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC ATRICLIP LAA EXCULSN", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8192019", "type": "CDM"}], "standard_charges": [{"gross_charge": 14819.0, "discounted_cash": 11114.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC ATRICLIP PRO*V LAA EXCLUSN", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8195408", "type": "CDM"}], "standard_charges": [{"gross_charge": 57530.0, "discounted_cash": 43147.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC CLOSURE PERCLOSE", "code_information": [{"code": "C1760", "type": "HCPCS"}, {"code": "8031997", "type": "CDM"}], "standard_charges": [{"gross_charge": 4843.0, "discounted_cash": 3632.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC ELEVATION PILLOW FETAL", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "4031884", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8106.0, "discounted_cash": 6079.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC EMBOLIZ MSH PIPELINE", "code_information": [{"code": "C2625", "type": "HCPCS"}, {"code": "8174018", "type": "CDM"}], "standard_charges": [{"gross_charge": 162130.0, "discounted_cash": 121597.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC ENDOBUTTON CL ULTRA", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011101", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2132.0, "discounted_cash": 1599.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC FEM ARTERY ACCESS", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8174110", "type": "CDM"}], "standard_charges": [{"gross_charge": 366.0, "discounted_cash": 274.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC FIXATION ADJUSTABLE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011102", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16381.0, "discounted_cash": 12285.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC HEMOSTAT ENDO HEMOSPRAY", "code_information": [{"code": "C1052", "type": "HCPCS"}, {"code": "8031981", "type": "CDM"}], "standard_charges": [{"gross_charge": 7311.0, "discounted_cash": 5483.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC MENISCAL CINCH", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011109", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3576.0, "discounted_cash": 2682.0, "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": 4507.0, "discounted_cash": 3380.25, "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": 4852.0, "discounted_cash": 3639.0, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC REVASCULARIZATION", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8174141", "type": "CDM"}], "standard_charges": [{"gross_charge": 88399.0, "discounted_cash": 66299.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC REVASCULARIZATION 3D", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8174146", "type": "CDM"}], "standard_charges": [{"gross_charge": 42763.0, "discounted_cash": 32072.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC THROMB FR REVASCULAR", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8174019", "type": "CDM"}], "standard_charges": [{"gross_charge": 82370.0, "discounted_cash": 61777.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC THROMB/EMB", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "4031900", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 81797.0, "discounted_cash": 61347.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC TISS LOCALZTN/EXCSN", "code_information": [{"code": "C1819", "type": "HCPCS"}, {"code": "8241819", "type": "CDM"}], "standard_charges": [{"gross_charge": 5726.0, "discounted_cash": 4294.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC TROCHANTER FX W CBL2", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8131573", "type": "CDM"}], "standard_charges": [{"gross_charge": 24873.0, "discounted_cash": 18654.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DVC VAS CLSR MYNX", "code_information": [{"code": "C1760", "type": "HCPCS"}, {"code": "8174113", "type": "CDM"}], "standard_charges": [{"gross_charge": 2105.0, "discounted_cash": 1578.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DX BONE MARROW BIOPSIES", "code_information": [{"code": "4918221", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2069.0, "discounted_cash": 1551.75, "setting": "both", "billing_class": "facility"}]}, {"description": "DX BONE MARROW BIOPSIES", "code_information": [{"code": "5058221", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5670.0, "discounted_cash": 4252.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DX MAMMO+CAD BILAT", "code_information": [{"code": "77066", "type": "CPT"}, {"code": "5010212", "type": "CDM"}, {"code": "401", "type": "RC"}], "standard_charges": [{"gross_charge": 1018.0, "discounted_cash": 763.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DX MAMMO+CAD BILAT", "code_information": [{"code": "77066", "type": "CPT"}, {"code": "5120204", "type": "CDM"}, {"code": "401", "type": "RC"}], "standard_charges": [{"gross_charge": 1018.0, "discounted_cash": 763.5, "setting": "both", "billing_class": "facility"}]}, {"description": "DX MAMMO+CAD UNILAT", "code_information": [{"code": "77065", "type": "CPT"}, {"code": "5010206", "type": "CDM"}, {"code": "401", "type": "RC"}], "standard_charges": [{"gross_charge": 871.0, "discounted_cash": 653.25, "setting": "both", "billing_class": "facility"}]}, {"description": "DX MAMMO+CAD UNILAT", "code_information": [{"code": "77065", "type": "CPT"}, {"code": "5120206", "type": "CDM"}, {"code": "401", "type": "RC"}], "standard_charges": [{"gross_charge": 871.0, "discounted_cash": 653.25, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL I", "code_information": [{"code": "99211", "type": "CPT"}, {"code": "4549211", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 174.0, "discounted_cash": 130.5, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL I", "code_information": [{"code": "99211", "type": "CPT"}, {"code": "4549211", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 174.0, "discounted_cash": 130.5, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL I", "code_information": [{"code": "99211", "type": "CPT"}, {"code": "6620911", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 220.0, "discounted_cash": 165.0, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL I", "code_information": [{"code": "99211", "type": "CPT"}, {"code": "6620911", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 220.0, "discounted_cash": 165.0, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL I", "code_information": [{"code": "99211", "type": "CPT"}, {"code": "6734003", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 371.0, "discounted_cash": 278.25, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL I", "code_information": [{"code": "99211", "type": "CPT"}, {"code": "6734003", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 371.0, "discounted_cash": 278.25, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL I", "code_information": [{"code": "99211", "type": "CPT"}, {"code": "6901603", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 174.0, "discounted_cash": 130.5, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL I", "code_information": [{"code": "99211", "type": "CPT"}, {"code": "6901603", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 174.0, "discounted_cash": 130.5, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL I", "code_information": [{"code": "99211", "type": "CPT"}, {"code": "6930467", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 271.0, "discounted_cash": 203.25, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL I", "code_information": [{"code": "99211", "type": "CPT"}, {"code": "6930467", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 271.0, "discounted_cash": 203.25, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL II", "code_information": [{"code": "99212", "type": "CPT"}, {"code": "6620912", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 380.0, "discounted_cash": 285.0, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL II", "code_information": [{"code": "99212", "type": "CPT"}, {"code": "6620912", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 380.0, "discounted_cash": 285.0, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL II", "code_information": [{"code": "99212", "type": "CPT"}, {"code": "6901604", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 380.0, "discounted_cash": 285.0, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL II", "code_information": [{"code": "99212", "type": "CPT"}, {"code": "6901604", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 380.0, "discounted_cash": 285.0, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL II", "code_information": [{"code": "99212", "type": "CPT"}, {"code": "6930468", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 497.0, "discounted_cash": 372.75, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL II", "code_information": [{"code": "99212", "type": "CPT"}, {"code": "6930468", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 497.0, "discounted_cash": 372.75, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL III", "code_information": [{"code": "99213", "type": "CPT"}, {"code": "6620913", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 531.0, "discounted_cash": 398.25, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL III", "code_information": [{"code": "99213", "type": "CPT"}, {"code": "6620913", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 531.0, "discounted_cash": 398.25, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL III", "code_information": [{"code": "99213", "type": "CPT"}, {"code": "6906005", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 668.0, "discounted_cash": 501.0, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL III", "code_information": [{"code": "99213", "type": "CPT"}, {"code": "6906005", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 668.0, "discounted_cash": 501.0, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL III", "code_information": [{"code": "99213", "type": "CPT"}, {"code": "6930469", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 621.0, "discounted_cash": 465.75, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL III", "code_information": [{"code": "99213", "type": "CPT"}, {"code": "6930469", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 621.0, "discounted_cash": 465.75, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL IV", "code_information": [{"code": "99214", "type": "CPT"}, {"code": "6620914", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 887.0, "discounted_cash": 665.25, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL IV", "code_information": [{"code": "99214", "type": "CPT"}, {"code": "6620914", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 887.0, "discounted_cash": 665.25, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL IV", "code_information": [{"code": "99214", "type": "CPT"}, {"code": "6906006", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 928.0, "discounted_cash": 696.0, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL IV", "code_information": [{"code": "99214", "type": "CPT"}, {"code": "6906006", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 928.0, "discounted_cash": 696.0, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL IV", "code_information": [{"code": "99214", "type": "CPT"}, {"code": "6930470", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 727.0, "discounted_cash": 545.25, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL IV", "code_information": [{"code": "99214", "type": "CPT"}, {"code": "6930470", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 727.0, "discounted_cash": 545.25, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL V", "code_information": [{"code": "99215", "type": "CPT"}, {"code": "6620915", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 1186.0, "discounted_cash": 889.5, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL V", "code_information": [{"code": "99215", "type": "CPT"}, {"code": "6620915", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1186.0, "discounted_cash": 889.5, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL V", "code_information": [{"code": "99215", "type": "CPT"}, {"code": "6906007", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 1548.0, "discounted_cash": 1161.0, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL V", "code_information": [{"code": "99215", "type": "CPT"}, {"code": "6906007", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1548.0, "discounted_cash": 1161.0, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL V", "code_information": [{"code": "99215", "type": "CPT"}, {"code": "6930472", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 697.0, "discounted_cash": 522.75, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-EST. PATIENT-LVL V", "code_information": [{"code": "99215", "type": "CPT"}, {"code": "6930472", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 697.0, "discounted_cash": 522.75, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL II", "code_information": [{"code": "99202", "type": "CPT"}, {"code": "6620902", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 635.0, "discounted_cash": 476.25, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL II", "code_information": [{"code": "99202", "type": "CPT"}, {"code": "6620902", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 635.0, "discounted_cash": 476.25, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL II", "code_information": [{"code": "99202", "type": "CPT"}, {"code": "6901002", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 544.0, "discounted_cash": 408.0, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL II", "code_information": [{"code": "99202", "type": "CPT"}, {"code": "6901002", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 544.0, "discounted_cash": 408.0, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL II", "code_information": [{"code": "99202", "type": "CPT"}, {"code": "6930461", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 334.0, "discounted_cash": 250.5, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL II", "code_information": [{"code": "99202", "type": "CPT"}, {"code": "6930461", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 334.0, "discounted_cash": 250.5, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL III", "code_information": [{"code": "99203", "type": "CPT"}, {"code": "6620903", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 911.0, "discounted_cash": 683.25, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL III", "code_information": [{"code": "99203", "type": "CPT"}, {"code": "6620903", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 911.0, "discounted_cash": 683.25, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL III", "code_information": [{"code": "99203", "type": "CPT"}, {"code": "6901003", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 1380.0, "discounted_cash": 1035.0, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL III", "code_information": [{"code": "99203", "type": "CPT"}, {"code": "6901003", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1380.0, "discounted_cash": 1035.0, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL III", "code_information": [{"code": "99203", "type": "CPT"}, {"code": "6930462", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 553.0, "discounted_cash": 414.75, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL III", "code_information": [{"code": "99203", "type": "CPT"}, {"code": "6930462", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 553.0, "discounted_cash": 414.75, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL IV", "code_information": [{"code": "99204", "type": "CPT"}, {"code": "6901004", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 1737.0, "discounted_cash": 1302.75, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL IV", "code_information": [{"code": "99204", "type": "CPT"}, {"code": "6901004", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1737.0, "discounted_cash": 1302.75, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL IV", "code_information": [{"code": "99204", "type": "CPT"}, {"code": "6930463", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 956.0, "discounted_cash": 717.0, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL IV", "code_information": [{"code": "99204", "type": "CPT"}, {"code": "6930463", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 956.0, "discounted_cash": 717.0, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL V", "code_information": [{"code": "99205", "type": "CPT"}, {"code": "6620905", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 1987.0, "discounted_cash": 1490.25, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL V", "code_information": [{"code": "99205", "type": "CPT"}, {"code": "6620905", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1987.0, "discounted_cash": 1490.25, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL V", "code_information": [{"code": "99205", "type": "CPT"}, {"code": "6901005", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 1362.0, "discounted_cash": 1021.5, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL V", "code_information": [{"code": "99205", "type": "CPT"}, {"code": "6901005", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1362.0, "discounted_cash": 1021.5, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL V", "code_information": [{"code": "99205", "type": "CPT"}, {"code": "6930464", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 808.0, "discounted_cash": 606.0, "setting": "both", "billing_class": "facility"}]}, {"description": "E&M-NEW PATIENT-LVL V", "code_information": [{"code": "99205", "type": "CPT"}, {"code": "6930464", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 808.0, "discounted_cash": 606.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EA MLTPLX STAIN MANUAL", "code_information": [{"code": "88377", "type": "CPT"}, {"code": "7098837", "type": "CDM"}], "standard_charges": [{"gross_charge": 936.0, "discounted_cash": 702.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EA MLTPLX STAIN MANUAL", "code_information": [{"code": "88377", "type": "CPT"}, {"code": "7270098", "type": "CDM"}], "standard_charges": [{"gross_charge": 1237.0, "discounted_cash": 927.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EAR STAPES", "code_information": [{"code": "L8613", "type": "HCPCS"}, {"code": "8121050", "type": "CDM"}], "standard_charges": [{"gross_charge": 3599.0, "discounted_cash": 2699.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EAR TUBE", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8121065", "type": "CDM"}], "standard_charges": [{"gross_charge": 985.0, "discounted_cash": 738.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EBUS SAMPLING 1-2 NODES", "code_information": [{"code": "5500053", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 9881.0, "discounted_cash": 7410.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EBUS SAMPLING 1-2 NODES", "code_information": [{"code": "5500053", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 9881.0, "discounted_cash": 7410.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ECHO 2D COMP W/CONTRAST", "code_information": [{"code": "C8923", "type": "HCPCS"}, {"code": "4638923", "type": "CDM"}, {"code": "483", "type": "RC"}], "standard_charges": [{"gross_charge": 4682.0, "discounted_cash": 3511.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ECHO TRANSTHORACIC COMP", "code_information": [{"code": "93303", "type": "CPT"}, {"code": "4636606", "type": "CDM"}, {"code": "483", "type": "RC"}], "standard_charges": [{"gross_charge": 4484.0, "discounted_cash": 3363.0, "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": 4303.0, "discounted_cash": 3227.25, "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": 7328.0, "discounted_cash": 5496.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ECHOCARD LTD CONG ANOMAL", "code_information": [{"code": "93304", "type": "CPT"}, {"code": "4633304", "type": "CDM"}, {"code": "483", "type": "RC"}], "standard_charges": [{"gross_charge": 3100.0, "discounted_cash": 2325.0, "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": 3972.0, "discounted_cash": 2979.0, "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": 1159.0, "discounted_cash": 869.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ECMO CANNULATION >6YRS", "code_information": [{"code": "3316822", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6241.0, "discounted_cash": 4680.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ECMO CANNULATION >6YRS", "code_information": [{"code": "4613952", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6241.0, "discounted_cash": 4680.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ECMO/INIT DAY VENO-ARTERIAL", "code_information": [{"code": "3313947", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 39968.0, "discounted_cash": 29976.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ECMO/INIT DAY VENO-ARTERIAL", "code_information": [{"code": "4613947", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 39968.0, "discounted_cash": 29976.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ECONAZOLE 1% 15GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335315", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 432.0, "discounted_cash": 324.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ECONAZOLE 1% 15GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335315", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 432.0, "discounted_cash": 324.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EDARAVONE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1301", "type": "HCPCS"}, {"code": "5320331", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EDARAVONE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1301", "type": "HCPCS"}, {"code": "5320331", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "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": 63.0, "discounted_cash": 47.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "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": 60.0, "discounted_cash": 45.0, "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": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EEG AWAKE/DROWSY", "code_information": [{"code": "95816", "type": "CPT"}, {"code": "4805817", "type": "CDM"}, {"code": "740", "type": "RC"}], "standard_charges": [{"gross_charge": 2301.0, "discounted_cash": 1725.75, "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": 2623.0, "discounted_cash": 1967.25, "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": 1247.0, "discounted_cash": 935.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EEG DIGITAL ANALY SPIKE", "code_information": [{"code": "95957", "type": "CPT"}, {"code": "4805936", "type": "CDM"}, {"code": "740", "type": "RC"}], "standard_charges": [{"gross_charge": 966.0, "discounted_cash": 724.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EEG MONITOR SLEEP", "code_information": [{"code": "95822", "type": "CPT"}, {"code": "4805822", "type": "CDM"}, {"code": "740", "type": "RC"}], "standard_charges": [{"gross_charge": 1833.0, "discounted_cash": 1374.75, "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": 1347.0, "discounted_cash": 1010.25, "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": 2706.0, "discounted_cash": 2029.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EFAVIR/EMTRICT/TENOFV TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304464", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 289.0, "discounted_cash": 216.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EFAVIR/EMTRICT/TENOFV TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304464", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 289.0, "discounted_cash": 216.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EFAVIRENZ 100MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304429", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 319.0, "discounted_cash": 239.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EFAVIRENZ 100MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304429", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 319.0, "discounted_cash": 239.25, "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": 304.0, "discounted_cash": 228.0, "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": 304.0, "discounted_cash": 228.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EGFR COMMON VARIANTS", "code_information": [{"code": "81235", "type": "CPT"}, {"code": "7270017", "type": "CDM"}], "standard_charges": [{"gross_charge": 2246.0, "discounted_cash": 1684.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EHRLICHIA AB", "code_information": [{"code": "86666", "type": "CPT"}, {"code": "7250666", "type": "CDM"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EHRLICHIA AB/2", "code_information": [{"code": "86666", "type": "CPT"}, {"code": "7256643", "type": "CDM"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EHRLICHIA AB/3", "code_information": [{"code": "86666", "type": "CPT"}, {"code": "7256644", "type": "CDM"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EHRLICHIA AB/4", "code_information": [{"code": "86666", "type": "CPT"}, {"code": "7256649", "type": "CDM"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "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": 1201.0, "discounted_cash": 900.75, "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": 921.0, "discounted_cash": 690.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ELBOW 2 VIEWS", "code_information": [{"code": "73070", "type": "CPT"}, {"code": "4903070", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 752.0, "discounted_cash": 564.0, "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": 752.0, "discounted_cash": 564.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ELBOW 2 VIEWS", "code_information": [{"code": "73070", "type": "CPT"}, {"code": "5123070", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 752.0, "discounted_cash": 564.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ELBOW 3 VIEW MINIMUM", "code_information": [{"code": "73080", "type": "CPT"}, {"code": "4903080", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1342.0, "discounted_cash": 1006.5, "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": 1345.0, "discounted_cash": 1008.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ELBOW 3 VIEW MINIMUM", "code_information": [{"code": "73080", "type": "CPT"}, {"code": "5113080", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1344.0, "discounted_cash": 1008.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ELBOW 3 VIEW MINIMUM", "code_information": [{"code": "73080", "type": "CPT"}, {"code": "5123080", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1342.0, "discounted_cash": 1006.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ELBOW ARTHROGRAPHY", "code_information": [{"code": "73085", "type": "CPT"}, {"code": "4903085", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2402.0, "discounted_cash": 1801.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ELCTRD SUBCUTANEOUS", "code_information": [{"code": "C1896", "type": "HCPCS"}, {"code": "4008490", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 45637.0, "discounted_cash": 34227.75, "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": 222.0, "discounted_cash": 166.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ELECTROLYTE PANEL", "code_information": [{"code": "80051", "type": "CPT"}, {"code": "4170004", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 175.0, "discounted_cash": 131.25, "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": 5611.0, "discounted_cash": 4208.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ELECTRON MICROSCOPY DIAG", "code_information": [{"code": "88348", "type": "CPT"}, {"code": "7018348", "type": "CDM"}], "standard_charges": [{"gross_charge": 3089.0, "discounted_cash": 2316.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ELECTRON MICROSCOPY DIAG", "code_information": [{"code": "88348", "type": "CPT"}, {"code": "7078361", "type": "CDM"}], "standard_charges": [{"gross_charge": 4167.0, "discounted_cash": 3125.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ELECTRON MICROSCOPY DIAG", "code_information": [{"code": "88348", "type": "CPT"}, {"code": "7098349", "type": "CDM"}], "standard_charges": [{"gross_charge": 3858.0, "discounted_cash": 2893.5, "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": 419.0, "discounted_cash": 314.25, "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": 419.0, "discounted_cash": 314.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EMB MICROSPHR 100-300MIC", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8032151", "type": "CDM"}], "standard_charges": [{"gross_charge": 2100.0, "discounted_cash": 1575.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EMB MICROSPHR 500-700MIC", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8032146", "type": "CDM"}], "standard_charges": [{"gross_charge": 5135.0, "discounted_cash": 3851.25, "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": 17.0, "discounted_cash": 12.75, "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": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EMOLLIENT 180ML LT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336319", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 146.0, "discounted_cash": 109.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EMOLLIENT 180ML LT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336319", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 146.0, "discounted_cash": 109.5, "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": 80.0, "discounted_cash": 60.0, "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": 80.0, "discounted_cash": 60.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EMOLLIENT 454GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335378", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 171.0, "discounted_cash": 128.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EMOLLIENT 454GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335378", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 171.0, "discounted_cash": 128.25, "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": 111.0, "discounted_cash": 83.25, "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": 111.0, "discounted_cash": 83.25, "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": 16.0, "discounted_cash": 12.0, "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": 16.0, "discounted_cash": 12.0, "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": 383.0, "discounted_cash": 287.25, "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": 383.0, "discounted_cash": 287.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EMPTY BAG IV 1000ML", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5413240", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 382.0, "discounted_cash": 286.5, "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": 424.0, "discounted_cash": 318.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EMPTY BAG IV 500ML", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5412040", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 403.0, "discounted_cash": 302.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EMPTY BAG IV 50ML", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5412025", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 44.0, "discounted_cash": 33.0, "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": 351.0, "discounted_cash": 263.25, "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": 351.0, "discounted_cash": 263.25, "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": 328.0, "discounted_cash": 246.0, "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": 328.0, "discounted_cash": 246.0, "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": 342.0, "discounted_cash": 256.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EMTRICITABINE 200MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304456", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 342.0, "discounted_cash": 256.5, "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": 268.0, "discounted_cash": 201.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EMTRICITBINE/TENFOVIR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304455", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 268.0, "discounted_cash": 201.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ENALAPRIL 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304439", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ENALAPRIL 2.5MG/2ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5320396", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 222.0, "discounted_cash": 166.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ENALAPRIL1.25MG/1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5320395", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 105.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ENALAPRL/HCTZ 10/25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304435", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 58.0, "discounted_cash": 43.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ENALAPRL/HCTZ 10/25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304435", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 58.0, "discounted_cash": 43.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ENCEPHALITIS CA LCROS AB", "code_information": [{"code": "86651", "type": "CPT"}, {"code": "7006192", "type": "CDM"}], "standard_charges": [{"gross_charge": 205.0, "discounted_cash": 153.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ENCEPHALITIS EAST EQ AB", "code_information": [{"code": "86652", "type": "CPT"}, {"code": "7006652", "type": "CDM"}], "standard_charges": [{"gross_charge": 205.0, "discounted_cash": 153.75, "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": 274.0, "discounted_cash": 205.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ENCEPHALITIS ST LOUIS AB", "code_information": [{"code": "86653", "type": "CPT"}, {"code": "7006653", "type": "CDM"}], "standard_charges": [{"gross_charge": 205.0, "discounted_cash": 153.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ENDO RPR THOR AO W/LT SCA+S&I", "code_information": [{"code": "75956", "type": "CPT"}, {"code": "4905956", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 711.0, "discounted_cash": 533.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ENDOLUM BX URTR RNL PLVS", "code_information": [{"code": "4910606", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5162.0, "discounted_cash": 3871.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ENDOMYSIAL AB", "code_information": [{"code": "86231", "type": "CPT"}, {"code": "7008676", "type": "CDM"}], "standard_charges": [{"gross_charge": 300.0, "discounted_cash": 225.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ENDOMYSIAL AB", "code_information": [{"code": "86231", "type": "CPT"}, {"code": "7258676", "type": "CDM"}], "standard_charges": [{"gross_charge": 261.0, "discounted_cash": 195.75, "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": 33622.0, "discounted_cash": 25216.5, "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": 101177.0, "discounted_cash": 75882.75, "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": 31326.0, "discounted_cash": 23494.5, "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": 271.0, "discounted_cash": 203.25, "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": 271.0, "discounted_cash": 203.25, "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": 183.0, "discounted_cash": 137.25, "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": 183.0, "discounted_cash": 137.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ENTERCOLYSIS SM BOWEL DBL CM", "code_information": [{"code": "74251", "type": "CPT"}, {"code": "4904251", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2390.0, "discounted_cash": 1792.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ENTEROVIRUS AB", "code_information": [{"code": "86658", "type": "CPT"}, {"code": "7256568", "type": "CDM"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ENTEROVIRUS AB/2", "code_information": [{"code": "86658", "type": "CPT"}, {"code": "7256569", "type": "CDM"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ENTEROVIRUS AMP PROBE/2", "code_information": [{"code": "87498", "type": "CPT"}, {"code": "7258750", "type": "CDM"}], "standard_charges": [{"gross_charge": 1282.0, "discounted_cash": 961.5, "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": 12793.0, "discounted_cash": 9594.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ENZYME ACTIVITY NES/9", "code_information": [{"code": "82657", "type": "CPT"}, {"code": "7258268", "type": "CDM"}], "standard_charges": [{"gross_charge": 998.0, "discounted_cash": 748.5, "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": 20073.0, "discounted_cash": 15054.75, "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": 21772.0, "discounted_cash": 16329.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EP EVAL AICD LEADS INIT", "code_information": [{"code": "93640", "type": "CPT"}, {"code": "4610640", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 5861.0, "discounted_cash": 4395.75, "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": 4076.0, "discounted_cash": 3057.0, "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": 9696.0, "discounted_cash": 7272.0, "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": 4811.0, "discounted_cash": 3608.25, "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": 53.0, "discounted_cash": 39.75, "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": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EPHEDRINE50MGNS 5MLPFSIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5320389", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 367.0, "discounted_cash": 275.25, "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": 266.0, "discounted_cash": 199.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EPIFIX 2CM X 3CM PER SQ CM", "code_information": [{"code": "Q4186", "type": "HCPCS"}, {"code": "4028026", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 699.0, "discounted_cash": 524.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EPIFIX 2CM X 3CM PER SQ CM", "code_information": [{"code": "Q4186", "type": "HCPCS"}, {"code": "4028026", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 699.0, "discounted_cash": 524.25, "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": 1707.0, "discounted_cash": 1280.25, "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": 1707.0, "discounted_cash": 1280.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EPINEPH100MCG D510ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5320457", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EPINEPHRIN4MG/D5W250MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5320461", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 324.0, "discounted_cash": 243.0, "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": 122.0, "discounted_cash": 91.5, "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": 724.0, "discounted_cash": 543.0, "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": 724.0, "discounted_cash": 543.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EPINEPHRINE 2.25%.5ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330865", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 744.0, "discounted_cash": 558.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EPINEPHRINE 2.25%.5ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330865", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 744.0, "discounted_cash": 558.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EPINEPHRINE NEO PER1MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5320453", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "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": 142.0, "discounted_cash": 106.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EPINEPHRINEPER0.1MGPFSIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0165", "type": "HCPCS"}, {"code": "5320459", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EPINEPHRINEPER0.1MGPFSIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0165", "type": "HCPCS"}, {"code": "5320459", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "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": 21.0, "discounted_cash": 15.75, "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": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EPOETIN ESRD PER 100U IJ", "code_information": [{"code": "Q4081", "type": "HCPCS"}, {"code": "5320419", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "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": 17.0, "discounted_cash": 12.75, "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": 235.0, "discounted_cash": 176.25, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 235.0, "discounted_cash": 176.25, "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": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EPOETIN-EPBX ESRD PER 100U IJ", "code_information": [{"code": "Q5105", "type": "HCPCS"}, {"code": "5320471", "type": "CDM"}, {"code": "634", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EPOETIN-EPBX NON-ESRD 1000U IJ", "code_information": [{"code": "Q5106", "type": "HCPCS"}, {"code": "5320472", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "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": 95.0, "discounted_cash": 71.25, "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": 95.0, "discounted_cash": 71.25, "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": 296.0, "discounted_cash": 222.0, "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": 242.0, "discounted_cash": 181.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EPSTEIN-BARR VIRUS NA AB", "code_information": [{"code": "86664", "type": "CPT"}, {"code": "4179430", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 201.0, "discounted_cash": 150.75, "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": 255.0, "discounted_cash": 191.25, "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": 156.0, "discounted_cash": 117.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EPSTEIN-BARR VIRUS VCA AB", "code_information": [{"code": "86665", "type": "CPT"}, {"code": "4179431", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 274.0, "discounted_cash": 205.5, "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": 156.0, "discounted_cash": 117.0, "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": 349.0, "discounted_cash": 261.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EPSTEIN-BARR VIRUS VCA AB/3", "code_information": [{"code": "86665", "type": "CPT"}, {"code": "7009431", "type": "CDM"}], "standard_charges": [{"gross_charge": 156.0, "discounted_cash": 117.0, "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": 232.0, "discounted_cash": 174.0, "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": 304.0, "discounted_cash": 228.0, "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": 211.0, "discounted_cash": 158.25, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 211.0, "discounted_cash": 158.25, "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": 879.0, "discounted_cash": 659.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ER VISIT LVL I", "code_information": [{"code": "99281", "type": "CPT"}, {"code": "6189281", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 879.0, "discounted_cash": 659.25, "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": 1576.0, "discounted_cash": 1182.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ER VISIT LVL II", "code_information": [{"code": "99282", "type": "CPT"}, {"code": "6189282", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1576.0, "discounted_cash": 1182.0, "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": 2454.0, "discounted_cash": 1840.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ER VISIT LVL III", "code_information": [{"code": "99283", "type": "CPT"}, {"code": "6189283", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 2454.0, "discounted_cash": 1840.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ER VISIT LVL IV", "code_information": [{"code": "99284", "type": "CPT"}, {"code": "6100526", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 4496.0, "discounted_cash": 3372.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ER VISIT LVL IV", "code_information": [{"code": "99284", "type": "CPT"}, {"code": "6189284", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 4496.0, "discounted_cash": 3372.0, "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": 5368.0, "discounted_cash": 4026.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ER VISIT LVL V", "code_information": [{"code": "99285", "type": "CPT"}, {"code": "6189285", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 5368.0, "discounted_cash": 4026.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ERCP BILIARY&PANCREATIC", "code_information": [{"code": "74330", "type": "CPT"}, {"code": "4904200", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 3842.0, "discounted_cash": 2881.5, "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": 528.0, "discounted_cash": 396.0, "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": 528.0, "discounted_cash": 396.0, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 20.0, "discounted_cash": 15.0, "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": 20.0, "discounted_cash": 15.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1173.0, "discounted_cash": 879.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1173.0, "discounted_cash": 879.75, "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": 1312.0, "discounted_cash": 984.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1312.0, "discounted_cash": 984.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ERTAPENEM PER 500MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1335", "type": "HCPCS"}, {"code": "5320491", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1099.0, "discounted_cash": 824.25, "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": 1099.0, "discounted_cash": 824.25, "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": 289.0, "discounted_cash": 216.75, "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": 289.0, "discounted_cash": 216.75, "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": 45.0, "discounted_cash": 33.75, "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": 45.0, "discounted_cash": 33.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ERYTHROMY400/5 100ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315163", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ERYTHROMY400/5 100ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315163", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "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": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ERYTHROMYC BASE 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304647", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ERYTHROMYC BASE 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304653", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ERYTHROMYC/SULF 100 PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315151", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 541.0, "discounted_cash": 405.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ERYTHROMYC/SULF 100 PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315151", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 541.0, "discounted_cash": 405.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ERYTHROMYCIN .5% 1GM OO", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330923", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "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": "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": 338.0, "discounted_cash": 253.5, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 338.0, "discounted_cash": 253.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ERYTHROPOIETIN", "code_information": [{"code": "82668", "type": "CPT"}, {"code": "4170063", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 316.0, "discounted_cash": 237.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ERYTHROPOIETIN", "code_information": [{"code": "82668", "type": "CPT"}, {"code": "7002668", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 183.0, "discounted_cash": 137.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ERYTHROPOIETIN", "code_information": [{"code": "82668", "type": "CPT"}, {"code": "7252668", "type": "CDM"}], "standard_charges": [{"gross_charge": 401.0, "discounted_cash": 300.75, "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": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ESCITALOPRAM 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304665", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "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": 0.84, "discounted_cash": 0.63, "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": 0.84, "discounted_cash": 0.63, "setting": "both", "billing_class": "facility"}]}, {"description": "ESOMEPRAZOL10MGXR PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304667", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ESOMEPRAZOL10MGXR PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304667", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "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": 267.0, "discounted_cash": 200.25, "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": 267.0, "discounted_cash": 200.25, "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": 2499.0, "discounted_cash": 1874.25, "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": 4273.0, "discounted_cash": 3204.75, "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": 1521.0, "discounted_cash": 1140.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTAZOLAM 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304660", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTAZOLAM 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304660", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTRADIOL", "code_information": [{"code": "82670", "type": "CPT"}, {"code": "4122670", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 193.0, "discounted_cash": 144.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTRADIOL", "code_information": [{"code": "82670", "type": "CPT"}, {"code": "4172670", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 397.0, "discounted_cash": 297.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTRADIOL", "code_information": [{"code": "82670", "type": "CPT"}, {"code": "7002670", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 256.0, "discounted_cash": 192.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTRADIOL", "code_information": [{"code": "82670", "type": "CPT"}, {"code": "7252670", "type": "CDM"}], "standard_charges": [{"gross_charge": 505.0, "discounted_cash": 378.75, "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": 467.0, "discounted_cash": 350.25, "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": 467.0, "discounted_cash": 350.25, "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": 133.0, "discounted_cash": 99.75, "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": 133.0, "discounted_cash": 99.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTRADIOL .075BIWK EA TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5335366", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 189.0, "discounted_cash": 141.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTRADIOL .075BIWK EA TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5335366", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 189.0, "discounted_cash": 141.75, "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": 497.0, "discounted_cash": 372.75, "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": 497.0, "discounted_cash": 372.75, "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": 133.0, "discounted_cash": 99.75, "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": 133.0, "discounted_cash": 99.75, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 10.0, "discounted_cash": 7.5, "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": 10.0, "discounted_cash": 7.5, "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": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "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": 238.0, "discounted_cash": 178.5, "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": 238.0, "discounted_cash": 178.5, "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": 94.0, "discounted_cash": 70.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 94.0, "discounted_cash": 70.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 130.0, "discounted_cash": 97.5, "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": 130.0, "discounted_cash": 97.5, "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": 290.0, "discounted_cash": 217.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 290.0, "discounted_cash": 217.5, "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": 1118.0, "discounted_cash": 838.5, "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": 1118.0, "discounted_cash": 838.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTROGEN ESTRFD.625MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304708", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTROGEN ESTRFD.625MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304708", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTROGEN ESTRFD1.25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304709", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTROGEN ESTRFD1.25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304709", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTROGENS TOTAL", "code_information": [{"code": "82672", "type": "CPT"}, {"code": "4172672", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 134.0, "discounted_cash": 100.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTROGENS TOTAL", "code_information": [{"code": "82672", "type": "CPT"}, {"code": "7002672", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 178.0, "discounted_cash": 133.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTROGENS TOTAL", "code_information": [{"code": "82672", "type": "CPT"}, {"code": "7252672", "type": "CDM"}], "standard_charges": [{"gross_charge": 171.0, "discounted_cash": 128.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTROPIPATE 0.625MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304730", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTROPIPATE 0.625MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304730", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTROPIPATE 1.25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304731", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ESTROPIPATE 1.25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304731", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "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": 68.0, "discounted_cash": 51.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "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": 461.0, "discounted_cash": 345.75, "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": 461.0, "discounted_cash": 345.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ETHACRYNIC ACID 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304747", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ETHACRYNIC ACID 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304747", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "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": 101.0, "discounted_cash": 75.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ETHAMBUTOL 400MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304774", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 101.0, "discounted_cash": 75.75, "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": 1722.0, "discounted_cash": 1291.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ETHANOLAMINE PER100MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1430", "type": "HCPCS"}, {"code": "5320560", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1966.0, "discounted_cash": 1474.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ETHANOLAMINE PER100MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1430", "type": "HCPCS"}, {"code": "5320560", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1966.0, "discounted_cash": 1474.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ETHOSUXIMIDE", "code_information": [{"code": "80168", "type": "CPT"}, {"code": "7002692", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 149.0, "discounted_cash": 111.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ETHOSUXIMIDE", "code_information": [{"code": "80168", "type": "CPT"}, {"code": "7252692", "type": "CDM"}], "standard_charges": [{"gross_charge": 229.0, "discounted_cash": 171.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ETHYL CHLORIDE 105ML SP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335374", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 647.0, "discounted_cash": 485.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ETHYL CHLORIDE 105ML SP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335374", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 647.0, "discounted_cash": 485.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ETHYLENE GLYCOL", "code_information": [{"code": "82693", "type": "CPT"}, {"code": "7002691", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ETHYLENE GLYCOL", "code_information": [{"code": "82693", "type": "CPT"}, {"code": "7252691", "type": "CDM"}], "standard_charges": [{"gross_charge": 266.0, "discounted_cash": 199.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ETODOLAC 200MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304883", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 106.0, "discounted_cash": 79.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ETODOLAC 200MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304883", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 106.0, "discounted_cash": 79.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ETODOLAC 300MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304884", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ETODOLAC 300MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304884", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ETODOLAC 400MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304885", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ETODOLAC 400MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304885", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ETODOLAC 400MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304887", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 89.0, "discounted_cash": 66.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ETODOLAC 400MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304887", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 89.0, "discounted_cash": 66.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ETODOLAC 500MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304889", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ETODOLAC 500MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304889", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "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": 28.0, "discounted_cash": 21.0, "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": 349.0, "discounted_cash": 261.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ETOMIDATE40MG/20ML PFSIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5320613", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 82.0, "discounted_cash": 61.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 148.0, "discounted_cash": 111.0, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 148.0, "discounted_cash": 111.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EXAM MACRO PARASITE/2", "code_information": [{"code": "87169", "type": "CPT"}, {"code": "7257175", "type": "CDM"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EXCERCIS TST BRONCHSPASM W/EKG", "code_information": [{"code": "94617", "type": "CPT"}, {"code": "6034617", "type": "CDM"}, {"code": "460", "type": "RC"}], "standard_charges": [{"gross_charge": 1027.0, "discounted_cash": 770.25, "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": 3284.0, "discounted_cash": 2463.0, "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": 3284.0, "discounted_cash": 2463.0, "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": 191.0, "discounted_cash": 143.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 191.0, "discounted_cash": 143.25, "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": 3764.0, "discounted_cash": 2823.0, "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": 3764.0, "discounted_cash": 2823.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 929.0, "discounted_cash": 696.75, "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": 929.0, "discounted_cash": 696.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EXT TB GLAUCOMA VALVE", "code_information": [{"code": "C1783", "type": "HCPCS"}, {"code": "8182350", "type": "CDM"}], "standard_charges": [{"gross_charge": 12282.0, "discounted_cash": 9211.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EXTENDER BUTTN TIGHTROPE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011900", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2565.0, "discounted_cash": 1923.75, "setting": "both", "billing_class": "facility"}]}, {"description": "EYE CIRC/BA", "code_information": [{"code": "L8610", "type": "HCPCS"}, {"code": "8122000", "type": "CDM"}], "standard_charges": [{"gross_charge": 190.0, "discounted_cash": 142.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EYE SPHERE", "code_information": [{"code": "V2623", "type": "HCPCS"}, {"code": "8122120", "type": "CDM"}], "standard_charges": [{"gross_charge": 8103.0, "discounted_cash": 6077.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EYE SPHERE PLSTC", "code_information": [{"code": "V2629", "type": "HCPCS"}, {"code": "8122114", "type": "CDM"}], "standard_charges": [{"gross_charge": 663.0, "discounted_cash": 497.25, "setting": "both", "billing_class": "facility"}]}, {"description": "EYE STNT MINI MONOKA S1.1500", "code_information": [{"code": "A4263", "type": "HCPCS"}, {"code": "8122108", "type": "CDM"}], "standard_charges": [{"gross_charge": 708.0, "discounted_cash": 531.0, "setting": "both", "billing_class": "facility"}]}, {"description": "EZETIMB/SIMVAS10/40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304878", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 10.0, "discounted_cash": 7.5, "setting": "both", "billing_class": "facility"}]}, {"description": "EZETIMB/SIMVAS10/40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304878", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 10.0, "discounted_cash": 7.5, "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": 222.0, "discounted_cash": 166.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 222.0, "discounted_cash": 166.5, "setting": "both", "billing_class": "facility"}]}, {"description": "F18 FDG DOSE", "code_information": [{"code": "A9552", "type": "HCPCS"}, {"code": "5191100", "type": "CDM"}, {"code": "343", "type": "RC"}], "standard_charges": [{"gross_charge": 3136.0, "discounted_cash": 2352.0, "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": 511.0, "discounted_cash": 383.25, "setting": "both", "billing_class": "facility"}]}, {"description": "F5 LEIDEN VARIANT", "code_information": [{"code": "81241", "type": "CPT"}, {"code": "4101241", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 1173.0, "discounted_cash": 879.75, "setting": "both", "billing_class": "facility"}]}, {"description": "F5 LEIDEN VARIANT", "code_information": [{"code": "81241", "type": "CPT"}, {"code": "7259207", "type": "CDM"}], "standard_charges": [{"gross_charge": 486.0, "discounted_cash": 364.5, "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": 633.0, "discounted_cash": 474.75, "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": 633.0, "discounted_cash": 474.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FACIAL BONES 3VW MIN", "code_information": [{"code": "70150", "type": "CPT"}, {"code": "4900150", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1109.0, "discounted_cash": 831.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FACIAL BONES 3VW MIN", "code_information": [{"code": "70150", "type": "CPT"}, {"code": "5010150", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1220.0, "discounted_cash": 915.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FACIAL BONES 3VW MIN", "code_information": [{"code": "70150", "type": "CPT"}, {"code": "5110150", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1220.0, "discounted_cash": 915.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FACIAL BONES 3VW MIN", "code_information": [{"code": "70150", "type": "CPT"}, {"code": "5120150", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1109.0, "discounted_cash": 831.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FACTOR 8 XYNTHA PER IUIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7185", "type": "HCPCS"}, {"code": "5320699", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "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": 10.0, "discounted_cash": 7.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FACTOR VIIA PER 1MCG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7189", "type": "HCPCS"}, {"code": "5320639", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FACTR VIII RISTO CO-FCTR", "code_information": [{"code": "85245", "type": "CPT"}, {"code": "4175245", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 491.0, "discounted_cash": 368.25, "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": 591.0, "discounted_cash": 443.25, "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": 623.0, "discounted_cash": 467.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FACTR VIII VW AG CO-FCTR", "code_information": [{"code": "85246", "type": "CPT"}, {"code": "4175246", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 427.0, "discounted_cash": 320.25, "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": 543.0, "discounted_cash": 407.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FALLOPIAN RING", "code_information": [{"code": "A4264", "type": "HCPCS"}, {"code": "8151500", "type": "CDM"}], "standard_charges": [{"gross_charge": 2680.0, "discounted_cash": 2010.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 367.0, "discounted_cash": 275.25, "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": 367.0, "discounted_cash": 275.25, "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": 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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FAMOTIDINE 40/5 50MLPWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315186", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 880.0, "discounted_cash": 660.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FAMOTIDINE 40/5 50MLPWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315186", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 880.0, "discounted_cash": 660.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FAMOTIDINE PER 0.25MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1308", "type": "HCPCS"}, {"code": "5320584", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.1, "discounted_cash": 0.08, "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": 0.1, "discounted_cash": 0.08, "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": 561.0, "discounted_cash": 420.75, "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": 2443.0, "discounted_cash": 1832.25, "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": 755.0, "discounted_cash": 566.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FAT EMULS 20% 250ML TPN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5413470", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 734.0, "discounted_cash": 550.5, "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": 679.0, "discounted_cash": 509.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FAT OR LIPID FECES QUAL", "code_information": [{"code": "82705", "type": "CPT"}, {"code": "7252705", "type": "CDM"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FAT OR LIPID FECES QUANT", "code_information": [{"code": "82710", "type": "CPT"}, {"code": "7002700", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 327.0, "discounted_cash": 245.25, "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": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FAT STAIN FECES/URIN/ETC", "code_information": [{"code": "89125", "type": "CPT"}, {"code": "4109125", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 157.0, "discounted_cash": 117.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FCTR VIII VW MLT CO-FCTR", "code_information": [{"code": "85247", "type": "CPT"}, {"code": "4175800", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 236.0, "discounted_cash": 177.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FCTR VIII VW MLT CO-FCTR", "code_information": [{"code": "85247", "type": "CPT"}, {"code": "7005247", "type": "CDM"}], "standard_charges": [{"gross_charge": 924.0, "discounted_cash": 693.0, "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": 300.0, "discounted_cash": 225.0, "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": 623.0, "discounted_cash": 467.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FDP D-DIMER QNT", "code_information": [{"code": "85379", "type": "CPT"}, {"code": "4175350", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 491.0, "discounted_cash": 368.25, "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": 352.0, "discounted_cash": 264.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FDP FSP AGGLUTNATN SEMQTY", "code_information": [{"code": "85362", "type": "CPT"}, {"code": "4175362", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 277.0, "discounted_cash": 207.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 223.0, "discounted_cash": 167.25, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 223.0, "discounted_cash": 167.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FE POLY/ASC AC 150/50 CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5306056", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FE POLY/ASC AC 150/50 CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5306056", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FE POLYSACCHAR 150MG CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5306061", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FE POLYSACCHAR 150MG CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5306061", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "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": 13.0, "discounted_cash": 9.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FECAL ELASTASE EL1 QN", "code_information": [{"code": "82653", "type": "CPT"}, {"code": "7252654", "type": "CDM"}], "standard_charges": [{"gross_charge": 973.0, "discounted_cash": 729.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FECAL MICROBIOTA 250ML", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5338375", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2919.0, "discounted_cash": 2189.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FELODIPINE 5MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304920", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FELODIPINE 5MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304920", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FEM CEMENT REST", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8174600", "type": "CDM"}], "standard_charges": [{"gross_charge": 2179.0, "discounted_cash": 1634.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FEM COMP", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8132505", "type": "CDM"}], "standard_charges": [{"gross_charge": 46347.0, "discounted_cash": 34760.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FEM COMPONENT", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8132500", "type": "CDM"}], "standard_charges": [{"gross_charge": 32700.0, "discounted_cash": 24525.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FEM NAIL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132510", "type": "CDM"}], "standard_charges": [{"gross_charge": 31213.0, "discounted_cash": 23409.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FEM STEM", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8132535", "type": "CDM"}], "standard_charges": [{"gross_charge": 6920.0, "discounted_cash": 5190.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FEMUR 1 VW", "code_information": [{"code": "73551", "type": "CPT"}, {"code": "4903552", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 724.0, "discounted_cash": 543.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FEMUR 1 VW", "code_information": [{"code": "73551", "type": "CPT"}, {"code": "5013552", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 724.0, "discounted_cash": 543.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FEMUR 1 VW", "code_information": [{"code": "73551", "type": "CPT"}, {"code": "5113552", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 724.0, "discounted_cash": 543.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FEMUR 1 VW", "code_information": [{"code": "73551", "type": "CPT"}, {"code": "5123552", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 724.0, "discounted_cash": 543.0, "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": 989.0, "discounted_cash": 741.75, "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": 1053.0, "discounted_cash": 789.75, "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": 989.0, "discounted_cash": 741.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FEMUR 2 VIEWS MIN", "code_information": [{"code": "73552", "type": "CPT"}, {"code": "5123550", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 989.0, "discounted_cash": 741.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FENOFIBRATE 145MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304938", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 717.0, "discounted_cash": 537.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FENOFIBRATE 145MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304938", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 717.0, "discounted_cash": 537.75, "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": 84.0, "discounted_cash": 63.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FENOFIBRATE 48MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304933", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 106.0, "discounted_cash": 79.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FENOFIBRATE 48MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304933", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 106.0, "discounted_cash": 79.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FENOFIBRATE 67MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304932", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FENOFIBRATE 67MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304932", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "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": 4082.0, "discounted_cash": 3061.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FENT/BUPIV EPID PER1MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5320705", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FENT/BUPIV EPID PER1MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5320705", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FENTANYL", "code_information": [{"code": "80354", "type": "CPT"}, {"code": "7052555", "type": "CDM"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FENTANYL", "code_information": [{"code": "80354", "type": "CPT"}, {"code": "7253936", "type": "CDM"}], "standard_charges": [{"gross_charge": 320.0, "discounted_cash": 240.0, "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": 116.0, "discounted_cash": 87.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FENTANYL 100MCG/HR TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5327513", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 89.0, "discounted_cash": 66.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 89.0, "discounted_cash": 66.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "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": 71.0, "discounted_cash": 53.25, "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": 467.0, "discounted_cash": 350.25, "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": 900.0, "discounted_cash": 675.0, "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": 900.0, "discounted_cash": 675.0, "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": 718.0, "discounted_cash": 538.5, "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": 718.0, "discounted_cash": 538.5, "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": 600.0, "discounted_cash": 450.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 89.0, "discounted_cash": 66.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FENTANYL 75MCG/HR TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5327512", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 89.0, "discounted_cash": 66.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FENTANYL NEO PER 1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5320711", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.99, "discounted_cash": 0.74, "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": 14.0, "discounted_cash": 10.5, "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": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FENTANYL PER 0.1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3010", "type": "HCPCS"}, {"code": "5327501", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 101.0, "discounted_cash": 75.75, "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": 101.0, "discounted_cash": 75.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FENTANYL/BUPIV 250ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5320653", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 399.0, "discounted_cash": 299.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FENTANYL/BUPIV 250ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5320653", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 399.0, "discounted_cash": 299.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FERR CARBOXY PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1439", "type": "HCPCS"}, {"code": "5320596", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FERR CARBOXY PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1439", "type": "HCPCS"}, {"code": "5320596", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "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": 133.0, "discounted_cash": 99.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FERR SULF 15MG/ML50ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315198", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 133.0, "discounted_cash": 99.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FERRIC SUBSULF 30ML TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336682", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 985.0, "discounted_cash": 738.75, "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": 89.0, "discounted_cash": 66.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FERRIC SUBSULFATE 8ML TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335384", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 187.0, "discounted_cash": 140.25, "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": 583.0, "discounted_cash": 437.25, "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": 106.0, "discounted_cash": 79.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FERRITIN", "code_information": [{"code": "82728", "type": "CPT"}, {"code": "4172726", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 458.0, "discounted_cash": 343.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FERRITIN", "code_information": [{"code": "82728", "type": "CPT"}, {"code": "7252726", "type": "CDM"}], "standard_charges": [{"gross_charge": 197.0, "discounted_cash": 147.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FERROFUMR/DOC150/100XRTB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5304982", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FERROFUMR/DOC150/100XRTB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5304982", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FERROFUMR/FA324MG/1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304997", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FERROFUMR/FA324MG/1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5304997", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FERROUS FUMARAT100MG CTB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5304987", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FERROUS FUMARAT100MG CTB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5304987", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FERROUS GLUCONT 225MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5305012", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FERROUS GLUCONT 225MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5305012", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FERROUS GLUCONT 240MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5305010", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FERROUS GLUCONT 240MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5305010", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FERROUS GLUCONT 256MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5305011", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FERROUS GLUCONT 256MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5305011", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FERROUS SULF 160MG XR TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5305042", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FERROUS SULF 160MG XR TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5305042", "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": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FERROUS SULF 300MG/5MLLQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315207", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FERROUS SULF220MG/5ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315210", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FERROUS SULF220MG/5ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315210", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "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": 63.0, "discounted_cash": 47.25, "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": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FERROUS SULFATE 200MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5305058", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FERROUS SULFATE 200MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5305058", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 26.0, "discounted_cash": 19.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FERROUS SULFATE 325MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5305044", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "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": 3.0, "discounted_cash": 2.25, "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": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FESOTERODINE 4MG XRTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305068", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FESOTERODINE 4MG XRTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305068", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FETAL BIOPHYS PROFLE NST", "code_information": [{"code": "76818", "type": "CPT"}, {"code": "3120175", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 935.0, "discounted_cash": 701.25, "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": 935.0, "discounted_cash": 701.25, "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": 935.0, "discounted_cash": 701.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FETAL BIOPHYS PROFLE NST", "code_information": [{"code": "76818", "type": "CPT"}, {"code": "5126818", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 935.0, "discounted_cash": 701.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FETAL BIOPHYS W/O STRESS", "code_information": [{"code": "76819", "type": "CPT"}, {"code": "3126180", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1257.0, "discounted_cash": 942.75, "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": 1257.0, "discounted_cash": 942.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FETAL CV ECHO", "code_information": [{"code": "76825", "type": "CPT"}, {"code": "3126870", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2361.0, "discounted_cash": 1770.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FETAL CV ECHO", "code_information": [{"code": "76825", "type": "CPT"}, {"code": "5066870", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2361.0, "discounted_cash": 1770.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FETAL CV ECHO W/DOPP F/U", "code_information": [{"code": "76828", "type": "CPT"}, {"code": "3126828", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1092.0, "discounted_cash": 819.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FETAL CV ECHO W/DOPPLER", "code_information": [{"code": "76827", "type": "CPT"}, {"code": "3120190", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1716.0, "discounted_cash": 1287.0, "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": 1880.0, "discounted_cash": 1410.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FETAL FIBRONECTIN", "code_information": [{"code": "82731", "type": "CPT"}, {"code": "4172731", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1479.0, "discounted_cash": 1109.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FETAL FIBRONECTIN", "code_information": [{"code": "82731", "type": "CPT"}, {"code": "7012731", "type": "CDM"}], "standard_charges": [{"gross_charge": 2905.0, "discounted_cash": 2178.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FETAL LUNG MAT L/S RATIO", "code_information": [{"code": "83661", "type": "CPT"}, {"code": "7013661", "type": "CDM"}], "standard_charges": [{"gross_charge": 468.0, "discounted_cash": 351.0, "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": 1863.0, "discounted_cash": 1397.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FETAL NON-STRESS TEST", "code_information": [{"code": "59025", "type": "CPT"}, {"code": "3120440", "type": "CDM"}, {"code": "920", "type": "RC"}], "standard_charges": [{"gross_charge": 1600.0, "discounted_cash": 1200.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FETAL NON-STRESS TEST", "code_information": [{"code": "59025", "type": "CPT"}, {"code": "6169025", "type": "CDM"}, {"code": "920", "type": "RC"}], "standard_charges": [{"gross_charge": 1507.0, "discounted_cash": 1130.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FETAL RBC ROSETTE", "code_information": [{"code": "85461", "type": "CPT"}, {"code": "4102720", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 722.0, "discounted_cash": 541.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FETAL RBC ROSETTE", "code_information": [{"code": "85461", "type": "CPT"}, {"code": "4175461", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 568.0, "discounted_cash": 426.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FEXOFENADINE 180MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305059", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 308.0, "discounted_cash": 231.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FEXOFENADINE 180MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305059", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 308.0, "discounted_cash": 231.0, "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": 282.0, "discounted_cash": 211.5, "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": 253.0, "discounted_cash": 189.75, "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": 14329.0, "discounted_cash": 10746.75, "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": 10235.0, "discounted_cash": 7676.25, "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": 277.0, "discounted_cash": 207.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FIBRINOGEN ACTIVITY", "code_information": [{"code": "85384", "type": "CPT"}, {"code": "4175384", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 218.0, "discounted_cash": 163.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FIBRINOLYSINS SCREENING", "code_information": [{"code": "85390", "type": "CPT"}, {"code": "4105390", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 67.0, "discounted_cash": 50.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FIBRNOLTIC PLSMNOGEN AG", "code_information": [{"code": "85421", "type": "CPT"}, {"code": "7255421", "type": "CDM"}], "standard_charges": [{"gross_charge": 982.0, "discounted_cash": 736.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FIBRNOLTIC PLSMNOGEN XCPT AG", "code_information": [{"code": "85420", "type": "CPT"}, {"code": "7005420", "type": "CDM"}], "standard_charges": [{"gross_charge": 749.0, "discounted_cash": 561.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FIDAXOMICIN 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305069", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1036.0, "discounted_cash": 777.0, "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": 1036.0, "discounted_cash": 777.0, "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": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FILTER VENA CAVA", "code_information": [{"code": "C1880", "type": "HCPCS"}, {"code": "8240143", "type": "CDM"}], "standard_charges": [{"gross_charge": 19379.0, "discounted_cash": 14534.25, "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": 222.0, "discounted_cash": 166.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FINASTERIDE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305066", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 222.0, "discounted_cash": 166.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FINGER(S) 2 VIEWS", "code_information": [{"code": "73140", "type": "CPT"}, {"code": "4903140", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1044.0, "discounted_cash": 783.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FINGER(S) 2 VIEWS", "code_information": [{"code": "73140", "type": "CPT"}, {"code": "5013140", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1044.0, "discounted_cash": 783.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FINGER(S) 2 VIEWS", "code_information": [{"code": "73140", "type": "CPT"}, {"code": "5113140", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1044.0, "discounted_cash": 783.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FINGER(S) 2 VIEWS", "code_information": [{"code": "73140", "type": "CPT"}, {"code": "5123140", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1044.0, "discounted_cash": 783.0, "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": 1878.0, "discounted_cash": 1408.5, "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": 1878.0, "discounted_cash": 1408.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLAVORING AGENT 5ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315213", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLAVORING AGENT 5ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315213", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLAVOXATE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305079", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 116.0, "discounted_cash": 87.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLAVOXATE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305079", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 116.0, "discounted_cash": 87.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLECAINIDE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305085", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "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": 50.0, "discounted_cash": 37.5, "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": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLECAINIDE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305084", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLEXIBLE NAIL AS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132615", "type": "CDM"}], "standard_charges": [{"gross_charge": 2633.0, "discounted_cash": 1974.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLOW CYTO ADD MARKER", "code_information": [{"code": "88185", "type": "CPT"}, {"code": "4170076", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 148.0, "discounted_cash": 111.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLOW CYTO ADD MARKER", "code_information": [{"code": "88185", "type": "CPT"}, {"code": "7258185", "type": "CDM"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLOW CYTO ADD MARKER", "code_information": [{"code": "88185", "type": "CPT"}, {"code": "7270101", "type": "CDM"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLOW CYTO ADD MARKER", "code_information": [{"code": "88185", "type": "CPT"}, {"code": "7270102", "type": "CDM"}], "standard_charges": [{"gross_charge": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLOW CYTO ADD MARKER/2", "code_information": [{"code": "88185", "type": "CPT"}, {"code": "4300076", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 189.0, "discounted_cash": 141.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLOW CYTO ADD MARKER/2", "code_information": [{"code": "88185", "type": "CPT"}, {"code": "7030076", "type": "CDM"}], "standard_charges": [{"gross_charge": 130.0, "discounted_cash": 97.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLOW CYTO ADD MARKER/3", "code_information": [{"code": "88185", "type": "CPT"}, {"code": "7030016", "type": "CDM"}], "standard_charges": [{"gross_charge": 617.0, "discounted_cash": 462.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLOW CYTO ADD MARKER/4", "code_information": [{"code": "88185", "type": "CPT"}, {"code": "7030077", "type": "CDM"}], "standard_charges": [{"gross_charge": 172.0, "discounted_cash": 129.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLOW CYTO CEL FIRST MRKR", "code_information": [{"code": "88184", "type": "CPT"}, {"code": "4178818", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 1416.0, "discounted_cash": 1062.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLOW CYTO CEL FIRST MRKR", "code_information": [{"code": "88184", "type": "CPT"}, {"code": "4300009", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 1800.0, "discounted_cash": 1350.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLOW CYTO CEL FIRST MRKR", "code_information": [{"code": "88184", "type": "CPT"}, {"code": "7270062", "type": "CDM"}], "standard_charges": [{"gross_charge": 1961.0, "discounted_cash": 1470.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLOW CYTO CEL FIRST MRKR/2", "code_information": [{"code": "88184", "type": "CPT"}, {"code": "7030012", "type": "CDM"}], "standard_charges": [{"gross_charge": 617.0, "discounted_cash": 462.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLOW CYTO CEL FIRST MRKR/5", "code_information": [{"code": "88184", "type": "CPT"}, {"code": "7258184", "type": "CDM"}], "standard_charges": [{"gross_charge": 1493.0, "discounted_cash": 1119.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLOW CYTO INTERP 16+ MARK", "code_information": [{"code": "88189", "type": "CPT"}, {"code": "7258189", "type": "CDM"}], "standard_charges": [{"gross_charge": 159.0, "discounted_cash": 119.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLOW CYTO INTERP 16+ MARK", "code_information": [{"code": "88189", "type": "CPT"}, {"code": "7270105", "type": "CDM"}], "standard_charges": [{"gross_charge": 324.0, "discounted_cash": 243.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLOW EA ADD MARKER/3", "code_information": [{"code": "88185", "type": "CPT"}, {"code": "7000057", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 350.0, "discounted_cash": 262.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLTR VC GREENFIELD 12INT", "code_information": [{"code": "C1880", "type": "HCPCS"}, {"code": "8246300", "type": "CDM"}], "standard_charges": [{"gross_charge": 19379.0, "discounted_cash": 14534.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLTR VC GUNTHER TULIP", "code_information": [{"code": "C1880", "type": "HCPCS"}, {"code": "4021036", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12549.0, "discounted_cash": 9411.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLU VAC < 3 YRS IM PF IJ", "code_information": [{"code": "90655", "type": "CPT"}, {"code": "5320685", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 120.0, "discounted_cash": 90.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLU VAC <3Y 4 VAL PF IJ", "code_information": [{"code": "90685", "type": "CPT"}, {"code": "5320789", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 98.0, "discounted_cash": 73.5, "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": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLU VAC >3Y 4 VAL PF IJ", "code_information": [{"code": "90686", "type": "CPT"}, {"code": "5320777", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLU VAC CELL CULT PF IJ", "code_information": [{"code": "90674", "type": "CPT"}, {"code": "5320729", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 62.0, "discounted_cash": 46.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLU VAC>3Y FLUVIRN IM IJ", "code_information": [{"code": "Q2037", "type": "HCPCS"}, {"code": "5320703", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 237.0, "discounted_cash": 177.75, "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": 602.0, "discounted_cash": 451.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUCONAZ PER200MG PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1450", "type": "HCPCS"}, {"code": "5320677", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 717.0, "discounted_cash": 537.75, "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": 717.0, "discounted_cash": 537.75, "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": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUCONAZOLE 100MG PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1450", "type": "HCPCS"}, {"code": "5320700", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUCONAZOLE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305096", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 87.75, "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": 117.0, "discounted_cash": 87.75, "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": 511.0, "discounted_cash": 383.25, "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": 511.0, "discounted_cash": 383.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUCONAZOLE10MG/ML35PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315224", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 592.0, "discounted_cash": 444.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUCONAZOLE10MG/ML35PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315224", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 592.0, "discounted_cash": 444.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUCONAZOLE40MG/ML35PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315222", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 304.0, "discounted_cash": 228.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUCONAZOLE40MG/ML35PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315222", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 304.0, "discounted_cash": 228.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUCYTOSINE 500MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305106", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 543.0, "discounted_cash": 407.25, "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": 543.0, "discounted_cash": 407.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2370.0, "discounted_cash": 1777.5, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 2370.0, "discounted_cash": 1777.5, "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": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUDROCORTISONE .1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305129", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "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": 367.0, "discounted_cash": 275.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUOCINOL OIL.01%120MLTS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335453", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 822.0, "discounted_cash": 616.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUOCINOL OIL.01%120MLTS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335453", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 822.0, "discounted_cash": 616.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUOCINOLONE .01% 60MLTS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335452", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 524.0, "discounted_cash": 393.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUOCINOLONE .01% 60MLTS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335452", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 524.0, "discounted_cash": 393.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUOCINONIDE .05%30GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335513", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 283.0, "discounted_cash": 212.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUOCINONIDE .05%30GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335513", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 283.0, "discounted_cash": 212.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUOCINONIDE .05%30GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335508", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1031.0, "discounted_cash": 773.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUOCINONIDE .05%30GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335508", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1031.0, "discounted_cash": 773.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORESCEIN PER 1MG IJ", "code_information": [{"code": "A9612", "type": "HCPCS"}, {"code": "5320819", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.34, "discounted_cash": 0.26, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORESCEIN PER 1MG IJ", "code_information": [{"code": "A9612", "type": "HCPCS"}, {"code": "5320819", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 0.34, "discounted_cash": 0.26, "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": 26.0, "discounted_cash": 19.5, "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": 130.0, "discounted_cash": 97.5, "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": 334.0, "discounted_cash": 250.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORESCENT AB TITER EA/13", "code_information": [{"code": "86256", "type": "CPT"}, {"code": "7256259", "type": "CDM"}], "standard_charges": [{"gross_charge": 146.0, "discounted_cash": 109.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORESCENT AB TITER EA/15", "code_information": [{"code": "86256", "type": "CPT"}, {"code": "7008622", "type": "CDM"}], "standard_charges": [{"gross_charge": 179.0, "discounted_cash": 134.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORESCENT AB TITER EA/16", "code_information": [{"code": "86256", "type": "CPT"}, {"code": "7008623", "type": "CDM"}], "standard_charges": [{"gross_charge": 171.0, "discounted_cash": 128.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORESCENT AB TITER EA/16", "code_information": [{"code": "86256", "type": "CPT"}, {"code": "7256268", "type": "CDM"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORESCENT AB TITER EA/19", "code_information": [{"code": "86256", "type": "CPT"}, {"code": "7258625", "type": "CDM"}], "standard_charges": [{"gross_charge": 146.0, "discounted_cash": 109.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORESCENT AB TITER EA/2", "code_information": [{"code": "86256", "type": "CPT"}, {"code": "7254218", "type": "CDM"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "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": 130.0, "discounted_cash": 97.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORESCENT AB TITER EA/21", "code_information": [{"code": "86256", "type": "CPT"}, {"code": "7258746", "type": "CDM"}], "standard_charges": [{"gross_charge": 158.0, "discounted_cash": 118.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORESCENT AB TITER EA/3", "code_information": [{"code": "86256", "type": "CPT"}, {"code": "7254219", "type": "CDM"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORESCENT AB TITER EA/4", "code_information": [{"code": "86256", "type": "CPT"}, {"code": "7004218", "type": "CDM"}], "standard_charges": [{"gross_charge": 165.0, "discounted_cash": 123.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORESCENT AB TITER EA/6", "code_information": [{"code": "86256", "type": "CPT"}, {"code": "7006256", "type": "CDM"}], "standard_charges": [{"gross_charge": 455.0, "discounted_cash": 341.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORESCNT SCRN EA AB", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "7006255", "type": "CDM"}], "standard_charges": [{"gross_charge": 455.0, "discounted_cash": 341.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORESCNT SCRN EA AB", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "7258627", "type": "CDM"}], "standard_charges": [{"gross_charge": 629.0, "discounted_cash": 471.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORESCNT SCRN EA AB/7", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "7250531", "type": "CDM"}], "standard_charges": [{"gross_charge": 839.0, "discounted_cash": 629.25, "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": 1236.0, "discounted_cash": 927.0, "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": 1236.0, "discounted_cash": 927.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORO BX/ASP/INJ/GUIDE", "code_information": [{"code": "77002", "type": "CPT"}, {"code": "6936003", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1236.0, "discounted_cash": 927.0, "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": 1082.0, "discounted_cash": 811.5, "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": 1082.0, "discounted_cash": 811.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORO GUIDE SPINE INJ", "code_information": [{"code": "77003", "type": "CPT"}, {"code": "4957003", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1082.0, "discounted_cash": 811.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUORO GUIDE SPINE INJ", "code_information": [{"code": "77003", "type": "CPT"}, {"code": "6936011", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1082.0, "discounted_cash": 811.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUOROGUID FOR VEIN DVCE", "code_information": [{"code": "77001", "type": "CPT"}, {"code": "4905997", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2056.0, "discounted_cash": 1542.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUOROGUID FOR VEIN DVCE", "code_information": [{"code": "77001", "type": "CPT"}, {"code": "4915997", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2056.0, "discounted_cash": 1542.0, "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": 470.0, "discounted_cash": 352.5, "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": 470.0, "discounted_cash": 352.5, "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": 1236.0, "discounted_cash": 927.0, "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": 1236.0, "discounted_cash": 927.0, "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": 1236.0, "discounted_cash": 927.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUOROSCOPY <1HOUR", "code_information": [{"code": "76000", "type": "CPT"}, {"code": "5016000", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1236.0, "discounted_cash": 927.0, "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": 301.0, "discounted_cash": 225.75, "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": 301.0, "discounted_cash": 225.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 10.0, "discounted_cash": 7.5, "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": 10.0, "discounted_cash": 7.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 761.0, "discounted_cash": 570.75, "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": 761.0, "discounted_cash": 570.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "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": 53.0, "discounted_cash": 39.75, "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": 148.0, "discounted_cash": 111.0, "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": 148.0, "discounted_cash": 111.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUPHENAZINE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305207", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUPHENAZINE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305207", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUPHENAZINE HCL PER 1.25MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2679", "type": "HCPCS"}, {"code": "5320816", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUPHENAZINE HCL PER 1.25MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2679", "type": "HCPCS"}, {"code": "5320816", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUPHENAZINE2.5MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315232", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 44.0, "discounted_cash": 33.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUPHENAZINE2.5MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315232", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 44.0, "discounted_cash": 33.0, "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": 225.0, "discounted_cash": 168.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 225.0, "discounted_cash": 168.75, "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": 1669.0, "discounted_cash": 1251.75, "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": 1669.0, "discounted_cash": 1251.75, "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": 282.0, "discounted_cash": 211.5, "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": 282.0, "discounted_cash": 211.5, "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": 1825.0, "discounted_cash": 1368.75, "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": 1825.0, "discounted_cash": 1368.75, "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": 1210.0, "discounted_cash": 907.5, "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": 1210.0, "discounted_cash": 907.5, "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": 2213.0, "discounted_cash": 1659.75, "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": 2213.0, "discounted_cash": 1659.75, "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": 467.0, "discounted_cash": 350.25, "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": 467.0, "discounted_cash": 350.25, "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": 717.0, "discounted_cash": 537.75, "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": 717.0, "discounted_cash": 537.75, "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": 717.0, "discounted_cash": 537.75, "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": 717.0, "discounted_cash": 537.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 165.0, "discounted_cash": 123.75, "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": 165.0, "discounted_cash": 123.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUTICASONE 110MCG 7.9GM", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5331002", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1224.0, "discounted_cash": 918.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUTICASONE 110MCG 7.9GM", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5331002", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1224.0, "discounted_cash": 918.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUTICASONE110MCG12GM IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330978", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1368.0, "discounted_cash": 1026.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUTICASONE110MCG12GM IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330978", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1368.0, "discounted_cash": 1026.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUTICASONE110MCGG DS IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5331009", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 75.0, "discounted_cash": 56.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUTICASONE110MCGG DS IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5331009", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 75.0, "discounted_cash": 56.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUTICASONE220MCG DS IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5331011", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 148.0, "discounted_cash": 111.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUTICASONE220MCG DS IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5331011", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 148.0, "discounted_cash": 111.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUTICASONE220MCG12GM IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330977", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1897.0, "discounted_cash": 1422.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUTICASONE220MCG12GM IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330977", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1897.0, "discounted_cash": 1422.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUTICASONE220MCG7.9GMIH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5331007", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2365.0, "discounted_cash": 1773.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUTICASONE220MCG7.9GMIH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5331007", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2365.0, "discounted_cash": 1773.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUTICASONE44MCG DS IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5331012", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUTICASONE44MCG DS IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5331012", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUTICASONE44MCG10.6GMIH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330979", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 855.0, "discounted_cash": 641.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUTICASONE44MCG10.6GMIH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5330979", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 855.0, "discounted_cash": 641.25, "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": 70.0, "discounted_cash": 52.5, "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": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUVASTATIN 80MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305238", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 440.0, "discounted_cash": 330.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUVASTATIN 80MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305238", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 440.0, "discounted_cash": 330.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUVOXAMINE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305236", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 10.0, "discounted_cash": 7.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUVOXAMINE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305236", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 10.0, "discounted_cash": 7.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUVOXAMINE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305235", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FLUVOXAMINE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305235", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FMLY THRPY 120MIN", "code_information": [{"code": "90847", "type": "CPT"}, {"code": "6401978", "type": "CDM"}, {"code": "916", "type": "RC"}], "standard_charges": [{"gross_charge": 3168.0, "discounted_cash": 2376.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FMLY THRPY 30 MIN", "code_information": [{"code": "90847", "type": "CPT"}, {"code": "6401970", "type": "CDM"}, {"code": "916", "type": "RC"}], "standard_charges": [{"gross_charge": 561.0, "discounted_cash": 420.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FMLY THRPY 45 MIN", "code_information": [{"code": "90847", "type": "CPT"}, {"code": "6401972", "type": "CDM"}, {"code": "916", "type": "RC"}], "standard_charges": [{"gross_charge": 814.0, "discounted_cash": 610.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FMLY THRPY 60 MIN", "code_information": [{"code": "90847", "type": "CPT"}, {"code": "6401974", "type": "CDM"}, {"code": "916", "type": "RC"}], "standard_charges": [{"gross_charge": 1182.0, "discounted_cash": 886.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FMLY THRPY 90 MIN", "code_information": [{"code": "90847", "type": "CPT"}, {"code": "6401976", "type": "CDM"}, {"code": "916", "type": "RC"}], "standard_charges": [{"gross_charge": 2382.0, "discounted_cash": 1786.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FMLY THRPY W/O PT 50MIN", "code_information": [{"code": "90846", "type": "CPT"}, {"code": "6401960", "type": "CDM"}, {"code": "916", "type": "RC"}], "standard_charges": [{"gross_charge": 797.0, "discounted_cash": 597.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FNA ADEQ EA ADD EVAL", "code_information": [{"code": "88177", "type": "CPT"}, {"code": "4170023", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 81.0, "discounted_cash": 60.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FNA ADEQUACY FIRST EVAL", "code_information": [{"code": "88172", "type": "CPT"}, {"code": "4170018", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 119.0, "discounted_cash": 89.25, "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": 1394.0, "discounted_cash": 1045.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FNA BX FLUOR GUIDANCE 1ST LES", "code_information": [{"code": "4910112", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1396.0, "discounted_cash": 1047.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FNA BX US GUIDANCE 1ST LESION", "code_information": [{"code": "5010105", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2775.0, "discounted_cash": 2081.25, "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": 2775.0, "discounted_cash": 2081.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FNA BX US GUIDANCE EA ADD LES", "code_information": [{"code": "5010107", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2709.0, "discounted_cash": 2031.75, "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": 2709.0, "discounted_cash": 2031.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FNA BX W/O IMG GUIDE 1ST LES", "code_information": [{"code": "6900131", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 671.0, "discounted_cash": 503.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FNA BX W/O IMG GUIDE 1ST LES", "code_information": [{"code": "6900131", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 671.0, "discounted_cash": 503.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FNA INTRP/REPRT", "code_information": [{"code": "88173", "type": "CPT"}, {"code": "4170021", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 693.0, "discounted_cash": 519.75, "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": 256.0, "discounted_cash": 192.0, "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": 101.0, "discounted_cash": 75.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FOLIC ACID", "code_information": [{"code": "82746", "type": "CPT"}, {"code": "4172746", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 202.0, "discounted_cash": 151.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FOLIC ACID", "code_information": [{"code": "82746", "type": "CPT"}, {"code": "7252746", "type": "CDM"}], "standard_charges": [{"gross_charge": 189.0, "discounted_cash": 141.75, "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": 10.0, "discounted_cash": 7.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FOLIC ACID 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305233", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 10.0, "discounted_cash": 7.5, "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": 3.0, "discounted_cash": 2.25, "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": 3.0, "discounted_cash": 2.25, "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": 0.43, "discounted_cash": 0.32, "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": 0.43, "discounted_cash": 0.32, "setting": "both", "billing_class": "facility"}]}, {"description": "FOLIC ACID RBC", "code_information": [{"code": "82747", "type": "CPT"}, {"code": "4102747", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 275.0, "discounted_cash": 206.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FOLIC ACID RBC", "code_information": [{"code": "82747", "type": "CPT"}, {"code": "7002747", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 235.0, "discounted_cash": 176.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FOLIC ACID RBC", "code_information": [{"code": "82747", "type": "CPT"}, {"code": "7252747", "type": "CDM"}], "standard_charges": [{"gross_charge": 334.0, "discounted_cash": 250.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FOLLICLE STIMLAT HORMONE", "code_information": [{"code": "83001", "type": "CPT"}, {"code": "4173001", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 412.0, "discounted_cash": 309.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FOLLICLE STIMLAT HORMONE", "code_information": [{"code": "83001", "type": "CPT"}, {"code": "7003001", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 98.0, "discounted_cash": 73.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FOLLICLE STIMLAT HORMONE", "code_information": [{"code": "83001", "type": "CPT"}, {"code": "7253001", "type": "CDM"}], "standard_charges": [{"gross_charge": 524.0, "discounted_cash": 393.0, "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": "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": 61.0, "discounted_cash": 45.75, "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": 61.0, "discounted_cash": 45.75, "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": 697.0, "discounted_cash": 522.75, "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": 697.0, "discounted_cash": 522.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FOOT 2 VIEWS", "code_information": [{"code": "73620", "type": "CPT"}, {"code": "5127362", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 697.0, "discounted_cash": 522.75, "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": 1364.0, "discounted_cash": 1023.0, "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": 1364.0, "discounted_cash": 1023.0, "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": 1364.0, "discounted_cash": 1023.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FOOT 3 VIEWS MINIMUM", "code_information": [{"code": "73630", "type": "CPT"}, {"code": "5123630", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1364.0, "discounted_cash": 1023.0, "setting": "both", "billing_class": "facility"}]}, {"description": "FOREARM 2 VIEWS", "code_information": [{"code": "73090", "type": "CPT"}, {"code": "4903091", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1449.0, "discounted_cash": 1086.75, "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": 1449.0, "discounted_cash": 1086.75, "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": 1449.0, "discounted_cash": 1086.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FOREARM 2 VIEWS", "code_information": [{"code": "73090", "type": "CPT"}, {"code": "5123090", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1449.0, "discounted_cash": 1086.75, "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": 238.0, "discounted_cash": 178.5, "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": 238.0, "discounted_cash": 178.5, "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": 20.0, "discounted_cash": 15.0, "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": 20.0, "discounted_cash": 15.0, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "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": 31.0, "discounted_cash": 23.25, "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": 31.0, "discounted_cash": 23.25, "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": 295.0, "discounted_cash": 221.25, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 295.0, "discounted_cash": 221.25, "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": 661.0, "discounted_cash": 495.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 661.0, "discounted_cash": 495.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FOSINOPRIL 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305244", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FOSINOPRIL 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305244", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FOSPHENYTOIN PER 50MG IJ", "code_information": [{"code": "Q2009", "type": "HCPCS"}, {"code": "5320749", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "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": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FRESH FRZN PLASMA JUMBO", "code_information": [{"code": "P9017", "type": "HCPCS"}, {"code": "4500105", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 495.0, "discounted_cash": 371.25, "setting": "both", "billing_class": "facility"}]}, {"description": "FUNGUS AB NES", "code_information": [{"code": "86671", "type": "CPT"}, {"code": "7000351", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 865.0, "discounted_cash": 648.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FUNGUS AB NES", "code_information": [{"code": "86671", "type": "CPT"}, {"code": "7256671", "type": "CDM"}], "standard_charges": [{"gross_charge": 133.0, "discounted_cash": 99.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FUNGUS AB NES/2", "code_information": [{"code": "86671", "type": "CPT"}, {"code": "7256672", "type": "CDM"}], "standard_charges": [{"gross_charge": 133.0, "discounted_cash": 99.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FUNGUS AB NES/4", "code_information": [{"code": "86671", "type": "CPT"}, {"code": "7006671", "type": "CDM"}], "standard_charges": [{"gross_charge": 865.0, "discounted_cash": 648.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FUNGUS AB NES/5", "code_information": [{"code": "86671", "type": "CPT"}, {"code": "7256736", "type": "CDM"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "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": 3.0, "discounted_cash": 2.25, "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": 3.0, "discounted_cash": 2.25, "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": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FUROSEMIDE 40MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315248", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 10.0, "discounted_cash": 7.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FUROSEMIDE 40MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315248", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 10.0, "discounted_cash": 7.5, "setting": "both", "billing_class": "facility"}]}, {"description": "FUROSEMIDE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1938", "type": "HCPCS"}, {"code": "5320822", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.31, "discounted_cash": 0.23, "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": 0.31, "discounted_cash": 0.23, "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": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "FUROSEMIDE10MG/ML60ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315244", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "G6PD QUANT", "code_information": [{"code": "82955", "type": "CPT"}, {"code": "7002955", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 149.0, "discounted_cash": 111.75, "setting": "both", "billing_class": "facility"}]}, {"description": "G6PD QUANT", "code_information": [{"code": "82955", "type": "CPT"}, {"code": "7252955", "type": "CDM"}], "standard_charges": [{"gross_charge": 129.0, "discounted_cash": 96.75, "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": 385.0, "discounted_cash": 288.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GABAPENTIN", "code_information": [{"code": "80171", "type": "CPT"}, {"code": "7250250", "type": "CDM"}], "standard_charges": [{"gross_charge": 584.0, "discounted_cash": 438.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GABAPENTIN 100MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305290", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 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": 28.0, "discounted_cash": 21.0, "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": 28.0, "discounted_cash": 21.0, "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": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GABAPENTIN 300MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305291", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GADOBENATE DIM PER1ML IJ", "code_information": [{"code": "A9577", "type": "HCPCS"}, {"code": "5356161", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GADOTERATE MEG 0.1ML IJ", "code_information": [{"code": "A9575", "type": "HCPCS"}, {"code": "5356164", "type": "CDM"}, {"code": "255", "type": "RC"}], "standard_charges": [{"gross_charge": 0.57, "discounted_cash": 0.43, "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": 0.57, "discounted_cash": 0.43, "setting": "both", "billing_class": "facility"}]}, {"description": "GADOXETATE PER 1ML IJ", "code_information": [{"code": "A9581", "type": "HCPCS"}, {"code": "5356177", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 237.0, "discounted_cash": 177.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GADOXETATE PER 1ML IJ", "code_information": [{"code": "A9581", "type": "HCPCS"}, {"code": "5356177", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 237.0, "discounted_cash": 177.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GALAC-1-PH/URID/TRNSFRSE", "code_information": [{"code": "82775", "type": "CPT"}, {"code": "7002775", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 762.0, "discounted_cash": 571.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GALANTAMINE 12MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305301", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 269.0, "discounted_cash": 201.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GALANTAMINE 12MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305301", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 269.0, "discounted_cash": 201.75, "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": 191.0, "discounted_cash": 143.25, "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": 191.0, "discounted_cash": 143.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GALANTAMINE 8MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305308", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 213.0, "discounted_cash": 159.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GALANTAMINE 8MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305308", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 213.0, "discounted_cash": 159.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GALLIUM ILLUCCIX PER 1MCI", "code_information": [{"code": "A9596", "type": "HCPCS"}, {"code": "5191402", "type": "CDM"}, {"code": "343", "type": "RC"}], "standard_charges": [{"gross_charge": 2145.0, "discounted_cash": 1608.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMA GLOBULIN PER 1MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1460", "type": "HCPCS"}, {"code": "5320820", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 4587.0, "discounted_cash": 3440.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMA GLOBULIN PER 1MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1460", "type": "HCPCS"}, {"code": "5320820", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 4587.0, "discounted_cash": 3440.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMAGLOBULIN EA", "code_information": [{"code": "82784", "type": "CPT"}, {"code": "7002783", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMAGLOBULIN EA/10", "code_information": [{"code": "82784", "type": "CPT"}, {"code": "7003521", "type": "CDM"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 105.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMAGLOBULIN EA/13", "code_information": [{"code": "82784", "type": "CPT"}, {"code": "7007468", "type": "CDM"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMAGLOBULIN EA/13", "code_information": [{"code": "82784", "type": "CPT"}, {"code": "7258296", "type": "CDM"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMAGLOBULIN EA/4", "code_information": [{"code": "82784", "type": "CPT"}, {"code": "4172786", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMAGLOBULIN EA/4", "code_information": [{"code": "82784", "type": "CPT"}, {"code": "7003512", "type": "CDM"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMAGLOBULIN EA/4", "code_information": [{"code": "82784", "type": "CPT"}, {"code": "7252786", "type": "CDM"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 87.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMAGLOBULIN EA/5", "code_information": [{"code": "82784", "type": "CPT"}, {"code": "7003514", "type": "CDM"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMAGLOBULIN EA/6", "code_information": [{"code": "82784", "type": "CPT"}, {"code": "4173512", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMAGLOBULIN EA/6", "code_information": [{"code": "82784", "type": "CPT"}, {"code": "7003515", "type": "CDM"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMAGLOBULIN EA/6", "code_information": [{"code": "82784", "type": "CPT"}, {"code": "7253512", "type": "CDM"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 87.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMAGLOBULIN EA/7", "code_information": [{"code": "82784", "type": "CPT"}, {"code": "4173514", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMAGLOBULIN EA/7", "code_information": [{"code": "82784", "type": "CPT"}, {"code": "7253514", "type": "CDM"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 87.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMAGLOBULIN EA/8", "code_information": [{"code": "82784", "type": "CPT"}, {"code": "7253515", "type": "CDM"}], "standard_charges": [{"gross_charge": 159.0, "discounted_cash": 119.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMAGLOBULIN EA/9", "code_information": [{"code": "82784", "type": "CPT"}, {"code": "4173519", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GAMMAGLOBULIN EA/9", "code_information": [{"code": "82784", "type": "CPT"}, {"code": "7253521", "type": "CDM"}], "standard_charges": [{"gross_charge": 98.0, "discounted_cash": 73.5, "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": 347.0, "discounted_cash": 260.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 347.0, "discounted_cash": 260.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1133.0, "discounted_cash": 849.75, "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": 1133.0, "discounted_cash": 849.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GANGLIOSIDE AB/2", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "7253027", "type": "CDM"}], "standard_charges": [{"gross_charge": 190.0, "discounted_cash": 142.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GANGLIOSIDE AB/3", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "7253029", "type": "CDM"}], "standard_charges": [{"gross_charge": 190.0, "discounted_cash": 142.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GANGLIOSIDE AB/3", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7253535", "type": "CDM"}], "standard_charges": [{"gross_charge": 181.0, "discounted_cash": 135.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GANGLIOSIDE AB/4", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7253536", "type": "CDM"}], "standard_charges": [{"gross_charge": 112.0, "discounted_cash": 84.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GANGLIOSIDE AB/5", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7253601", "type": "CDM"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GANGLIOSIDE AB/6", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7008360", "type": "CDM"}], "standard_charges": [{"gross_charge": 262.0, "discounted_cash": 196.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GANGLIOSIDE AB/8", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7008528", "type": "CDM"}], "standard_charges": [{"gross_charge": 262.0, "discounted_cash": 196.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GANGLIOSIDE AB/9", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7008529", "type": "CDM"}], "standard_charges": [{"gross_charge": 262.0, "discounted_cash": 196.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GAS BLD ANY COMB W/CALO2", "code_information": [{"code": "82803", "type": "CPT"}, {"code": "4102803", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 219.0, "discounted_cash": 164.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GAS BLD ANY COMB W/CALO2", "code_information": [{"code": "82803", "type": "CPT"}, {"code": "4172803", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 172.0, "discounted_cash": 129.0, "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": 178.0, "discounted_cash": 133.5, "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": 4315.0, "discounted_cash": 3236.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GASTRIN", "code_information": [{"code": "82941", "type": "CPT"}, {"code": "7002941", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 147.0, "discounted_cash": 110.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GASTRIN", "code_information": [{"code": "82941", "type": "CPT"}, {"code": "7252941", "type": "CDM"}], "standard_charges": [{"gross_charge": 315.0, "discounted_cash": 236.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GASTRIN SECRETIN STMULTN", "code_information": [{"code": "82938", "type": "CPT"}, {"code": "7002938", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 399.0, "discounted_cash": 299.25, "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": 3430.0, "discounted_cash": 2572.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GATIFLOXACIN .3% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331020", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1492.0, "discounted_cash": 1119.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GATIFLOXACIN .3% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331020", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1492.0, "discounted_cash": 1119.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GATIFLOXACIN .5%2.5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331021", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1330.0, "discounted_cash": 997.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GATIFLOXACIN .5%2.5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331021", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1330.0, "discounted_cash": 997.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GC DNA AMP PROBE", "code_information": [{"code": "87591", "type": "CPT"}, {"code": "4107592", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 764.0, "discounted_cash": 573.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GC DNA AMP PROBE", "code_information": [{"code": "87591", "type": "CPT"}, {"code": "4177592", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 601.0, "discounted_cash": 450.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GC DNA AMP PROBE", "code_information": [{"code": "87591", "type": "CPT"}, {"code": "7007592", "type": "CDM"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GC DNA AMP PROBE", "code_information": [{"code": "87591", "type": "CPT"}, {"code": "7257592", "type": "CDM"}], "standard_charges": [{"gross_charge": 572.0, "discounted_cash": 429.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GC DNA DIR PROBE", "code_information": [{"code": "87590", "type": "CPT"}, {"code": "4177174", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 41.0, "discounted_cash": 30.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GC DNA DIR PROBE", "code_information": [{"code": "87590", "type": "CPT"}, {"code": "7007191", "type": "CDM"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GC DNA DIR PROBE", "code_information": [{"code": "87590", "type": "CPT"}, {"code": "7257191", "type": "CDM"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GCATH CRAGG-MCNAMARA", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8241069", "type": "CDM"}], "standard_charges": [{"gross_charge": 2034.0, "discounted_cash": 1525.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GCATH CRDS VISTABRT TP 8", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8241078", "type": "CDM"}], "standard_charges": [{"gross_charge": 1448.0, "discounted_cash": 1086.0, "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": 4033.0, "discounted_cash": 3024.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GCATH PERIPHERAL VERIPAT", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8241095", "type": "CDM"}], "standard_charges": [{"gross_charge": 2881.0, "discounted_cash": 2160.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GDE MICROWR APPROACH CTO", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8073034", "type": "CDM"}], "standard_charges": [{"gross_charge": 532.0, "discounted_cash": 399.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GDE SAVARY GIL", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8073035", "type": "CDM"}], "standard_charges": [{"gross_charge": 765.0, "discounted_cash": 573.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GEL VOICE INJ", "code_information": [{"code": "C1878", "type": "HCPCS"}, {"code": "8032293", "type": "CDM"}], "standard_charges": [{"gross_charge": 6680.0, "discounted_cash": 5010.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2276.0, "discounted_cash": 1707.0, "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": 2276.0, "discounted_cash": 1707.0, "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": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GEMFIBROZIL 600MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305311", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GEN ANES W/RAD EA ADD15", "code_information": [{"code": "3700023", "type": "CDM"}, {"code": "371", "type": "RC"}], "standard_charges": [{"gross_charge": 1233.0, "discounted_cash": 924.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GEN ANES W/RAD INIT 30MIN", "code_information": [{"code": "3700020", "type": "CDM"}, {"code": "371", "type": "RC"}], "standard_charges": [{"gross_charge": 2621.0, "discounted_cash": 1965.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GEN ASPIRESR VNS THERAPY", "code_information": [{"code": "C1767", "type": "HCPCS"}, {"code": "4008497", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 222304.0, "discounted_cash": 166728.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GEN HEALTH PANEL", "code_information": [{"code": "80050", "type": "CPT"}, {"code": "4100052", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 929.0, "discounted_cash": 696.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GEN HEALTH PANEL", "code_information": [{"code": "80050", "type": "CPT"}, {"code": "4170052", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 731.0, "discounted_cash": 548.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GEN NSTIM OSA INSPIRE 3028", "code_information": [{"code": "C1767", "type": "HCPCS"}, {"code": "4008498", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 175537.0, "discounted_cash": 131652.75, "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": 143373.0, "discounted_cash": 107529.75, "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": 139181.0, "discounted_cash": 104385.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GEN NSTIM PULSE PROCLAIM 3664", "code_information": [{"code": "C1767", "type": "HCPCS"}, {"code": "4008533", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 184225.0, "discounted_cash": 138168.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GEN NSTIM RECHRG INCEPTIV", "code_information": [{"code": "C1826", "type": "HCPCS"}, {"code": "4008681", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 199629.0, "discounted_cash": 149721.75, "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": 190828.0, "discounted_cash": 143121.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GEN NSTM PROCLAIM ELITE 3662", "code_information": [{"code": "C1767", "type": "HCPCS"}, {"code": "4008504", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 152168.0, "discounted_cash": 114126.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GEN PULSE SPECTRA WAVEWRITER", "code_information": [{"code": "C1820", "type": "HCPCS"}, {"code": "8178065", "type": "CDM"}], "standard_charges": [{"gross_charge": 183202.0, "discounted_cash": 137401.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GENTAMICIN", "code_information": [{"code": "80170", "type": "CPT"}, {"code": "4103004", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 399.0, "discounted_cash": 299.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GENTAMICIN", "code_information": [{"code": "80170", "type": "CPT"}, {"code": "4170170", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 314.0, "discounted_cash": 235.5, "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": 130.0, "discounted_cash": 97.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GENTAMICIN .1% 15GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335724", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 130.0, "discounted_cash": 97.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GENTAMICIN .1% 15GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335729", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 87.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GENTAMICIN .1% 15GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335729", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 87.75, "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": 253.0, "discounted_cash": 189.75, "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": 253.0, "discounted_cash": 189.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 290.0, "discounted_cash": 217.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GENTAMICIN .3% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331038", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 290.0, "discounted_cash": 217.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GENTAMICIN NEO CMPD IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5320851", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GENTAMICIN UPTO 80 PMXIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1580", "type": "HCPCS"}, {"code": "5320846", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "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": "636", "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "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": 64.0, "discounted_cash": 48.0, "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": 399.0, "discounted_cash": 299.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GENTAMICIN/2", "code_information": [{"code": "80170", "type": "CPT"}, {"code": "4173004", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 314.0, "discounted_cash": 235.5, "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": 492.0, "discounted_cash": 369.0, "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": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GENTAMICIN/3", "code_information": [{"code": "80170", "type": "CPT"}, {"code": "4173009", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 387.0, "discounted_cash": 290.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GENTIAN VIOLET 1%60ML TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335748", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 328.0, "discounted_cash": 246.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GENTRIX SURGICAL MATRIX", "code_information": [{"code": "C1763", "type": "HCPCS"}, {"code": "4023908", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 37916.0, "discounted_cash": 28437.0, "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": 26.0, "discounted_cash": 19.5, "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": 26.0, "discounted_cash": 19.5, "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": 19.0, "discounted_cash": 14.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GF/DM 100-10/5 10ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315304", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GF/DM 100-10/5 10ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315304", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GF/PSE 600MG/120MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310263", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GF/PSE 600MG/120MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310263", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GF/PSE 600MG/30MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309341", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GF/PSE 600MG/30MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309341", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "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": 149.0, "discounted_cash": 111.75, "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": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GGT", "code_information": [{"code": "82977", "type": "CPT"}, {"code": "4172980", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GGT", "code_information": [{"code": "82977", "type": "CPT"}, {"code": "7252980", "type": "CDM"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 129.0, "discounted_cash": 96.75, "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": 129.0, "discounted_cash": 96.75, "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": 3207.0, "discounted_cash": 2405.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GI PATHOGEN 6-11 AMP PROBE", "code_information": [{"code": "87506", "type": "CPT"}, {"code": "4107506", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1982.0, "discounted_cash": 1486.5, "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": 504.0, "discounted_cash": 378.0, "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": 4014.0, "discounted_cash": 3010.5, "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": 1912.0, "discounted_cash": 1434.0, "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": 7219.0, "discounted_cash": 5414.25, "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": 1264.0, "discounted_cash": 948.0, "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": 9436.0, "discounted_cash": 7077.0, "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": 981.0, "discounted_cash": 735.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GIARDIA IA", "code_information": [{"code": "87329", "type": "CPT"}, {"code": "4107328", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 367.0, "discounted_cash": 275.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GIARDIA IA", "code_information": [{"code": "87329", "type": "CPT"}, {"code": "4177328", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 289.0, "discounted_cash": 216.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GIARDIA IA", "code_information": [{"code": "87329", "type": "CPT"}, {"code": "7252934", "type": "CDM"}], "standard_charges": [{"gross_charge": 147.0, "discounted_cash": 110.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GINTRO AGILIS STRB NPEEL", "code_information": [{"code": "C1766", "type": "HCPCS"}, {"code": "8241099", "type": "CDM"}], "standard_charges": [{"gross_charge": 9965.0, "discounted_cash": 7473.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GINTRO CPS DIRECT", "code_information": [{"code": "C1893", "type": "HCPCS"}, {"code": "8241101", "type": "CDM"}], "standard_charges": [{"gross_charge": 1821.0, "discounted_cash": 1365.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GINTRO RAMP", "code_information": [{"code": "C1893", "type": "HCPCS"}, {"code": "8241160", "type": "CDM"}], "standard_charges": [{"gross_charge": 2315.0, "discounted_cash": 1736.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GINTRO SWARTZ", "code_information": [{"code": "C1893", "type": "HCPCS"}, {"code": "8241178", "type": "CDM"}], "standard_charges": [{"gross_charge": 2109.0, "discounted_cash": 1581.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GJB2 FULL GENE SEQUENCE", "code_information": [{"code": "81252", "type": "CPT"}, {"code": "7251252", "type": "CDM"}], "standard_charges": [{"gross_charge": 3992.0, "discounted_cash": 2994.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GLENIOD PEG KEEL HYB STRY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013021", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 7217.0, "discounted_cash": 5412.75, "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": 19246.0, "discounted_cash": 14434.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GLENOID PEG KEEL HYB DEPUY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013170", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6177.0, "discounted_cash": 4632.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GLENOID PEG/KEEL/HYBRD DJO CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013423", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 7845.0, "discounted_cash": 5883.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GLENOSPHERE DEPUY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013171", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 14821.0, "discounted_cash": 11115.75, "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": 11506.0, "discounted_cash": 8629.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GLENOSPHERE GELNOID MEDACTA CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013465", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 15163.0, "discounted_cash": 11372.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GLENOSPHERE GLENOID DJO CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013422", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10460.0, "discounted_cash": 7845.0, "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": 10826.0, "discounted_cash": 8119.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GLIADIN AB", "code_information": [{"code": "86258", "type": "CPT"}, {"code": "7253508", "type": "CDM"}], "standard_charges": [{"gross_charge": 232.0, "discounted_cash": 174.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GLIADIN AB/2", "code_information": [{"code": "86258", "type": "CPT"}, {"code": "7254213", "type": "CDM"}], "standard_charges": [{"gross_charge": 275.0, "discounted_cash": 206.25, "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": 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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GLIMEPIRIDE 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305321", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "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": 141.0, "discounted_cash": 105.75, "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": 141.0, "discounted_cash": 105.75, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GLIPIZIDE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305345", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GLIPIZIDE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305345", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GLIPIZIDE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305346", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "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": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCAGON", "code_information": [{"code": "82943", "type": "CPT"}, {"code": "7002943", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 238.0, "discounted_cash": 178.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCAGON", "code_information": [{"code": "82943", "type": "CPT"}, {"code": "7252943", "type": "CDM"}], "standard_charges": [{"gross_charge": 292.0, "discounted_cash": 219.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCAGON PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1610", "type": "HCPCS"}, {"code": "5320898", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1562.0, "discounted_cash": 1171.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCAGON PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1610", "type": "HCPCS"}, {"code": "5320898", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1562.0, "discounted_cash": 1171.5, "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": 106.0, "discounted_cash": 79.5, "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": 106.0, "discounted_cash": 79.5, "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": 173.0, "discounted_cash": 129.75, "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": 173.0, "discounted_cash": 129.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCOSE 40% 80GM GL LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315258", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 174.0, "discounted_cash": 130.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCOSE 40% 80GM GL LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315258", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 174.0, "discounted_cash": 130.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCOSE 4GM CTB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5305354", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 10.0, "discounted_cash": 7.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCOSE 4GM CTB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5305354", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 10.0, "discounted_cash": 7.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCOSE 5GM CTB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5305356", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCOSE 5GM CTB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5305356", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCOSE BLD BY MONIT DEV", "code_information": [{"code": "82962", "type": "CPT"}, {"code": "4182962", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCOSE BLD RGT ST VISU", "code_information": [{"code": "82948", "type": "CPT"}, {"code": "4102948", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 98.0, "discounted_cash": 73.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCOSE BLD RGT ST VISU", "code_information": [{"code": "82948", "type": "CPT"}, {"code": "4172948", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "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": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCOSE BODY FLUID", "code_information": [{"code": "82945", "type": "CPT"}, {"code": "4172945", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "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/3", "code_information": [{"code": "82945", "type": "CPT"}, {"code": "4102954", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 106.0, "discounted_cash": 79.5, "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": 113.0, "discounted_cash": 84.75, "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": 211.0, "discounted_cash": 158.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCOSE POST DOSE", "code_information": [{"code": "82950", "type": "CPT"}, {"code": "4172950", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 167.0, "discounted_cash": 125.25, "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": 74.0, "discounted_cash": 55.5, "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": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCOSE QUANTITATIVE", "code_information": [{"code": "82947", "type": "CPT"}, {"code": "4172947", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 58.0, "discounted_cash": 43.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCOSE QUANTITATIVE", "code_information": [{"code": "82947", "type": "CPT"}, {"code": "4182947", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}], "modifiers": "QW"}, {"description": "GLUCOSE TOLERANCE 3SPEC", "code_information": [{"code": "82951", "type": "CPT"}, {"code": "4102951", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 477.0, "discounted_cash": 357.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUCOSE TOLERANCE 3SPEC", "code_information": [{"code": "82951", "type": "CPT"}, {"code": "4172951", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 376.0, "discounted_cash": 282.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUTAMIC ACID AB", "code_information": [{"code": "83519", "type": "CPT"}, {"code": "7003538", "type": "CDM"}], "standard_charges": [{"gross_charge": 749.0, "discounted_cash": 561.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GLUTAMIC ACID AB", "code_information": [{"code": "83519", "type": "CPT"}, {"code": "7253538", "type": "CDM"}], "standard_charges": [{"gross_charge": 617.0, "discounted_cash": 462.75, "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": 13.0, "discounted_cash": 9.75, "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": 13.0, "discounted_cash": 9.75, "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": 14.0, "discounted_cash": 10.5, "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": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GLYBURIDE MIC 3MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305407", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GLYBURIDE MIC 3MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305407", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": 33.0, "discounted_cash": 24.75, "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": 33.0, "discounted_cash": 24.75, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 416.0, "discounted_cash": 312.0, "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": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GLYCOPYRROLATE 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305429", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GLYCOPYRROLATE PER 0.1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1596", "type": "HCPCS"}, {"code": "5320923", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "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": 4.0, "discounted_cash": 3.0, "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": 606.0, "discounted_cash": 454.5, "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": 106.0, "discounted_cash": 79.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GONADTOPN CHORNC(HCG)QNT", "code_information": [{"code": "84702", "type": "CPT"}, {"code": "4173014", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 477.0, "discounted_cash": 357.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GONADTOPN CHORNC(HCG)QNT", "code_information": [{"code": "84702", "type": "CPT"}, {"code": "7253014", "type": "CDM"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "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": 377.0, "discounted_cash": 282.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GONADTOPN CHRONC(HCG)QL", "code_information": [{"code": "84703", "type": "CPT"}, {"code": "4123013", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GONADTOPN CHRONC(HCG)QL", "code_information": [{"code": "84703", "type": "CPT"}, {"code": "4173013", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 296.0, "discounted_cash": 222.0, "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": 3271.0, "discounted_cash": 2453.25, "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": 3271.0, "discounted_cash": 2453.25, "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": 1497.0, "discounted_cash": 1122.75, "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": 1497.0, "discounted_cash": 1122.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GRAFIX PRIME DISC", "code_information": [{"code": "Q4133", "type": "HCPCS"}, {"code": "4021506", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1497.0, "discounted_cash": 1122.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GRAFIX PRIME DISC", "code_information": [{"code": "Q4133", "type": "HCPCS"}, {"code": "4021506", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1497.0, "discounted_cash": 1122.75, "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": 1769.0, "discounted_cash": 1326.75, "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": 1769.0, "discounted_cash": 1326.75, "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": 93410.0, "discounted_cash": 70057.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GRAFT TENDON", "code_information": [{"code": "C1762", "type": "HCPCS"}, {"code": "8151555", "type": "CDM"}], "standard_charges": [{"gross_charge": 40838.0, "discounted_cash": 30628.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GRAFT VASC ARTEGRAFT", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8142136", "type": "CDM"}], "standard_charges": [{"gross_charge": 10542.0, "discounted_cash": 7906.5, "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": 1301.0, "discounted_cash": 975.75, "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": 1301.0, "discounted_cash": 975.75, "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": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GRAM STAIN SMEAR", "code_information": [{"code": "87205", "type": "CPT"}, {"code": "4177205", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 236.0, "discounted_cash": 177.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GRAM STAIN SMEAR", "code_information": [{"code": "87205", "type": "CPT"}, {"code": "7257205", "type": "CDM"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "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": 68.0, "discounted_cash": 51.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1650.0, "discounted_cash": 1237.5, "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": 1650.0, "discounted_cash": 1237.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT AAA MAIN BODY", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "4021483", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 44812.0, "discounted_cash": 33609.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT AAA MAIN BODY C3", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "4028400", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 80626.0, "discounted_cash": 60469.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT AAA STENT", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8142003", "type": "CDM"}], "standard_charges": [{"gross_charge": 22878.0, "discounted_cash": 17158.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT ALLOMAX 16 X 20CM", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4021491", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 91922.0, "discounted_cash": 68941.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT ALLOMAX 4X16", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4021482", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 17521.0, "discounted_cash": 13140.75, "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": 26286.0, "discounted_cash": 19714.5, "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": 35046.0, "discounted_cash": 26284.5, "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": 25007.0, "discounted_cash": 18755.25, "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": 53410.0, "discounted_cash": 40057.5, "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": 20390.0, "discounted_cash": 15292.5, "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": 34642.0, "discounted_cash": 25981.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT CNTRLTRL LEG 12X12", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "4028401", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 28887.0, "discounted_cash": 21665.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT CV PLEDGET", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8142055", "type": "CDM"}], "standard_charges": [{"gross_charge": 1642.0, "discounted_cash": 1231.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT DURAL COLLAGEN BASE", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "4028403", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6014.0, "discounted_cash": 4510.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT DVF WOVN HEMASHIELD", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8246550", "type": "CDM"}], "standard_charges": [{"gross_charge": 6598.0, "discounted_cash": 4948.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT ENDOV PROX CMP PROF", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "4028414", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 97558.0, "discounted_cash": 73168.5, "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": 52546.0, "discounted_cash": 39409.5, "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": 60905.0, "discounted_cash": 45678.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT ILIAC LEG AAA ZENTH", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "4028398", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 27650.0, "discounted_cash": 20737.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT INTEXEN APPOGEE", "code_information": [{"code": "C1763", "type": "HCPCS"}, {"code": "4021501", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 18198.0, "discounted_cash": 13648.5, "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": 67516.0, "discounted_cash": 50637.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT MESH COMPOSIX 6X8", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8142103", "type": "CDM"}], "standard_charges": [{"gross_charge": 10851.0, "discounted_cash": 8138.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT MESH MARLX", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8142080", "type": "CDM"}], "standard_charges": [{"gross_charge": 5336.0, "discounted_cash": 4002.0, "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": 27880.0, "discounted_cash": 20910.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT PATCH", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8142115", "type": "CDM"}], "standard_charges": [{"gross_charge": 3599.0, "discounted_cash": 2699.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT PTCH", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8142125", "type": "CDM"}], "standard_charges": [{"gross_charge": 1264.0, "discounted_cash": 948.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT SAPHENOUS 60-69CM", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "4022003", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 65620.0, "discounted_cash": 49215.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT STNT ABD AORTC BODY", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "4028444", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 112956.0, "discounted_cash": 84717.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT STNT ABD BIFURCATED", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "4022009", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 80464.0, "discounted_cash": 60348.0, "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": 119618.0, "discounted_cash": 89713.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT STNT CNTRLTRL ILIAC", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "4022007", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 44590.0, "discounted_cash": 33442.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT STNT ENDOVASCULR", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "4028459", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 22680.0, "discounted_cash": 17010.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT STNT ILIAC EXT PMA", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "4028465", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 32022.0, "discounted_cash": 24016.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT STNT ILIAC LIMB PMA", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "4028466", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 35369.0, "discounted_cash": 26526.75, "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": 118982.0, "discounted_cash": 89236.5, "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": 79013.0, "discounted_cash": 59259.75, "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": 60889.0, "discounted_cash": 45666.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT TUTOPLAST DERMIS", "code_information": [{"code": "C1762", "type": "HCPCS"}, {"code": "4022012", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10731.0, "discounted_cash": 8048.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT VASC 6MM", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8142300", "type": "CDM"}], "standard_charges": [{"gross_charge": 13877.0, "discounted_cash": 10407.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT VASC BIF C", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8142140", "type": "CDM"}], "standard_charges": [{"gross_charge": 43603.0, "discounted_cash": 32702.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT VASC BIF D", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8142145", "type": "CDM"}], "standard_charges": [{"gross_charge": 8082.0, "discounted_cash": 6061.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT VASC BOV", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8142170", "type": "CDM"}], "standard_charges": [{"gross_charge": 3599.0, "discounted_cash": 2699.25, "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": 25007.0, "discounted_cash": 18755.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT VASC STR B", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8142220", "type": "CDM"}], "standard_charges": [{"gross_charge": 21267.0, "discounted_cash": 15950.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT VASC STR S", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8142270", "type": "CDM"}], "standard_charges": [{"gross_charge": 28847.0, "discounted_cash": 21635.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT VASC STR W", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8142280", "type": "CDM"}], "standard_charges": [{"gross_charge": 2604.0, "discounted_cash": 1953.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT VASCULAR", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8240177", "type": "CDM"}], "standard_charges": [{"gross_charge": 8521.0, "discounted_cash": 6390.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT VASCULAR 2", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8240158", "type": "CDM"}], "standard_charges": [{"gross_charge": 7980.0, "discounted_cash": 5985.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT VASCULAR 3", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8240159", "type": "CDM"}], "standard_charges": [{"gross_charge": 7980.0, "discounted_cash": 5985.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT VASCULAR 4", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8246578", "type": "CDM"}], "standard_charges": [{"gross_charge": 18550.0, "discounted_cash": 13912.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT VASCULAR 5", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8246579", "type": "CDM"}], "standard_charges": [{"gross_charge": 16652.0, "discounted_cash": 12489.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GRFT VSC STNT BIF", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "4022324", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 7803.0, "discounted_cash": 5852.25, "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": 29110.0, "discounted_cash": 21832.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GRISEOFLVN125/5 120ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305459", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 114.0, "discounted_cash": 85.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GRISEOFLVN125/5 120ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305459", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 114.0, "discounted_cash": 85.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GRISEOFULV 125MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315260", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GRISEOFULV 125MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315260", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GRISEOFULV U-MIC 250MGTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305471", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GRISEOFULV U-MIC 250MGTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305471", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GROSS EXAM ONLY", "code_information": [{"code": "88300", "type": "CPT"}, {"code": "4170024", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 247.0, "discounted_cash": 185.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GROUP PSYCHOTHERAPY", "code_information": [{"code": "90853", "type": "CPT"}, {"code": "6401936", "type": "CDM"}, {"code": "915", "type": "RC"}], "standard_charges": [{"gross_charge": 886.0, "discounted_cash": 664.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GROWTH HORMONE(HGH)", "code_information": [{"code": "83003", "type": "CPT"}, {"code": "4173003", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 383.0, "discounted_cash": 287.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GROWTH HORMONE(HGH)", "code_information": [{"code": "83003", "type": "CPT"}, {"code": "7003003", "type": "CDM"}], "standard_charges": [{"gross_charge": 149.0, "discounted_cash": 111.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GROWTH HORMONE(HGH)", "code_information": [{"code": "83003", "type": "CPT"}, {"code": "7253003", "type": "CDM"}], "standard_charges": [{"gross_charge": 487.0, "discounted_cash": 365.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GRP PSYCHTHRPY 30 MIN", "code_information": [{"code": "90853", "type": "CPT"}, {"code": "6401940", "type": "CDM"}, {"code": "915", "type": "RC"}], "standard_charges": [{"gross_charge": 476.0, "discounted_cash": 357.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GRP PSYCHTHRPY 45 MIN", "code_information": [{"code": "90853", "type": "CPT"}, {"code": "6401942", "type": "CDM"}, {"code": "915", "type": "RC"}], "standard_charges": [{"gross_charge": 792.0, "discounted_cash": 594.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GRP PSYCHTHRPY 60 MIN", "code_information": [{"code": "90853", "type": "CPT"}, {"code": "6401944", "type": "CDM"}, {"code": "915", "type": "RC"}], "standard_charges": [{"gross_charge": 953.0, "discounted_cash": 714.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GRP PSYCHTHRPY 90 MIN", "code_information": [{"code": "90853", "type": "CPT"}, {"code": "6401946", "type": "CDM"}, {"code": "915", "type": "RC"}], "standard_charges": [{"gross_charge": 1354.0, "discounted_cash": 1015.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GTT EA ADD >3SPEC", "code_information": [{"code": "82952", "type": "CPT"}, {"code": "4102952", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 166.0, "discounted_cash": 124.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GTT EA ADD >3SPEC", "code_information": [{"code": "82952", "type": "CPT"}, {"code": "4172952", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 131.0, "discounted_cash": 98.25, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GUAF 100MG/5ML120ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315284", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GUAF 100MG/5ML120ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315284", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GUAF 200MG/10ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315280", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GUAF 200MG/10ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315280", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GUAF CF 100MG/5ML 5ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315306", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GUAF CF 100MG/5ML 5ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315306", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "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": 19.0, "discounted_cash": 14.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "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": 14.0, "discounted_cash": 10.5, "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": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GUANFACINE 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305540", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GUANFACINE 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305541", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GUANFACINE 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305541", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GUIDE CATH FLUID DRAINAG", "code_information": [{"code": "4911030", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2193.0, "discounted_cash": 1644.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GUIDE CATH FLUID DRAINAG", "code_information": [{"code": "5051030", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2516.0, "discounted_cash": 1887.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GUIDE CATH FLUID DRAINAG", "code_information": [{"code": "5061030", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2279.0, "discounted_cash": 1709.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GUIDEWIRE", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8240179", "type": "CDM"}], "standard_charges": [{"gross_charge": 423.0, "discounted_cash": 317.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GUIDEWIRE II", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8240163", "type": "CDM"}], "standard_charges": [{"gross_charge": 1983.0, "discounted_cash": 1487.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GUIDEWIRE III", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8240167", "type": "CDM"}], "standard_charges": [{"gross_charge": 2152.0, "discounted_cash": 1614.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GUIDEWIRE IV", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8240161", "type": "CDM"}], "standard_charges": [{"gross_charge": 2552.0, "discounted_cash": 1914.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GUIDEWIRE V", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8246599", "type": "CDM"}], "standard_charges": [{"gross_charge": 1224.0, "discounted_cash": 918.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GUIDEWIRE VI", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8246598", "type": "CDM"}], "standard_charges": [{"gross_charge": 2870.0, "discounted_cash": 2152.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GW", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8073055", "type": "CDM"}], "standard_charges": [{"gross_charge": 2315.0, "discounted_cash": 1736.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GW", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8073060", "type": "CDM"}], "standard_charges": [{"gross_charge": 1352.0, "discounted_cash": 1014.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GW", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8073075", "type": "CDM"}], "standard_charges": [{"gross_charge": 708.0, "discounted_cash": 531.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GW", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8073086", "type": "CDM"}], "standard_charges": [{"gross_charge": 4528.0, "discounted_cash": 3396.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GW ATTAIN HYBRID", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8073087", "type": "CDM"}], "standard_charges": [{"gross_charge": 3005.0, "discounted_cash": 2253.75, "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": 822.0, "discounted_cash": 616.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GW CEREBRAL", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8073098", "type": "CDM"}], "standard_charges": [{"gross_charge": 3786.0, "discounted_cash": 2839.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GW DRILL TIP", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8073144", "type": "CDM"}], "standard_charges": [{"gross_charge": 1257.0, "discounted_cash": 942.75, "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": 8970.0, "discounted_cash": 6727.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GW GLIDEWIRE GOLD", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8246665", "type": "CDM"}], "standard_charges": [{"gross_charge": 3899.0, "discounted_cash": 2924.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GW GLIDEWIRE STD ANGLE", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8246666", "type": "CDM"}], "standard_charges": [{"gross_charge": 780.0, "discounted_cash": 585.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GW GLIDEWIRE STIFF", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8246669", "type": "CDM"}], "standard_charges": [{"gross_charge": 1251.0, "discounted_cash": 938.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GW HI-TORQ PILOT", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8241281", "type": "CDM"}], "standard_charges": [{"gross_charge": 1040.0, "discounted_cash": 780.0, "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": 848.0, "discounted_cash": 636.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GW HITORQ FLOPPY II", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8246676", "type": "CDM"}], "standard_charges": [{"gross_charge": 1294.0, "discounted_cash": 970.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GW HITORQ STD", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8246680", "type": "CDM"}], "standard_charges": [{"gross_charge": 5292.0, "discounted_cash": 3969.0, "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": 2783.0, "discounted_cash": 2087.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GW IABP IMPELLA", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8073106", "type": "CDM"}], "standard_charges": [{"gross_charge": 2225.0, "discounted_cash": 1668.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GW INTR", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8073165", "type": "CDM"}], "standard_charges": [{"gross_charge": 785.0, "discounted_cash": 588.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GW NITINOL ULTRASELECT", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8246760", "type": "CDM"}], "standard_charges": [{"gross_charge": 1412.0, "discounted_cash": 1059.0, "setting": "both", "billing_class": "facility"}]}, {"description": "GW PTCA LUGE 182/300", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8241212", "type": "CDM"}], "standard_charges": [{"gross_charge": 2793.0, "discounted_cash": 2094.75, "setting": "both", "billing_class": "facility"}]}, {"description": "GW SAFARI ALL CURVES", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8073036", "type": "CDM"}], "standard_charges": [{"gross_charge": 1335.0, "discounted_cash": 1001.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GW SINUS", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8073186", "type": "CDM"}], "standard_charges": [{"gross_charge": 3899.0, "discounted_cash": 2924.25, "setting": "both", "billing_class": "facility"}]}, {"description": "GW STTIP", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8073250", "type": "CDM"}], "standard_charges": [{"gross_charge": 1002.0, "discounted_cash": 751.5, "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": 3110.0, "discounted_cash": 2332.5, "setting": "both", "billing_class": "facility"}]}, {"description": "GW TRANSCAROTID ENROUTE STRT", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8073056", "type": "CDM"}], "standard_charges": [{"gross_charge": 765.0, "discounted_cash": 573.75, "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": 1506.0, "discounted_cash": 1129.5, "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": 28.0, "discounted_cash": 21.0, "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": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "H PYLORI BRTH TST", "code_information": [{"code": "83013", "type": "CPT"}, {"code": "7253007", "type": "CDM"}], "standard_charges": [{"gross_charge": 1381.0, "discounted_cash": 1035.75, "setting": "both", "billing_class": "facility"}]}, {"description": "H. PYLORI STOOL IA", "code_information": [{"code": "87338", "type": "CPT"}, {"code": "4107338", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 336.0, "discounted_cash": 252.0, "setting": "both", "billing_class": "facility"}]}, {"description": "H. PYLORI STOOL IA", "code_information": [{"code": "87338", "type": "CPT"}, {"code": "4177338", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 264.0, "discounted_cash": 198.0, "setting": "both", "billing_class": "facility"}]}, {"description": "H. PYLORI STOOL IA", "code_information": [{"code": "87338", "type": "CPT"}, {"code": "7257338", "type": "CDM"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "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": 97.0, "discounted_cash": 72.75, "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": 97.0, "discounted_cash": 72.75, "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": 1070.0, "discounted_cash": 802.5, "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": 1070.0, "discounted_cash": 802.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HALOBETASOL .05% 15GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335809", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 911.0, "discounted_cash": 683.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HALOBETASOL .05% 15GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335809", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 911.0, "discounted_cash": 683.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HALOPERID DEC PER 50MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1631", "type": "HCPCS"}, {"code": "5320973", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1118.0, "discounted_cash": 838.5, "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": 1118.0, "discounted_cash": 838.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "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": 93.0, "discounted_cash": 69.75, "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": 93.0, "discounted_cash": 69.75, "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": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HALOPERIDOL 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305614", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "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": 12.0, "discounted_cash": 9.0, "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": 14.0, "discounted_cash": 10.5, "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": 14.0, "discounted_cash": 10.5, "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": 174.0, "discounted_cash": 130.5, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 174.0, "discounted_cash": 130.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HALOPERIDOL2MG/ML15ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315315", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 533.0, "discounted_cash": 399.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HALOPERIDOL2MG/ML15ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315315", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 533.0, "discounted_cash": 399.75, "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": 695.0, "discounted_cash": 521.25, "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": 695.0, "discounted_cash": 521.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HAND 2 VIEWS", "code_information": [{"code": "73120", "type": "CPT"}, {"code": "5123120", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 695.0, "discounted_cash": 521.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HAND 3 VIEWS MINIMUM", "code_information": [{"code": "73130", "type": "CPT"}, {"code": "4903130", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1444.0, "discounted_cash": 1083.0, "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": 1444.0, "discounted_cash": 1083.0, "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": 1444.0, "discounted_cash": 1083.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HAND 3 VIEWS MINIMUM", "code_information": [{"code": "73130", "type": "CPT"}, {"code": "5123130", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1444.0, "discounted_cash": 1083.0, "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": 1652.0, "discounted_cash": 1239.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HAPTOGLOBIN QUANT", "code_information": [{"code": "83010", "type": "CPT"}, {"code": "4103010", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 147.0, "discounted_cash": 110.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HAPTOGLOBIN QUANT", "code_information": [{"code": "83010", "type": "CPT"}, {"code": "4173010", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 273.0, "discounted_cash": 204.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HAPTOGLOBIN QUANT", "code_information": [{"code": "83010", "type": "CPT"}, {"code": "7003010", "type": "CDM"}], "standard_charges": [{"gross_charge": 157.0, "discounted_cash": 117.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HAPTOGLOBIN QUANT", "code_information": [{"code": "83010", "type": "CPT"}, {"code": "7253010", "type": "CDM"}], "standard_charges": [{"gross_charge": 348.0, "discounted_cash": 261.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HB FUL BDY CHMBR P 30MIN", "code_information": [{"code": "G0277", "type": "HCPCS"}, {"code": "6620020", "type": "CDM"}, {"code": "413", "type": "RC"}], "standard_charges": [{"gross_charge": 858.0, "discounted_cash": 643.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HBA 1/2 DELETES/VARIANTS", "code_information": [{"code": "81257", "type": "CPT"}, {"code": "7251257", "type": "CDM"}], "standard_charges": [{"gross_charge": 1235.0, "discounted_cash": 926.25, "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": 172.0, "discounted_cash": 129.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HBS IA", "code_information": [{"code": "87467", "type": "CPT"}, {"code": "4176287", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 59.0, "discounted_cash": 44.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HBS IA", "code_information": [{"code": "87467", "type": "CPT"}, {"code": "7006287", "type": "CDM"}], "standard_charges": [{"gross_charge": 75.0, "discounted_cash": 56.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HBS IA", "code_information": [{"code": "87467", "type": "CPT"}, {"code": "7256287", "type": "CDM"}], "standard_charges": [{"gross_charge": 75.0, "discounted_cash": 56.25, "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": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTS .2% 15GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335891", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTS .2% 45GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335892", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 592.0, "discounted_cash": 444.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTS .2% 45GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335892", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 592.0, "discounted_cash": 444.0, "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": 21.0, "discounted_cash": 15.75, "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": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTS 1% 28.4GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335920", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTS 1% 30GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335911", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTS 1% 30GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335911", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": 76.0, "discounted_cash": 57.0, "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": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTS 100MG/60ML RE", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338488", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 172.0, "discounted_cash": 129.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTS 100MG/60ML RE", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338488", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 172.0, "discounted_cash": 129.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTS 2.5% 30GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335913", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 58.0, "discounted_cash": 43.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 58.0, "discounted_cash": 43.5, "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": 424.0, "discounted_cash": 318.0, "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": 424.0, "discounted_cash": 318.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTS 2.5% 60ML LT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335904", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 528.0, "discounted_cash": 396.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTS 2.5% 60ML LT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335904", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 528.0, "discounted_cash": 396.0, "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": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "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": 146.0, "discounted_cash": 109.5, "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": 146.0, "discounted_cash": 109.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTS/PRAMO 1-1%60ML LT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335878", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1210.0, "discounted_cash": 907.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTS/PRAMO 1-1%60ML LT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5335878", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1210.0, "discounted_cash": 907.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTS/PRAMO2.5-1%30GM RCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337147", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 560.0, "discounted_cash": 420.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTS/PRAMO2.5-1%30GM RCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337147", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 560.0, "discounted_cash": 420.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 284.0, "discounted_cash": 213.0, "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": 284.0, "discounted_cash": 213.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTS/PRAMOXINE 10GM R FM", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338576", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 477.0, "discounted_cash": 357.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HCTS/PRAMOXINE 10GM R FM", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338576", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 477.0, "discounted_cash": 357.75, "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": 28.0, "discounted_cash": 21.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "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": 3.0, "discounted_cash": 2.25, "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": 3.0, "discounted_cash": 2.25, "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": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HCV GENOTYPE", "code_information": [{"code": "87902", "type": "CPT"}, {"code": "7007523", "type": "CDM"}], "standard_charges": [{"gross_charge": 1030.0, "discounted_cash": 772.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HCV GENOTYPE", "code_information": [{"code": "87902", "type": "CPT"}, {"code": "7257523", "type": "CDM"}], "standard_charges": [{"gross_charge": 1074.0, "discounted_cash": 805.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HD FM ALL MTL NON MTL MEDAC CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013440", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4138.0, "discounted_cash": 3103.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HD HUM STD OFFST ECC MEDACT CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013467", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9936.0, "discounted_cash": 7452.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HD HUM STD OFFST ECC STRYK CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013024", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9624.0, "discounted_cash": 7218.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEAD BIPOLR UNIPOLR MEDACTA CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013443", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1203.0, "discounted_cash": 902.25, "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": 1203.0, "discounted_cash": 902.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEAD FEM ALL MTL UNIPL DPY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012811", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4694.84, "discounted_cash": 3521.13, "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": 6103.29, "discounted_cash": 4577.47, "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": 8540.0, "discounted_cash": 6405.0, "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": 8841.0, "discounted_cash": 6630.75, "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": 4210.0, "discounted_cash": 3157.5, "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": 4154.0, "discounted_cash": 3115.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEAD FEM UNIPOLAR DEPUY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012809", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3169.0, "discounted_cash": 2376.75, "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": 4210.0, "discounted_cash": 3157.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEAD FEMORAL BIPOLAR STRYK CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013052", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3609.0, "discounted_cash": 2706.75, "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": 3609.0, "discounted_cash": 2706.75, "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": 16376.0, "discounted_cash": 12282.0, "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": 20469.0, "discounted_cash": 15351.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEAD HUM STD OFST ECC DEPY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013117", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 14821.0, "discounted_cash": 11115.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEAD HUM STD/OFFSET/ECC DJO CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013425", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10460.0, "discounted_cash": 7845.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEAD HUMERAL RESURFC DEPUY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012825", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 33346.0, "discounted_cash": 25009.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEAVY METAL QUAN/7", "code_information": [{"code": "83018", "type": "CPT"}, {"code": "7253022", "type": "CDM"}], "standard_charges": [{"gross_charge": 189.0, "discounted_cash": 141.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEAVY METAL QUAN/8", "code_information": [{"code": "83018", "type": "CPT"}, {"code": "7004410", "type": "CDM"}], "standard_charges": [{"gross_charge": 597.0, "discounted_cash": 447.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HELICOBACTER PYLORI AB", "code_information": [{"code": "86677", "type": "CPT"}, {"code": "4176056", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 266.0, "discounted_cash": 199.5, "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": 338.0, "discounted_cash": 253.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HELICOBACTER PYLORI AB/2", "code_information": [{"code": "86677", "type": "CPT"}, {"code": "7256074", "type": "CDM"}], "standard_charges": [{"gross_charge": 476.0, "discounted_cash": 357.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HELICOBACTER PYLORI AB/3", "code_information": [{"code": "86677", "type": "CPT"}, {"code": "7256076", "type": "CDM"}], "standard_charges": [{"gross_charge": 187.0, "discounted_cash": 140.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HELICOBACTER PYLORI AB/4", "code_information": [{"code": "86677", "type": "CPT"}, {"code": "7006074", "type": "CDM"}], "standard_charges": [{"gross_charge": 588.0, "discounted_cash": 441.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HELICOBACTER PYLORI AB/4", "code_information": [{"code": "86677", "type": "CPT"}, {"code": "7256615", "type": "CDM"}], "standard_charges": [{"gross_charge": 138.0, "discounted_cash": 103.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HELMINTH AB NES", "code_information": [{"code": "86682", "type": "CPT"}, {"code": "7250050", "type": "CDM"}], "standard_charges": [{"gross_charge": 171.0, "discounted_cash": 128.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HELMINTH AB NES/2", "code_information": [{"code": "86682", "type": "CPT"}, {"code": "7254183", "type": "CDM"}], "standard_charges": [{"gross_charge": 465.0, "discounted_cash": 348.75, "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": 211.0, "discounted_cash": 158.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMATOCRIT", "code_information": [{"code": "85014", "type": "CPT"}, {"code": "4175014", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 167.0, "discounted_cash": 125.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMATOCRIT", "code_information": [{"code": "85014", "type": "CPT"}, {"code": "7005015", "type": "CDM"}], "standard_charges": [{"gross_charge": 45.0, "discounted_cash": 33.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMATOCRIT", "code_information": [{"code": "85014", "type": "CPT"}, {"code": "7255014", "type": "CDM"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMGLBN METHEMOGLBN QUAL", "code_information": [{"code": "83045", "type": "CPT"}, {"code": "4100418", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "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": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMGLBN METHEMOGLBN QUAN", "code_information": [{"code": "83050", "type": "CPT"}, {"code": "7003050", "type": "CDM"}], "standard_charges": [{"gross_charge": 177.0, "discounted_cash": 132.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMIN PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1640", "type": "HCPCS"}, {"code": "5320979", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMIN PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1640", "type": "HCPCS"}, {"code": "5320979", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMOCHROM COMMON VARIANT/2", "code_information": [{"code": "81256", "type": "CPT"}, {"code": "7259211", "type": "CDM"}], "standard_charges": [{"gross_charge": 558.0, "discounted_cash": 418.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMOGLOBIN FRAC & QNT", "code_information": [{"code": "83021", "type": "CPT"}, {"code": "7253021", "type": "CDM"}], "standard_charges": [{"gross_charge": 288.0, "discounted_cash": 216.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMOGLOBIN FRAC & QNT/2", "code_information": [{"code": "83021", "type": "CPT"}, {"code": "7253067", "type": "CDM"}], "standard_charges": [{"gross_charge": 305.0, "discounted_cash": 228.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMOGLOBIN FRAC & QNT/4", "code_information": [{"code": "83021", "type": "CPT"}, {"code": "7258302", "type": "CDM"}], "standard_charges": [{"gross_charge": 266.0, "discounted_cash": 199.5, "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": 643.0, "discounted_cash": 482.25, "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": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMOGLOBIN GLYCATED", "code_information": [{"code": "83036", "type": "CPT"}, {"code": "4172994", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 506.0, "discounted_cash": 379.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMOGLOBIN GLYCATED", "code_information": [{"code": "83036", "type": "CPT"}, {"code": "7252994", "type": "CDM"}], "standard_charges": [{"gross_charge": 134.0, "discounted_cash": 100.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMOGLOBIN PLASMA", "code_information": [{"code": "83051", "type": "CPT"}, {"code": "4103051", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMOGLOBIN PLASMA", "code_information": [{"code": "83051", "type": "CPT"}, {"code": "7003051", "type": "CDM"}], "standard_charges": [{"gross_charge": 172.0, "discounted_cash": 129.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMOGLOBIN PLASMA", "code_information": [{"code": "83051", "type": "CPT"}, {"code": "7253051", "type": "CDM"}], "standard_charges": [{"gross_charge": 205.0, "discounted_cash": 153.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMOGLOBN ELECTRPHORESIS", "code_information": [{"code": "83020", "type": "CPT"}, {"code": "7003021", "type": "CDM"}], "standard_charges": [{"gross_charge": 143.0, "discounted_cash": 107.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMOGLOBN ELECTRPHORESIS", "code_information": [{"code": "83020", "type": "CPT"}, {"code": "7253023", "type": "CDM"}], "standard_charges": [{"gross_charge": 82.0, "discounted_cash": 61.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMOGLOBN ELECTRPHORESIS/2", "code_information": [{"code": "83020", "type": "CPT"}, {"code": "7003023", "type": "CDM"}], "standard_charges": [{"gross_charge": 209.0, "discounted_cash": 156.75, "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": 98.0, "discounted_cash": 73.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMOGLOBN FETAL CHEMICAL", "code_information": [{"code": "83030", "type": "CPT"}, {"code": "4173031", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMOGLOBN FETAL CHEMICAL", "code_information": [{"code": "83030", "type": "CPT"}, {"code": "7003030", "type": "CDM"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMOSIDERIN QUAL", "code_information": [{"code": "83070", "type": "CPT"}, {"code": "7253070", "type": "CDM"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEMOSTAT BN WAX WTR SOL", "code_information": [{"code": "8192050", "type": "CDM"}], "standard_charges": [{"gross_charge": 2371.0, "discounted_cash": 1778.25, "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": 219.0, "discounted_cash": 164.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEP B CORE AB IGM", "code_information": [{"code": "86705", "type": "CPT"}, {"code": "4176294", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 172.0, "discounted_cash": 129.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEP B CORE AB IGM", "code_information": [{"code": "86705", "type": "CPT"}, {"code": "7006294", "type": "CDM"}], "standard_charges": [{"gross_charge": 149.0, "discounted_cash": 111.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEP B CORE AB IGM", "code_information": [{"code": "86705", "type": "CPT"}, {"code": "7256294", "type": "CDM"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEP B CORE AB TOTAL", "code_information": [{"code": "86704", "type": "CPT"}, {"code": "4176289", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 97.0, "discounted_cash": 72.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEP B CORE AB TOTAL", "code_information": [{"code": "86704", "type": "CPT"}, {"code": "7006289", "type": "CDM"}], "standard_charges": [{"gross_charge": 89.0, "discounted_cash": 66.75, "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": 123.0, "discounted_cash": 92.25, "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": 123.0, "discounted_cash": 92.25, "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": 225.0, "discounted_cash": 168.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEP B SURFACE AB", "code_information": [{"code": "86706", "type": "CPT"}, {"code": "4176292", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 177.0, "discounted_cash": 132.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEP B SURFACE AB", "code_information": [{"code": "86706", "type": "CPT"}, {"code": "7256706", "type": "CDM"}], "standard_charges": [{"gross_charge": 174.0, "discounted_cash": 130.5, "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": 399.0, "discounted_cash": 299.25, "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": 2550.0, "discounted_cash": 1912.5, "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": 96.0, "discounted_cash": 72.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEP C AMPLIFIED PROBE", "code_information": [{"code": "87521", "type": "CPT"}, {"code": "7007521", "type": "CDM"}], "standard_charges": [{"gross_charge": 928.0, "discounted_cash": 696.0, "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": 1220.0, "discounted_cash": 915.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEP C QUANT", "code_information": [{"code": "87522", "type": "CPT"}, {"code": "7253933", "type": "CDM"}], "standard_charges": [{"gross_charge": 544.0, "discounted_cash": 408.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEP C QUANT/2", "code_information": [{"code": "87522", "type": "CPT"}, {"code": "7253934", "type": "CDM"}], "standard_charges": [{"gross_charge": 1342.0, "discounted_cash": 1006.5, "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": 252.0, "discounted_cash": 189.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPARIN ASSAY", "code_information": [{"code": "85520", "type": "CPT"}, {"code": "4175530", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 198.0, "discounted_cash": 148.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPARIN ASSAY", "code_information": [{"code": "85520", "type": "CPT"}, {"code": "7005520", "type": "CDM"}], "standard_charges": [{"gross_charge": 944.0, "discounted_cash": 708.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPARIN ASSAY", "code_information": [{"code": "85520", "type": "CPT"}, {"code": "7255520", "type": "CDM"}], "standard_charges": [{"gross_charge": 749.0, "discounted_cash": 561.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPARIN ASSAY/2", "code_information": [{"code": "85520", "type": "CPT"}, {"code": "4105001", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "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": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "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": 0.19, "discounted_cash": 0.14, "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": 0.19, "discounted_cash": 0.14, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPARIN NEUTRALIZATION", "code_information": [{"code": "85525", "type": "CPT"}, {"code": "4105525", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPARIN PER 1000U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1644", "type": "HCPCS"}, {"code": "5321063", "type": "CDM"}, {"code": "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 498.0, "discounted_cash": 373.5, "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": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATIC FUNCTION PANEL", "code_information": [{"code": "80076", "type": "CPT"}, {"code": "4170109", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 392.0, "discounted_cash": 294.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATIC VENGRPHY W/EVAL", "code_information": [{"code": "75889", "type": "CPT"}, {"code": "4915890", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 5218.0, "discounted_cash": 3913.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS A AB", "code_information": [{"code": "86708", "type": "CPT"}, {"code": "4176291", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 286.0, "discounted_cash": 214.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS A AB", "code_information": [{"code": "86708", "type": "CPT"}, {"code": "7006291", "type": "CDM"}], "standard_charges": [{"gross_charge": 130.0, "discounted_cash": 97.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS A AB", "code_information": [{"code": "86708", "type": "CPT"}, {"code": "7256291", "type": "CDM"}], "standard_charges": [{"gross_charge": 364.0, "discounted_cash": 273.0, "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": 192.0, "discounted_cash": 144.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS A AB IGM", "code_information": [{"code": "86709", "type": "CPT"}, {"code": "4176297", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 151.0, "discounted_cash": 113.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS A AB IGM", "code_information": [{"code": "86709", "type": "CPT"}, {"code": "7006303", "type": "CDM"}], "standard_charges": [{"gross_charge": 134.0, "discounted_cash": 100.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS A AB IGM", "code_information": [{"code": "86709", "type": "CPT"}, {"code": "7256303", "type": "CDM"}], "standard_charges": [{"gross_charge": 75.0, "discounted_cash": 56.25, "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": 3249.0, "discounted_cash": 2436.75, "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": 3249.0, "discounted_cash": 2436.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS B QUANT", "code_information": [{"code": "87517", "type": "CPT"}, {"code": "7008675", "type": "CDM"}], "standard_charges": [{"gross_charge": 1156.0, "discounted_cash": 867.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS B QUANT/3", "code_information": [{"code": "87517", "type": "CPT"}, {"code": "7258675", "type": "CDM"}], "standard_charges": [{"gross_charge": 761.0, "discounted_cash": 570.75, "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": 384.0, "discounted_cash": 288.0, "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": 384.0, "discounted_cash": 288.0, "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": 384.0, "discounted_cash": 288.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS B VACC ADMIN", "code_information": [{"code": "G0010", "type": "HCPCS"}, {"code": "6290010", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 384.0, "discounted_cash": 288.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS BE ANTIBODY", "code_information": [{"code": "86707", "type": "CPT"}, {"code": "4176707", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 87.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS BE ANTIBODY", "code_information": [{"code": "86707", "type": "CPT"}, {"code": "7006296", "type": "CDM"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS BE ANTIBODY", "code_information": [{"code": "86707", "type": "CPT"}, {"code": "7256296", "type": "CDM"}], "standard_charges": [{"gross_charge": 148.0, "discounted_cash": 111.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS BE IA", "code_information": [{"code": "87350", "type": "CPT"}, {"code": "7006293", "type": "CDM"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS BE IA", "code_information": [{"code": "87350", "type": "CPT"}, {"code": "7256293", "type": "CDM"}], "standard_charges": [{"gross_charge": 130.0, "discounted_cash": 97.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS C AB CONFIRM TST", "code_information": [{"code": "86804", "type": "CPT"}, {"code": "7006305", "type": "CDM"}], "standard_charges": [{"gross_charge": 617.0, "discounted_cash": 462.75, "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": 266.0, "discounted_cash": 199.5, "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": 210.0, "discounted_cash": 157.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS C ANTIBODY", "code_information": [{"code": "86803", "type": "CPT"}, {"code": "4176304", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 166.0, "discounted_cash": 124.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS C ANTIBODY", "code_information": [{"code": "86803", "type": "CPT"}, {"code": "7256304", "type": "CDM"}], "standard_charges": [{"gross_charge": 75.0, "discounted_cash": 56.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS DELTA AGENT AB", "code_information": [{"code": "86692", "type": "CPT"}, {"code": "7006297", "type": "CDM"}], "standard_charges": [{"gross_charge": 192.0, "discounted_cash": 144.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS DELTA AGENT AB", "code_information": [{"code": "86692", "type": "CPT"}, {"code": "7256297", "type": "CDM"}], "standard_charges": [{"gross_charge": 347.0, "discounted_cash": 260.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS DELTA AGENT IA", "code_information": [{"code": "87380", "type": "CPT"}, {"code": "7256306", "type": "CDM"}], "standard_charges": [{"gross_charge": 401.0, "discounted_cash": 300.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HEPATITIS E AB/2", "code_information": [{"code": "86790", "type": "CPT"}, {"code": "7256795", "type": "CDM"}], "standard_charges": [{"gross_charge": 924.0, "discounted_cash": 693.0, "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": 4755.0, "discounted_cash": 3566.25, "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": 3916.0, "discounted_cash": 2937.0, "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": 141.0, "discounted_cash": 105.75, "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": 305.0, "discounted_cash": 228.75, "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": 141.0, "discounted_cash": 105.75, "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": 348.0, "discounted_cash": 261.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HERPES AB SMPLX TYPE 2/3", "code_information": [{"code": "86696", "type": "CPT"}, {"code": "7006375", "type": "CDM"}], "standard_charges": [{"gross_charge": 986.0, "discounted_cash": 739.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HERPES AB SMPLX TYPE 2/7", "code_information": [{"code": "86696", "type": "CPT"}, {"code": "7258680", "type": "CDM"}], "standard_charges": [{"gross_charge": 123.0, "discounted_cash": 92.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HERPES AB SMPLX/2", "code_information": [{"code": "86694", "type": "CPT"}, {"code": "7256695", "type": "CDM"}], "standard_charges": [{"gross_charge": 193.0, "discounted_cash": 144.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HERPES AB SMPLX/5", "code_information": [{"code": "86694", "type": "CPT"}, {"code": "7006698", "type": "CDM"}], "standard_charges": [{"gross_charge": 275.0, "discounted_cash": 206.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HERPES SIMPLX AMP PRB", "code_information": [{"code": "87529", "type": "CPT"}, {"code": "4177530", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 555.0, "discounted_cash": 416.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HERPES SIMPLX AMP PRB", "code_information": [{"code": "87529", "type": "CPT"}, {"code": "7007529", "type": "CDM"}], "standard_charges": [{"gross_charge": 1854.0, "discounted_cash": 1390.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HERPES SIMPLX AMP PRB", "code_information": [{"code": "87529", "type": "CPT"}, {"code": "7257531", "type": "CDM"}], "standard_charges": [{"gross_charge": 705.0, "discounted_cash": 528.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HERPES SIMPLX AMP PRB/2", "code_information": [{"code": "87529", "type": "CPT"}, {"code": "4177531", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 555.0, "discounted_cash": 416.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HERPES SIMPLX AMP PRB/2", "code_information": [{"code": "87529", "type": "CPT"}, {"code": "7257530", "type": "CDM"}], "standard_charges": [{"gross_charge": 705.0, "discounted_cash": 528.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HERPES SIMPLX AMP PRB/3", "code_information": [{"code": "87529", "type": "CPT"}, {"code": "4177529", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 251.0, "discounted_cash": 188.25, "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": 319.0, "discounted_cash": 239.25, "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": 692.0, "discounted_cash": 519.0, "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": 593.0, "discounted_cash": 444.75, "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": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HETEROPHILE AB SCREEN", "code_information": [{"code": "86308", "type": "CPT"}, {"code": "4176003", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 467.0, "discounted_cash": 350.25, "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": 877.0, "discounted_cash": 657.75, "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": 877.0, "discounted_cash": 657.75, "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": 1761.0, "discounted_cash": 1320.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HIGH RISK OBSTETRICS", "code_information": [{"code": "1990098", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 7609.0, "discounted_cash": 5706.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HIGH RISK OBSTETRICS", "code_information": [{"code": "2510098", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 7609.0, "discounted_cash": 5706.75, "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": 2580.0, "discounted_cash": 1935.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HIP ARTHROGRAPHY", "code_information": [{"code": "73525", "type": "CPT"}, {"code": "4913525", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2580.0, "discounted_cash": 1935.0, "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": 2580.0, "discounted_cash": 1935.0, "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": 1222.0, "discounted_cash": 916.5, "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": 1222.0, "discounted_cash": 916.5, "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": 1222.0, "discounted_cash": 916.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HIP BI W/PEL 2WS", "code_information": [{"code": "73521", "type": "CPT"}, {"code": "5123520", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1222.0, "discounted_cash": 916.5, "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": 1530.0, "discounted_cash": 1147.5, "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": 1530.0, "discounted_cash": 1147.5, "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": 1530.0, "discounted_cash": 1147.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HIP BI W/PEL 3-4 VWS", "code_information": [{"code": "73522", "type": "CPT"}, {"code": "5123522", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1530.0, "discounted_cash": 1147.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HIP BI W/PEL 5VWS", "code_information": [{"code": "73523", "type": "CPT"}, {"code": "4903523", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1575.0, "discounted_cash": 1181.25, "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": 1575.0, "discounted_cash": 1181.25, "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": 1575.0, "discounted_cash": 1181.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HIP BI W/PEL 5VWS", "code_information": [{"code": "73523", "type": "CPT"}, {"code": "5123523", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1575.0, "discounted_cash": 1181.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HIP CENTRALIZER ACC DEPUY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012800", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 666.67, "discounted_cash": 500.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HIP PART SLF CENT COMP DPY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012821", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4018.78, "discounted_cash": 3014.09, "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": 2596.0, "discounted_cash": 1947.0, "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": 5714.0, "discounted_cash": 4285.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HIP PRT SLF CENT CMP CORIN CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013213", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5149.0, "discounted_cash": 3861.75, "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": 602.0, "discounted_cash": 451.5, "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": 1031.0, "discounted_cash": 773.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HIP UNI W/PEL 4+VWS", "code_information": [{"code": "73503", "type": "CPT"}, {"code": "4903503", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2231.0, "discounted_cash": 1673.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HIP UNI W/PEL 4+VWS", "code_information": [{"code": "73503", "type": "CPT"}, {"code": "5013503", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2231.0, "discounted_cash": 1673.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HIP UNI W/PEL 4+VWS", "code_information": [{"code": "73503", "type": "CPT"}, {"code": "5123503", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2231.0, "discounted_cash": 1673.25, "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": 2012.0, "discounted_cash": 1509.0, "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": 2024.0, "discounted_cash": 1518.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HIP UNI W/PELV 2-3 VWS", "code_information": [{"code": "73502", "type": "CPT"}, {"code": "5113505", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2012.0, "discounted_cash": 1509.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HIP UNI W/PELV 2-3 VWS", "code_information": [{"code": "73502", "type": "CPT"}, {"code": "5123505", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2012.0, "discounted_cash": 1509.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HIP UNI W/PELVIS 1VW", "code_information": [{"code": "73501", "type": "CPT"}, {"code": "4903501", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1031.0, "discounted_cash": 773.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HIP UNI W/PELVIS 1VW", "code_information": [{"code": "73501", "type": "CPT"}, {"code": "5013501", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1031.0, "discounted_cash": 773.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HIP UNI W/PELVIS 1VW", "code_information": [{"code": "73501", "type": "CPT"}, {"code": "5113501", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1031.0, "discounted_cash": 773.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HIP UNI W/PELVIS 1VW", "code_information": [{"code": "73501", "type": "CPT"}, {"code": "5123501", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1031.0, "discounted_cash": 773.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HIP UNILATERAL 2-3 VWS", "code_information": [{"code": "73502", "type": "CPT"}, {"code": "4903510", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2012.0, "discounted_cash": 1509.0, "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": 2024.0, "discounted_cash": 1518.0, "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": 2012.0, "discounted_cash": 1509.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HIP UNILATERAL 2-3VWS", "code_information": [{"code": "73502", "type": "CPT"}, {"code": "5123510", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1500.0, "discounted_cash": 1125.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HISTAMINE", "code_information": [{"code": "83088", "type": "CPT"}, {"code": "7003087", "type": "CDM"}], "standard_charges": [{"gross_charge": 365.0, "discounted_cash": 273.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HISTAMINE/2", "code_information": [{"code": "83088", "type": "CPT"}, {"code": "7003088", "type": "CDM"}], "standard_charges": [{"gross_charge": 365.0, "discounted_cash": 273.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HISTAMINE/2", "code_information": [{"code": "83088", "type": "CPT"}, {"code": "7253088", "type": "CDM"}], "standard_charges": [{"gross_charge": 604.0, "discounted_cash": 453.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HISTOCHEM STN W/FRZ SECT", "code_information": [{"code": "88314", "type": "CPT"}, {"code": "7090055", "type": "CDM"}], "standard_charges": [{"gross_charge": 220.0, "discounted_cash": 165.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HISTONE AB", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "7258673", "type": "CDM"}], "standard_charges": [{"gross_charge": 443.0, "discounted_cash": 332.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HISTONE AB QUAL/SEMIQUAN", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "7003588", "type": "CDM"}], "standard_charges": [{"gross_charge": 706.0, "discounted_cash": 529.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HISTOPLASMA IA", "code_information": [{"code": "87385", "type": "CPT"}, {"code": "7257386", "type": "CDM"}], "standard_charges": [{"gross_charge": 308.0, "discounted_cash": 231.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HISTOPLASMA IA/3", "code_information": [{"code": "87385", "type": "CPT"}, {"code": "7253507", "type": "CDM"}], "standard_charges": [{"gross_charge": 398.0, "discounted_cash": 298.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HISTOPLASMOSIS AB", "code_information": [{"code": "86698", "type": "CPT"}, {"code": "7006176", "type": "CDM"}], "standard_charges": [{"gross_charge": 130.0, "discounted_cash": 97.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HISTOPLASMOSIS AB", "code_information": [{"code": "86698", "type": "CPT"}, {"code": "7256176", "type": "CDM"}], "standard_charges": [{"gross_charge": 75.0, "discounted_cash": 56.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV 1 AB", "code_information": [{"code": "86701", "type": "CPT"}, {"code": "4126701", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 62.0, "discounted_cash": 46.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV 1 AB", "code_information": [{"code": "86701", "type": "CPT"}, {"code": "7006701", "type": "CDM"}], "standard_charges": [{"gross_charge": 94.0, "discounted_cash": 70.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV 1 AB", "code_information": [{"code": "86701", "type": "CPT"}, {"code": "7256701", "type": "CDM"}], "standard_charges": [{"gross_charge": 88.0, "discounted_cash": 66.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV 1 AB/2", "code_information": [{"code": "86701", "type": "CPT"}, {"code": "4106701", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 808.0, "discounted_cash": 606.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV 1 AMP PROBE", "code_information": [{"code": "87535", "type": "CPT"}, {"code": "7006321", "type": "CDM"}], "standard_charges": [{"gross_charge": 1080.0, "discounted_cash": 810.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV 1 AMP PROBE", "code_information": [{"code": "87535", "type": "CPT"}, {"code": "7256323", "type": "CDM"}], "standard_charges": [{"gross_charge": 1577.0, "discounted_cash": 1182.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV 1 AMP PROBE/3", "code_information": [{"code": "87535", "type": "CPT"}, {"code": "7257533", "type": "CDM"}], "standard_charges": [{"gross_charge": 222.0, "discounted_cash": 166.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV 1/HIV 2 SNGL RESULT", "code_information": [{"code": "86703", "type": "CPT"}, {"code": "4176703", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 207.0, "discounted_cash": 155.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV 1/HIV 2 SNGL RESULT", "code_information": [{"code": "86703", "type": "CPT"}, {"code": "7256703", "type": "CDM"}], "standard_charges": [{"gross_charge": 174.0, "discounted_cash": 130.5, "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": 264.0, "discounted_cash": 198.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV 2 AB", "code_information": [{"code": "86702", "type": "CPT"}, {"code": "7256702", "type": "CDM"}], "standard_charges": [{"gross_charge": 173.0, "discounted_cash": 129.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV GENO PROTEAS REGION", "code_information": [{"code": "87901", "type": "CPT"}, {"code": "7257902", "type": "CDM"}], "standard_charges": [{"gross_charge": 1309.0, "discounted_cash": 981.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV GENO PROTEAS REGION/2", "code_information": [{"code": "87901", "type": "CPT"}, {"code": "7257901", "type": "CDM"}], "standard_charges": [{"gross_charge": 1981.0, "discounted_cash": 1485.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV GENOTYPE", "code_information": [{"code": "87906", "type": "CPT"}, {"code": "7257906", "type": "CDM"}], "standard_charges": [{"gross_charge": 1101.0, "discounted_cash": 825.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV I AG HIV I HIV II AB", "code_information": [{"code": "87389", "type": "CPT"}, {"code": "4107389", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 244.0, "discounted_cash": 183.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV I AG HIV I HIV II AB", "code_information": [{"code": "87389", "type": "CPT"}, {"code": "4177389", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 192.0, "discounted_cash": 144.0, "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": 301.0, "discounted_cash": 225.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV-1 QUANT", "code_information": [{"code": "87536", "type": "CPT"}, {"code": "4177536", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 981.0, "discounted_cash": 735.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV-1 QUANT", "code_information": [{"code": "87536", "type": "CPT"}, {"code": "7003896", "type": "CDM"}], "standard_charges": [{"gross_charge": 1080.0, "discounted_cash": 810.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV-1 QUANT", "code_information": [{"code": "87536", "type": "CPT"}, {"code": "7257536", "type": "CDM"}], "standard_charges": [{"gross_charge": 1247.0, "discounted_cash": 935.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV-1 QUANT/2", "code_information": [{"code": "87536", "type": "CPT"}, {"code": "7257539", "type": "CDM"}], "standard_charges": [{"gross_charge": 590.0, "discounted_cash": 442.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HIV-1 QUANT/5", "code_information": [{"code": "87536", "type": "CPT"}, {"code": "7257537", "type": "CDM"}], "standard_charges": [{"gross_charge": 1354.0, "discounted_cash": 1015.5, "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": 130.0, "discounted_cash": 97.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HLA I ONE ALELE/GRP HIGH/2", "code_information": [{"code": "81381", "type": "CPT"}, {"code": "7251385", "type": "CDM"}], "standard_charges": [{"gross_charge": 1176.0, "discounted_cash": 882.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HLA II AG EQUIV EACH LOW/2", "code_information": [{"code": "81377", "type": "CPT"}, {"code": "7251377", "type": "CDM"}], "standard_charges": [{"gross_charge": 784.0, "discounted_cash": 588.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HLA II ONE ALELE/GRP HGH", "code_information": [{"code": "81383", "type": "CPT"}, {"code": "7251383", "type": "CDM"}], "standard_charges": [{"gross_charge": 933.0, "discounted_cash": 699.75, "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": 225.0, "discounted_cash": 168.75, "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": 1236.0, "discounted_cash": 927.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HMOGLBN FETAL(KLEIHAUER)", "code_information": [{"code": "85460", "type": "CPT"}, {"code": "4105460", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 509.0, "discounted_cash": 381.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HMOGLBN FETAL(KLEIHAUER)", "code_information": [{"code": "85460", "type": "CPT"}, {"code": "4175460", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 400.0, "discounted_cash": 300.0, "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": 38.0, "discounted_cash": 28.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 327.0, "discounted_cash": 245.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 327.0, "discounted_cash": 245.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HOMOCYSTEINE QUANT/2", "code_information": [{"code": "83090", "type": "CPT"}, {"code": "7003089", "type": "CDM"}], "standard_charges": [{"gross_charge": 328.0, "discounted_cash": 246.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HOMOCYSTEINE QUANT/2", "code_information": [{"code": "83090", "type": "CPT"}, {"code": "7253089", "type": "CDM"}], "standard_charges": [{"gross_charge": 222.0, "discounted_cash": 166.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HOMOVNLLC ACID(HVA)", "code_information": [{"code": "83150", "type": "CPT"}, {"code": "7003150", "type": "CDM"}], "standard_charges": [{"gross_charge": 244.0, "discounted_cash": 183.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HOMOVNLLC ACID(HVA)", "code_information": [{"code": "83150", "type": "CPT"}, {"code": "7253150", "type": "CDM"}], "standard_charges": [{"gross_charge": 356.0, "discounted_cash": 267.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HPV HIGH RISK", "code_information": [{"code": "87624", "type": "CPT"}, {"code": "7257644", "type": "CDM"}], "standard_charges": [{"gross_charge": 400.0, "discounted_cash": 300.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HPV HIGH RISK", "code_information": [{"code": "87624", "type": "CPT"}, {"code": "7270057", "type": "CDM"}], "standard_charges": [{"gross_charge": 1627.0, "discounted_cash": 1220.25, "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": 277.0, "discounted_cash": 207.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HTLV ANTIBODY/2", "code_information": [{"code": "86790", "type": "CPT"}, {"code": "7256791", "type": "CDM"}], "standard_charges": [{"gross_charge": 190.0, "discounted_cash": 142.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HTLV I AB", "code_information": [{"code": "86687", "type": "CPT"}, {"code": "7006687", "type": "CDM"}], "standard_charges": [{"gross_charge": 755.0, "discounted_cash": 566.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HTLV/HIV CONFIRM AB", "code_information": [{"code": "86689", "type": "CPT"}, {"code": "7006322", "type": "CDM"}], "standard_charges": [{"gross_charge": 885.0, "discounted_cash": 663.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HTLV/HIV CONFIRM AB", "code_information": [{"code": "86689", "type": "CPT"}, {"code": "7256322", "type": "CDM"}], "standard_charges": [{"gross_charge": 797.0, "discounted_cash": 597.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HU ANTIBODY SCREEN", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "7004193", "type": "CDM"}], "standard_charges": [{"gross_charge": 815.0, "discounted_cash": 611.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HU ANTIBODY SCREEN", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "7254193", "type": "CDM"}], "standard_charges": [{"gross_charge": 814.0, "discounted_cash": 610.5, "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": 1397.0, "discounted_cash": 1047.75, "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": 1397.0, "discounted_cash": 1047.75, "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": 1397.0, "discounted_cash": 1047.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HUMERUS 2 VIEW MINIMUM", "code_information": [{"code": "73060", "type": "CPT"}, {"code": "5123060", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1397.0, "discounted_cash": 1047.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYALURON EUFLX PER DS IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7323", "type": "HCPCS"}, {"code": "5321174", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2855.0, "discounted_cash": 2141.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HYALURON EUFLX PER DS IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7323", "type": "HCPCS"}, {"code": "5321174", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 2855.0, "discounted_cash": 2141.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HYALURON HYLGN PER DS IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7321", "type": "HCPCS"}, {"code": "5321171", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 408.0, "discounted_cash": 306.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HYALURON HYLGN PER DS IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7321", "type": "HCPCS"}, {"code": "5321171", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 408.0, "discounted_cash": 306.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HYALURON ORTHV PER DS IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7324", "type": "HCPCS"}, {"code": "5321176", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1027.0, "discounted_cash": 770.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HYALURON ORTHV PER DS IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7324", "type": "HCPCS"}, {"code": "5321176", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1027.0, "discounted_cash": 770.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HYALURON SUPRZ PER DS IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7321", "type": "HCPCS"}, {"code": "5321172", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2500.0, "discounted_cash": 1875.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HYALURON SUPRZ PER DS IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7321", "type": "HCPCS"}, {"code": "5321172", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 2500.0, "discounted_cash": 1875.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HYALURON SYNVS PER 1MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7325", "type": "HCPCS"}, {"code": "5321167", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 158.0, "discounted_cash": 118.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HYALURON SYNVS PER 1MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7325", "type": "HCPCS"}, {"code": "5321167", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 158.0, "discounted_cash": 118.5, "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": 286.0, "discounted_cash": 214.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HYALURONIDASE RECOMB 1U", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3473", "type": "HCPCS"}, {"code": "5321201", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HYALURONIDASE RECOMB 1U", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3473", "type": "HCPCS"}, {"code": "5321201", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "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": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDRALAZINE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305672", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "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": 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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDRALAZINE UPTO 20MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0360", "type": "HCPCS"}, {"code": "5321202", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 591.0, "discounted_cash": 443.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDRALAZINE UPTO 20MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0360", "type": "HCPCS"}, {"code": "5321202", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 591.0, "discounted_cash": 443.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDRALZN/ISORB37.5/20 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306190", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 87.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDRALZN/ISORB37.5/20 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306190", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 87.75, "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": 16.0, "discounted_cash": 12.0, "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": 16.0, "discounted_cash": 12.0, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 14.0, "discounted_cash": 10.5, "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": 14.0, "discounted_cash": 10.5, "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": 17.0, "discounted_cash": 12.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "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": 13.0, "discounted_cash": 9.75, "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": 13.0, "discounted_cash": 9.75, "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": 20.0, "discounted_cash": 15.0, "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": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROCOD/CPM 10MG/8MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327540", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROCOD/CPM 10MG/8MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327540", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "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": 70.0, "discounted_cash": 52.5, "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": 12.0, "discounted_cash": 9.0, "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": 12.0, "discounted_cash": 9.0, "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": 13.0, "discounted_cash": 9.75, "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": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROCOD/PSE 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327575", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROCOD/PSE 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327575", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "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": 16.0, "discounted_cash": 12.0, "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": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROCORTISONE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305742", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "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": 32.0, "discounted_cash": 24.0, "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": 0.82, "discounted_cash": 0.62, "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": 0.82, "discounted_cash": 0.62, "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": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROMORPHONE 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327587", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "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": 20.0, "discounted_cash": 15.0, "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": 20.0, "discounted_cash": 15.0, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROXYCHLOROQUN200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305788", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROXYUREA 200MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305810", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROXYUREA 200MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305810", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "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": 19.0, "discounted_cash": 14.25, "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": 19.0, "discounted_cash": 14.25, "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": 23.0, "discounted_cash": 17.25, "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": 23.0, "discounted_cash": 17.25, "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": 31.0, "discounted_cash": 23.25, "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": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROXYZINE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305835", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "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": 34.0, "discounted_cash": 25.5, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "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": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDROXYZINE UPTO25MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3410", "type": "HCPCS"}, {"code": "5321315", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDRXINDOL ACD5(HIAA)QT", "code_information": [{"code": "83497", "type": "CPT"}, {"code": "7003497", "type": "CDM"}], "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": "7253497", "type": "CDM"}], "standard_charges": [{"gross_charge": 432.0, "discounted_cash": 324.0, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDRXYPRGSTRONE 17-D", "code_information": [{"code": "83498", "type": "CPT"}, {"code": "7003498", "type": "CDM"}], "standard_charges": [{"gross_charge": 266.0, "discounted_cash": 199.5, "setting": "both", "billing_class": "facility"}]}, {"description": "HYDRXYPRGSTRONE 17-D/2", "code_information": [{"code": "83498", "type": "CPT"}, {"code": "7253498", "type": "CDM"}], "standard_charges": [{"gross_charge": 483.0, "discounted_cash": 362.25, "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": 17.0, "discounted_cash": 12.75, "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": 17.0, "discounted_cash": 12.75, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "HYOSCYAMINE.125MG/5MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315333", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYOSCYAMINE.125MG/5MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315333", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "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": 3061.0, "discounted_cash": 2295.75, "setting": "both", "billing_class": "facility"}]}, {"description": "HYSTEROSALPINGOGRAPHY", "code_information": [{"code": "74740", "type": "CPT"}, {"code": "5014740", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 3061.0, "discounted_cash": 2295.75, "setting": "both", "billing_class": "facility"}]}, {"description": "I 123 IOBENGUANE DOSE", "code_information": [{"code": "A4641", "type": "HCPCS"}, {"code": "5194641", "type": "CDM"}, {"code": "343", "type": "RC"}], "standard_charges": [{"gross_charge": 19522.0, "discounted_cash": 14641.5, "setting": "both", "billing_class": "facility"}]}, {"description": "I 123 SOD CAP PER 100UCI", "code_information": [{"code": "A9516", "type": "HCPCS"}, {"code": "5199516", "type": "CDM"}, {"code": "343", "type": "RC"}], "standard_charges": [{"gross_charge": 173.0, "discounted_cash": 129.75, "setting": "both", "billing_class": "facility"}]}, {"description": "I&D ABSCESS SIMP/SNGL", "code_information": [{"code": "4910060", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1065.0, "discounted_cash": 798.75, "setting": "both", "billing_class": "facility"}]}, {"description": "I&D ABSCESS SIMP/SNGL", "code_information": [{"code": "5050060", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1065.0, "discounted_cash": 798.75, "setting": "both", "billing_class": "facility"}]}, {"description": "I&D HEMA SEROMA FL", "code_information": [{"code": "5050140", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1749.0, "discounted_cash": 1311.75, "setting": "both", "billing_class": "facility"}]}, {"description": "I&D HEMA SEROMA FL", "code_information": [{"code": "5060010", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1749.0, "discounted_cash": 1311.75, "setting": "both", "billing_class": "facility"}]}, {"description": "I&D HEMA SEROMA FL", "code_information": [{"code": "6909896", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1749.0, "discounted_cash": 1311.75, "setting": "both", "billing_class": "facility"}]}, {"description": "I&D HEMA SEROMA FL", "code_information": [{"code": "6909896", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 1749.0, "discounted_cash": 1311.75, "setting": "both", "billing_class": "facility"}]}, {"description": "I-131 MIBG PER 0.5MCI", "code_information": [{"code": "A9508", "type": "HCPCS"}, {"code": "5192142", "type": "CDM"}, {"code": "343", "type": "RC"}], "standard_charges": [{"gross_charge": 10078.0, "discounted_cash": 7558.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IA INFECT AGENT AB QN NOS", "code_information": [{"code": "86317", "type": "CPT"}, {"code": "4176278", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 864.0, "discounted_cash": 648.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IA INFECT AGENT AB QN NOS", "code_information": [{"code": "86317", "type": "CPT"}, {"code": "7256072", "type": "CDM"}], "standard_charges": [{"gross_charge": 1100.0, "discounted_cash": 825.0, "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": 893.0, "discounted_cash": 669.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IA INFECT AGENT AB QN NOS/4", "code_information": [{"code": "86317", "type": "CPT"}, {"code": "7256315", "type": "CDM"}], "standard_charges": [{"gross_charge": 196.0, "discounted_cash": 147.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IA INFECT AGENT AB QN NOS/9", "code_information": [{"code": "86317", "type": "CPT"}, {"code": "7256617", "type": "CDM"}], "standard_charges": [{"gross_charge": 220.0, "discounted_cash": 165.0, "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": 584.0, "discounted_cash": 438.0, "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": 292.0, "discounted_cash": 219.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IA NFCT AB SARSCOV2 MULT", "code_information": [{"code": "86769", "type": "CPT"}, {"code": "4170007", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 230.0, "discounted_cash": 172.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IA NFCT AB SARSCOV2 MULT", "code_information": [{"code": "86769", "type": "CPT"}, {"code": "7250045", "type": "CDM"}], "standard_charges": [{"gross_charge": 216.0, "discounted_cash": 162.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IA NFCT AB SARSCOV2 MULT/2", "code_information": [{"code": "86769", "type": "CPT"}, {"code": "7250051", "type": "CDM"}], "standard_charges": [{"gross_charge": 216.0, "discounted_cash": 162.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IA NFCT AB SARSCOV2 MULT/3", "code_information": [{"code": "86769", "type": "CPT"}, {"code": "7250052", "type": "CDM"}], "standard_charges": [{"gross_charge": 216.0, "discounted_cash": 162.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IA NFCT AB SARSCOV2 MULT/4", "code_information": [{"code": "86769", "type": "CPT"}, {"code": "7250408", "type": "CDM"}], "standard_charges": [{"gross_charge": 268.0, "discounted_cash": 201.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IA TUMOR AG NES QUAN", "code_information": [{"code": "86316", "type": "CPT"}, {"code": "7002399", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 498.0, "discounted_cash": 373.5, "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": 432.0, "discounted_cash": 324.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IA TUMOR AG NES QUAN/5", "code_information": [{"code": "86316", "type": "CPT"}, {"code": "7258632", "type": "CDM"}], "standard_charges": [{"gross_charge": 276.0, "discounted_cash": 207.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IA TUMOR AG NES QUAN/7", "code_information": [{"code": "86316", "type": "CPT"}, {"code": "7006425", "type": "CDM"}], "standard_charges": [{"gross_charge": 656.0, "discounted_cash": 492.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IA TUMOR CA 125 QUAN", "code_information": [{"code": "86304", "type": "CPT"}, {"code": "4174904", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 514.0, "discounted_cash": 385.5, "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": 124.0, "discounted_cash": 93.0, "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": 653.0, "discounted_cash": 489.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IA TUMOR CA 15-3 QUAN", "code_information": [{"code": "86300", "type": "CPT"}, {"code": "4174902", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 302.0, "discounted_cash": 226.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IA TUMOR CA 15-3 QUAN", "code_information": [{"code": "86300", "type": "CPT"}, {"code": "7004898", "type": "CDM"}], "standard_charges": [{"gross_charge": 177.0, "discounted_cash": 132.75, "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": 384.0, "discounted_cash": 288.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IA TUMOR CA 15-3 QUAN/2", "code_information": [{"code": "86300", "type": "CPT"}, {"code": "4176300", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 577.0, "discounted_cash": 432.75, "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": 124.0, "discounted_cash": 93.0, "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": 734.0, "discounted_cash": 550.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IA TUMOR CA 19-9 QUAN", "code_information": [{"code": "86301", "type": "CPT"}, {"code": "4174900", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 526.0, "discounted_cash": 394.5, "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": 124.0, "discounted_cash": 93.0, "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": 668.0, "discounted_cash": 501.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IBANDRONATE 150MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305900", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IBANDRONATE 150MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305900", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2411.0, "discounted_cash": 1808.25, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 2411.0, "discounted_cash": 1808.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IBUPROFEN 100/5 120ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315336", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IBUPROFEN 100/5 120ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315336", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "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": 21.0, "discounted_cash": 15.75, "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": 21.0, "discounted_cash": 15.75, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IBUPROFEN 200MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5305909", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IBUPROFEN 600MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305919", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 10.0, "discounted_cash": 7.5, "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": 10.0, "discounted_cash": 7.5, "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": 13.0, "discounted_cash": 9.75, "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": 13.0, "discounted_cash": 9.75, "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": 4191.0, "discounted_cash": 3143.25, "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": 4191.0, "discounted_cash": 3143.25, "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": 16044.0, "discounted_cash": 12033.0, "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": 16044.0, "discounted_cash": 12033.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IEP OTHER SOURCE/3", "code_information": [{"code": "86325", "type": "CPT"}, {"code": "7006329", "type": "CDM"}], "standard_charges": [{"gross_charge": 216.0, "discounted_cash": 162.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IEP SERUM", "code_information": [{"code": "86320", "type": "CPT"}, {"code": "7006320", "type": "CDM"}], "standard_charges": [{"gross_charge": 216.0, "discounted_cash": 162.0, "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": 1074.0, "discounted_cash": 805.5, "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": 1074.0, "discounted_cash": 805.5, "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": 293.0, "discounted_cash": 219.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IG-E SERUM", "code_information": [{"code": "82785", "type": "CPT"}, {"code": "7003513", "type": "CDM"}], "standard_charges": [{"gross_charge": 143.0, "discounted_cash": 107.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IG-E SERUM", "code_information": [{"code": "82785", "type": "CPT"}, {"code": "7252780", "type": "CDM"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IG-E SERUM/3", "code_information": [{"code": "82785", "type": "CPT"}, {"code": "7253513", "type": "CDM"}], "standard_charges": [{"gross_charge": 123.0, "discounted_cash": 92.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IGF BINDING PROTEIN/3", "code_information": [{"code": "83519", "type": "CPT"}, {"code": "7002935", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 504.0, "discounted_cash": 378.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IGH VARIABLE MUTATION", "code_information": [{"code": "81263", "type": "CPT"}, {"code": "7270021", "type": "CDM"}], "standard_charges": [{"gross_charge": 1625.0, "discounted_cash": 1218.75, "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": 9093.0, "discounted_cash": 6819.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMATINIB 400MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305931", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1681.0, "discounted_cash": 1260.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMATINIB 400MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305931", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1681.0, "discounted_cash": 1260.75, "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": 7294.0, "discounted_cash": 5470.5, "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": 7294.0, "discounted_cash": 5470.5, "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": 4736.0, "discounted_cash": 3552.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMG CATH FLUID PERI/RETR", "code_information": [{"code": "5059406", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4801.0, "discounted_cash": 3600.75, "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": 5163.0, "discounted_cash": 3872.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMIPEN/CILA/RELEB PER 4/4/2 IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0742", "type": "HCPCS"}, {"code": "5321289", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMIPEN/CILA/RELEB PER 4/4/2 IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0742", "type": "HCPCS"}, {"code": "5321289", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "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": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "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": 10.0, "discounted_cash": 7.5, "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": 10.0, "discounted_cash": 7.5, "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": 23.0, "discounted_cash": 17.25, "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": 23.0, "discounted_cash": 17.25, "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": 28.0, "discounted_cash": 21.0, "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": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMM ADM EA ADDL VACCINE", "code_information": [{"code": "90472", "type": "CPT"}, {"code": "3100472", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 311.0, "discounted_cash": 233.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMM ADM EA ADDL VACCINE", "code_information": [{"code": "90472", "type": "CPT"}, {"code": "3110473", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 311.0, "discounted_cash": 233.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMM ADM EA ADDL VACCINE", "code_information": [{"code": "90472", "type": "CPT"}, {"code": "6103998", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 311.0, "discounted_cash": 233.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMM ADM EA ADDL VACCINE", "code_information": [{"code": "90472", "type": "CPT"}, {"code": "6160472", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 311.0, "discounted_cash": 233.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMM ADM EA ADDL VACCINE", "code_information": [{"code": "90472", "type": "CPT"}, {"code": "6290472", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 311.0, "discounted_cash": 233.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMM ADMIN SNGL/COMBO VAC", "code_information": [{"code": "90471", "type": "CPT"}, {"code": "3100471", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 220.0, "discounted_cash": 165.0, "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": 220.0, "discounted_cash": 165.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMM ADMIN SNGL/COMBO VAC", "code_information": [{"code": "90471", "type": "CPT"}, {"code": "4540471", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 220.0, "discounted_cash": 165.0, "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": 220.0, "discounted_cash": 165.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMM ADMIN SNGL/COMBO VAC", "code_information": [{"code": "90471", "type": "CPT"}, {"code": "6160471", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 220.0, "discounted_cash": 165.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMM ADMIN SNGL/COMBO VAC", "code_information": [{"code": "90471", "type": "CPT"}, {"code": "6290471", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 220.0, "discounted_cash": 165.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMCYT MLTIPLEX AB STAIN", "code_information": [{"code": "88344", "type": "CPT"}, {"code": "7098350", "type": "CDM"}], "standard_charges": [{"gross_charge": 1613.0, "discounted_cash": 1209.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNCYT 1ST AB PER SPEC", "code_information": [{"code": "88342", "type": "CPT"}, {"code": "4170044", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 696.0, "discounted_cash": 522.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNCYT 1ST AB PER SPEC", "code_information": [{"code": "88342", "type": "CPT"}, {"code": "4308314", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 885.0, "discounted_cash": 663.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNCYT 1ST AB PER SPEC", "code_information": [{"code": "88342", "type": "CPT"}, {"code": "7028340", "type": "CDM"}], "standard_charges": [{"gross_charge": 457.0, "discounted_cash": 342.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNCYT 1ST AB PER SPEC", "code_information": [{"code": "88342", "type": "CPT"}, {"code": "7078314", "type": "CDM"}], "standard_charges": [{"gross_charge": 799.0, "discounted_cash": 599.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNCYT 1ST AB PER SPEC", "code_information": [{"code": "88342", "type": "CPT"}, {"code": "7098342", "type": "CDM"}], "standard_charges": [{"gross_charge": 766.0, "discounted_cash": 574.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNCYT 1ST AB PER SPEC", "code_information": [{"code": "88342", "type": "CPT"}, {"code": "7270087", "type": "CDM"}], "standard_charges": [{"gross_charge": 995.0, "discounted_cash": 746.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNCYT 1ST AB PER SPEC/2", "code_information": [{"code": "88342", "type": "CPT"}, {"code": "7270138", "type": "CDM"}], "standard_charges": [{"gross_charge": 911.0, "discounted_cash": 683.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNE COMPLEX", "code_information": [{"code": "86332", "type": "CPT"}, {"code": "7003524", "type": "CDM"}], "standard_charges": [{"gross_charge": 774.0, "discounted_cash": 580.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOCYTO EA ADD AB STN", "code_information": [{"code": "88341", "type": "CPT"}, {"code": "4170043", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 640.0, "discounted_cash": 480.0, "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": 813.0, "discounted_cash": 609.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOCYTO EA ADD AB STN", "code_information": [{"code": "88341", "type": "CPT"}, {"code": "7098343", "type": "CDM"}], "standard_charges": [{"gross_charge": 177.0, "discounted_cash": 132.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOCYTO EA ADD AB STN", "code_information": [{"code": "88341", "type": "CPT"}, {"code": "7270086", "type": "CDM"}], "standard_charges": [{"gross_charge": 330.0, "discounted_cash": 247.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNODIFFUSION GEL QUAL/3", "code_information": [{"code": "86331", "type": "CPT"}, {"code": "7256346", "type": "CDM"}], "standard_charges": [{"gross_charge": 415.0, "discounted_cash": 311.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOFIX ELECTRO OTHER SR", "code_information": [{"code": "86335", "type": "CPT"}, {"code": "4176338", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 365.0, "discounted_cash": 273.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOFIX ELECTRO OTHER SR", "code_information": [{"code": "86335", "type": "CPT"}, {"code": "7256335", "type": "CDM"}], "standard_charges": [{"gross_charge": 464.0, "discounted_cash": 348.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOFIX ELECTRO OTHER SR/2", "code_information": [{"code": "86335", "type": "CPT"}, {"code": "7256337", "type": "CDM"}], "standard_charges": [{"gross_charge": 431.0, "discounted_cash": 323.25, "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": 467.0, "discounted_cash": 350.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOFIX ELECTRO SERUM", "code_information": [{"code": "86334", "type": "CPT"}, {"code": "4176334", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 150.0, "discounted_cash": 112.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOFIX ELECTRO SERUM", "code_information": [{"code": "86334", "type": "CPT"}, {"code": "7252785", "type": "CDM"}], "standard_charges": [{"gross_charge": 191.0, "discounted_cash": 143.25, "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": 559.0, "discounted_cash": 419.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOFLOR 1ST AB PER SPEC", "code_information": [{"code": "88346", "type": "CPT"}, {"code": "7008345", "type": "CDM"}], "standard_charges": [{"gross_charge": 516.0, "discounted_cash": 387.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOFLOR 1ST AB PER SPEC", "code_information": [{"code": "88346", "type": "CPT"}, {"code": "7098346", "type": "CDM"}], "standard_charges": [{"gross_charge": 766.0, "discounted_cash": 574.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOFLOR 1ST AB PER SPEC/2", "code_information": [{"code": "88346", "type": "CPT"}, {"code": "7018347", "type": "CDM"}], "standard_charges": [{"gross_charge": 1886.0, "discounted_cash": 1414.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOFLOR 1ST AB PER SPEC/2", "code_information": [{"code": "88346", "type": "CPT"}, {"code": "7078345", "type": "CDM"}], "standard_charges": [{"gross_charge": 1850.0, "discounted_cash": 1387.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOFLOR 1ST AB PER SPEC/2", "code_information": [{"code": "88346", "type": "CPT"}, {"code": "7258836", "type": "CDM"}], "standard_charges": [{"gross_charge": 1648.0, "discounted_cash": 1236.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOFLR AB ADDL STAIN", "code_information": [{"code": "88350", "type": "CPT"}, {"code": "7078351", "type": "CDM"}], "standard_charges": [{"gross_charge": 259.0, "discounted_cash": 194.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOFLR AB ADDL STAIN", "code_information": [{"code": "88350", "type": "CPT"}, {"code": "7098351", "type": "CDM"}], "standard_charges": [{"gross_charge": 215.0, "discounted_cash": 161.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOGLOB SUBCLASS EA", "code_information": [{"code": "82787", "type": "CPT"}, {"code": "7252788", "type": "CDM"}], "standard_charges": [{"gross_charge": 143.0, "discounted_cash": 107.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOGLOB SUBCLASS EA/2", "code_information": [{"code": "82787", "type": "CPT"}, {"code": "7002788", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 166.0, "discounted_cash": 124.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOGLOB SUBCLASS EA/2", "code_information": [{"code": "82787", "type": "CPT"}, {"code": "7252789", "type": "CDM"}], "standard_charges": [{"gross_charge": 143.0, "discounted_cash": 107.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOGLOB SUBCLASS EA/3", "code_information": [{"code": "82787", "type": "CPT"}, {"code": "7002789", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 166.0, "discounted_cash": 124.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOGLOB SUBCLASS EA/3", "code_information": [{"code": "82787", "type": "CPT"}, {"code": "7252790", "type": "CDM"}], "standard_charges": [{"gross_charge": 143.0, "discounted_cash": 107.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOGLOB SUBCLASS EA/4", "code_information": [{"code": "82787", "type": "CPT"}, {"code": "7002790", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 166.0, "discounted_cash": 124.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOGLOB SUBCLASS EA/4", "code_information": [{"code": "82787", "type": "CPT"}, {"code": "7252791", "type": "CDM"}], "standard_charges": [{"gross_charge": 143.0, "discounted_cash": 107.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMMUNOGLOB SUBCLASS EA/5", "code_information": [{"code": "82787", "type": "CPT"}, {"code": "7002791", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 166.0, "discounted_cash": 124.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP ACL TIGHTROPE RT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011189", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3136.0, "discounted_cash": 2352.0, "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": 2680.0, "discounted_cash": 2010.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP AMPLATZER PFO OCCLUD", "code_information": [{"code": "C1817", "type": "HCPCS"}, {"code": "8247000", "type": "CDM"}], "standard_charges": [{"gross_charge": 120230.0, "discounted_cash": 90172.5, "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": 1635.0, "discounted_cash": 1226.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BASE STM PLSM CTD TIB 16MM", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137743", "type": "CDM"}], "standard_charges": [{"gross_charge": 8467.0, "discounted_cash": 6350.25, "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": 27492.3, "discounted_cash": 20619.23, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BIOINTEGRATIVE TAPESTRY", "code_information": [{"code": "C1763", "type": "HCPCS"}, {"code": "4028481", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 26594.0, "discounted_cash": 19945.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BLN PRES REG", "code_information": [{"code": "C1815", "type": "HCPCS"}, {"code": "8172500", "type": "CDM"}], "standard_charges": [{"gross_charge": 20839.0, "discounted_cash": 15629.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BN CUBES", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132901", "type": "CDM"}], "standard_charges": [{"gross_charge": 733.0, "discounted_cash": 549.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BN DOWEL", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8132903", "type": "CDM"}], "standard_charges": [{"gross_charge": 9545.54, "discounted_cash": 7159.16, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BN FIBULA", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132906", "type": "CDM"}], "standard_charges": [{"gross_charge": 9033.0, "discounted_cash": 6774.75, "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": 3599.0, "discounted_cash": 2699.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BN MATRIX 1", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8132911", "type": "CDM"}], "standard_charges": [{"gross_charge": 3839.0, "discounted_cash": 2879.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BN MATRIX 2", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8132912", "type": "CDM"}], "standard_charges": [{"gross_charge": 8745.0, "discounted_cash": 6558.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BN MATRIX 3", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8132890", "type": "CDM"}], "standard_charges": [{"gross_charge": 12724.0, "discounted_cash": 9543.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BN MATRIX 4", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8132891", "type": "CDM"}], "standard_charges": [{"gross_charge": 12699.0, "discounted_cash": 9524.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BN MATRIX 5", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8132892", "type": "CDM"}], "standard_charges": [{"gross_charge": 16494.0, "discounted_cash": 12370.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BN MATRIX 6", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8132893", "type": "CDM"}], "standard_charges": [{"gross_charge": 13842.0, "discounted_cash": 10381.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BN MATRIX 8", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8132895", "type": "CDM"}], "standard_charges": [{"gross_charge": 19379.0, "discounted_cash": 14534.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BN SPACER", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132910", "type": "CDM"}], "standard_charges": [{"gross_charge": 12152.0, "discounted_cash": 9114.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BONE FIBERS SELECT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4023025", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3910.0, "discounted_cash": 2932.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BRIDGE SHORT W/LCKG POSTS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137007", "type": "CDM"}], "standard_charges": [{"gross_charge": 42955.0, "discounted_cash": 32216.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP BUSHGS/AXLE HINGE TRIATHLN", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137871", "type": "CDM"}], "standard_charges": [{"gross_charge": 16533.8, "discounted_cash": 12400.35, "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": 1107.0, "discounted_cash": 830.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP CLIP FALLOPIAN", "code_information": [{"code": "A4264", "type": "HCPCS"}, {"code": "8151998", "type": "CDM"}], "standard_charges": [{"gross_charge": 2390.0, "discounted_cash": 1792.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP COCHLEAR", "code_information": [{"code": "L8690", "type": "HCPCS"}, {"code": "8152004", "type": "CDM"}], "standard_charges": [{"gross_charge": 30117.0, "discounted_cash": 22587.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP COLLAGEN CONTIGEN BA", "code_information": [{"code": "L8603", "type": "HCPCS"}, {"code": "8247035", "type": "CDM"}], "standard_charges": [{"gross_charge": 4191.0, "discounted_cash": 3143.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP COMP FEM DIST RT SM STRYKR", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137713", "type": "CDM"}], "standard_charges": [{"gross_charge": 60137.0, "discounted_cash": 45102.75, "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": 10246.0, "discounted_cash": 7684.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP COUPLER OFFSET", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8132951", "type": "CDM"}], "standard_charges": [{"gross_charge": 14181.0, "discounted_cash": 10635.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP CRANIAL BONE PSI OSSDSIGN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4012017", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 115059.0, "discounted_cash": 86294.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP CRANIAL CUSTOM", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "4022994", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 108946.0, "discounted_cash": 81709.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP CUFF URIN SPHINCTER", "code_information": [{"code": "C1815", "type": "HCPCS"}, {"code": "8151993", "type": "CDM"}], "standard_charges": [{"gross_charge": 41495.0, "discounted_cash": 31121.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP CUP RVRS HUM PE/TA6V HMLCK", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8136706", "type": "CDM"}], "standard_charges": [{"gross_charge": 9776.0, "discounted_cash": 7332.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP END CAP SPINAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132921", "type": "CDM"}], "standard_charges": [{"gross_charge": 512.0, "discounted_cash": 384.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP FEM AUGMENT REVISN POST", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8139901", "type": "CDM"}], "standard_charges": [{"gross_charge": 10218.0, "discounted_cash": 7663.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP FEM DIS AUGMNT 10MM SZ6", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137755", "type": "CDM"}], "standard_charges": [{"gross_charge": 9727.0, "discounted_cash": 7295.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP FEM DISTAL AUG PSN ZIMMER", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137544", "type": "CDM"}], "standard_charges": [{"gross_charge": 11547.0, "discounted_cash": 8660.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP FEM NAIL ADV RETROGRADE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137555", "type": "CDM"}], "standard_charges": [{"gross_charge": 14109.0, "discounted_cash": 10581.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP FEM POST AUG PSN ZIMMER", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137546", "type": "CDM"}], "standard_charges": [{"gross_charge": 11547.0, "discounted_cash": 8660.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP FEM TM CONE CNT SM ZIMMER", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8136416", "type": "CDM"}], "standard_charges": [{"gross_charge": 41202.0, "discounted_cash": 30901.5, "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": 30475.0, "discounted_cash": 22856.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP FOIL SHEET NYLON", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8152021", "type": "CDM"}], "standard_charges": [{"gross_charge": 477.0, "discounted_cash": 357.75, "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": 14991.0, "discounted_cash": 11243.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP GASTRO INTERNAL CLIP", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8174866", "type": "CDM"}], "standard_charges": [{"gross_charge": 2241.0, "discounted_cash": 1680.75, "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": 141665.0, "discounted_cash": 106248.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP GEN NSTIM ETERNA", "code_information": [{"code": "C1822", "type": "HCPCS"}, {"code": "4008466", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 185300.0, "discounted_cash": 138975.0, "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": 145444.0, "discounted_cash": 109083.0, "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": 11258.0, "discounted_cash": 8443.5, "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": 99018.0, "discounted_cash": 74263.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP GEN NSTIM N-RECHG2", "code_information": [{"code": "C1767", "type": "HCPCS"}, {"code": "8240235", "type": "CDM"}], "standard_charges": [{"gross_charge": 116170.0, "discounted_cash": 87127.5, "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": 207072.0, "discounted_cash": 155304.0, "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": 179403.0, "discounted_cash": 134552.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP GEN NSTIM RECHARGE", "code_information": [{"code": "C1820", "type": "HCPCS"}, {"code": "8241453", "type": "CDM"}], "standard_charges": [{"gross_charge": 16771.0, "discounted_cash": 12578.25, "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": 161113.0, "discounted_cash": 120834.75, "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": 174607.0, "discounted_cash": 130955.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP GEN NSTM RESTORESNSR", "code_information": [{"code": "C1820", "type": "HCPCS"}, {"code": "8174861", "type": "CDM"}], "standard_charges": [{"gross_charge": 147190.0, "discounted_cash": 110392.5, "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": 183202.0, "discounted_cash": 137401.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP GLENOID POLY W/PEG", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137404", "type": "CDM"}], "standard_charges": [{"gross_charge": 11506.0, "discounted_cash": 8629.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP HELICAL BLADE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132924", "type": "CDM"}], "standard_charges": [{"gross_charge": 7825.0, "discounted_cash": 5868.75, "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": 562.0, "discounted_cash": 421.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP HIP MODULAR CONE STRYKER", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137736", "type": "CDM"}], "standard_charges": [{"gross_charge": 37161.0, "discounted_cash": 27870.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP HOLE ELIM POSITV STOP APEX", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136431", "type": "CDM"}], "standard_charges": [{"gross_charge": 1330.0, "discounted_cash": 997.5, "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": 5181.0, "discounted_cash": 3885.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP JOINT TOE", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8240149", "type": "CDM"}], "standard_charges": [{"gross_charge": 17389.0, "discounted_cash": 13041.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP LCKING COVER SPINAL CAGE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136449", "type": "CDM"}], "standard_charges": [{"gross_charge": 545.0, "discounted_cash": 408.75, "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": 55368.0, "discounted_cash": 41526.0, "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": 8722.0, "discounted_cash": 6541.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP LD NSTIM", "code_information": [{"code": "C1778", "type": "HCPCS"}, {"code": "8240193", "type": "CDM"}], "standard_charges": [{"gross_charge": 32051.0, "discounted_cash": 24038.25, "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": 16160.0, "discounted_cash": 12120.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP LD NSTIM3", "code_information": [{"code": "C1778", "type": "HCPCS"}, {"code": "8241456", "type": "CDM"}], "standard_charges": [{"gross_charge": 33080.0, "discounted_cash": 24810.0, "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": 18835.0, "discounted_cash": 14126.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP LOAD EYELID GOLD", "code_information": [{"code": "A4649", "type": "HCPCS"}, {"code": "8182895", "type": "CDM"}], "standard_charges": [{"gross_charge": 4159.0, "discounted_cash": 3119.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP MAGNET FOR BIM400", "code_information": [{"code": "L8690", "type": "HCPCS"}, {"code": "8124999", "type": "CDM"}], "standard_charges": [{"gross_charge": 30179.0, "discounted_cash": 22634.25, "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": 7980.0, "discounted_cash": 5985.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP MENISCAL SYS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132919", "type": "CDM"}], "standard_charges": [{"gross_charge": 5154.0, "discounted_cash": 3865.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP MESH", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8240199", "type": "CDM"}], "standard_charges": [{"gross_charge": 3599.0, "discounted_cash": 2699.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP MESH TITAN 2", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4028499", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11507.0, "discounted_cash": 8630.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP MONITOR CARDIAC", "code_information": [{"code": "C1764", "type": "HCPCS"}, {"code": "4008505", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 22408.0, "discounted_cash": 16806.0, "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": 45780.0, "discounted_cash": 34335.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP MONITR CARD BIOMNTR2", "code_information": [{"code": "C1764", "type": "HCPCS"}, {"code": "4008506", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 52484.0, "discounted_cash": 39363.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP MONITR CARD BIOMNTR3", "code_information": [{"code": "C1764", "type": "HCPCS"}, {"code": "4008525", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 35115.0, "discounted_cash": 26336.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP MONITR CARD INS LUXDX M301", "code_information": [{"code": "C1764", "type": "HCPCS"}, {"code": "4008530", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 50522.0, "discounted_cash": 37891.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP MONTR CRD BIOMNTR3M 450218", "code_information": [{"code": "C1764", "type": "HCPCS"}, {"code": "4008531", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 47995.0, "discounted_cash": 35996.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP MSH TIT MEDPOR", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4028503", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12549.0, "discounted_cash": 9411.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP NAIL CAP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132946", "type": "CDM"}], "standard_charges": [{"gross_charge": 2809.0, "discounted_cash": 2106.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP NAIL FIBULAR", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132611", "type": "CDM"}], "standard_charges": [{"gross_charge": 32186.0, "discounted_cash": 24139.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP NAIL TRIMMABLE FIXATION", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136461", "type": "CDM"}], "standard_charges": [{"gross_charge": 18487.0, "discounted_cash": 13865.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP NAIL TROCH CANN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132949", "type": "CDM"}], "standard_charges": [{"gross_charge": 11619.0, "discounted_cash": 8714.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP NAIL TROCHANTER", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132927", "type": "CDM"}], "standard_charges": [{"gross_charge": 16359.0, "discounted_cash": 12269.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP NASAL LATERA ABSORB", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8174865", "type": "CDM"}], "standard_charges": [{"gross_charge": 13687.0, "discounted_cash": 10265.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP NSTIM ELECTRODE EA", "code_information": [{"code": "L8680", "type": "HCPCS"}, {"code": "4008510", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 0.01, "discounted_cash": 0.01, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP NSTIM GEN DL N-RECHG", "code_information": [{"code": "L8688", "type": "HCPCS"}, {"code": "4008514", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 0.01, "discounted_cash": 0.01, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP NSTIM GEN DL RECHRG", "code_information": [{"code": "L8687", "type": "HCPCS"}, {"code": "4008513", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 0.01, "discounted_cash": 0.01, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP NSTIM GEN SGL N-RECH", "code_information": [{"code": "C1767", "type": "HCPCS"}, {"code": "4008512", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 0.01, "discounted_cash": 0.01, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP NSTIM GEN SGL RECHRG", "code_information": [{"code": "L8685", "type": "HCPCS"}, {"code": "4008511", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 0.01, "discounted_cash": 0.01, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP NSTIM PRECISION MONTAGE", "code_information": [{"code": "C1820", "type": "HCPCS"}, {"code": "4008522", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 180602.0, "discounted_cash": 135451.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP NSTM ELEC ARRAY", "code_information": [{"code": "4913650", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 16613.0, "discounted_cash": 12459.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP OFFSET ADAPTER", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137579", "type": "CDM"}], "standard_charges": [{"gross_charge": 25266.0, "discounted_cash": 18949.5, "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": 16895.0, "discounted_cash": 12671.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PEG METAGLENE DELTA XTEND", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136475", "type": "CDM"}], "standard_charges": [{"gross_charge": 16939.0, "discounted_cash": 12704.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PEG SMOOTH", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8241459", "type": "CDM"}], "standard_charges": [{"gross_charge": 2226.0, "discounted_cash": 1669.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PEG THREAD/UNTHREADED", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8241458", "type": "CDM"}], "standard_charges": [{"gross_charge": 985.92, "discounted_cash": 739.44, "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": 20365.0, "discounted_cash": 15273.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PLATE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8240213", "type": "CDM"}], "standard_charges": [{"gross_charge": 8533.0, "discounted_cash": 6399.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PLATE STRAIGHT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132930", "type": "CDM"}], "standard_charges": [{"gross_charge": 6369.0, "discounted_cash": 4776.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PLT ORBITAL FLOOR", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8152015", "type": "CDM"}], "standard_charges": [{"gross_charge": 13454.0, "discounted_cash": 10090.5, "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": 41495.0, "discounted_cash": 31121.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PMP INF SYNCHROMED", "code_information": [{"code": "C1772", "type": "HCPCS"}, {"code": "8241468", "type": "CDM"}], "standard_charges": [{"gross_charge": 126663.0, "discounted_cash": 94997.25, "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": 75557.0, "discounted_cash": 56667.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP POCKET ADPTR SPINAL", "code_information": [{"code": "C1883", "type": "HCPCS"}, {"code": "4000362", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12424.0, "discounted_cash": 9318.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PORT INDWELLING", "code_information": [{"code": "C1788", "type": "HCPCS"}, {"code": "8240201", "type": "CDM"}], "standard_charges": [{"gross_charge": 6296.0, "discounted_cash": 4722.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PORT INDWELLING 2", "code_information": [{"code": "C1788", "type": "HCPCS"}, {"code": "8241476", "type": "CDM"}], "standard_charges": [{"gross_charge": 7225.0, "discounted_cash": 5418.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP POST MODULAR AUG GLENOID", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137575", "type": "CDM"}], "standard_charges": [{"gross_charge": 13615.02, "discounted_cash": 10211.27, "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": 12485.0, "discounted_cash": 9363.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PROS URINARY SPHINCT", "code_information": [{"code": "C1815", "type": "HCPCS"}, {"code": "8240365", "type": "CDM"}], "standard_charges": [{"gross_charge": 19812.0, "discounted_cash": 14859.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PROSTHESIS BREAST", "code_information": [{"code": "C1789", "type": "HCPCS"}, {"code": "8240202", "type": "CDM"}], "standard_charges": [{"gross_charge": 11619.0, "discounted_cash": 8714.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PROXIMAL CONICAL BODY DPY", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8136427", "type": "CDM"}], "standard_charges": [{"gross_charge": 37861.0, "discounted_cash": 28395.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP PRT POWERPORT", "code_information": [{"code": "C1788", "type": "HCPCS"}, {"code": "4028504", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5715.0, "discounted_cash": 4286.25, "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": 43425.0, "discounted_cash": 32568.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP RESER 65ML", "code_information": [{"code": "C1813", "type": "HCPCS"}, {"code": "8155030", "type": "CDM"}], "standard_charges": [{"gross_charge": 21642.0, "discounted_cash": 16231.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP RETROBUTTON ACL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4023010", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4638.0, "discounted_cash": 3478.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP SAPH VEIN CRYO PRES", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8132933", "type": "CDM"}], "standard_charges": [{"gross_charge": 83710.0, "discounted_cash": 62782.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP SCAFFLD ARTHRO", "code_information": [{"code": "C1763", "type": "HCPCS"}, {"code": "4022987", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 21254.0, "discounted_cash": 15940.5, "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": 654.0, "discounted_cash": 490.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP SCREW TAP GLOBUS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132664", "type": "CDM"}], "standard_charges": [{"gross_charge": 4385.0, "discounted_cash": 3288.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP SCRW BIOTENODESIS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4012550", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4392.0, "discounted_cash": 3294.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP SCRW CORTICAL FT 4.5", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8247157", "type": "CDM"}], "standard_charges": [{"gross_charge": 2576.0, "discounted_cash": 1932.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP SCRW SET STRL TULIP HDS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136062", "type": "CDM"}], "standard_charges": [{"gross_charge": 3286.38, "discounted_cash": 2464.79, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP SHEET MEDPOR MCROTHN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4028518", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5151.0, "discounted_cash": 3863.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP SHELL ACETABULAR EMPHASYS", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8139920", "type": "CDM"}], "standard_charges": [{"gross_charge": 9211.0, "discounted_cash": 6908.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP SINUS STEROID RELEAS", "code_information": [{"code": "C2625", "type": "HCPCS"}, {"code": "8122944", "type": "CDM"}], "standard_charges": [{"gross_charge": 9842.0, "discounted_cash": 7381.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP SLV FEMORAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132935", "type": "CDM"}], "standard_charges": [{"gross_charge": 27157.0, "discounted_cash": 20367.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP SPACER CATALYFT", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8137865", "type": "CDM"}], "standard_charges": [{"gross_charge": 51174.0, "discounted_cash": 38380.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP SPACER CERVICAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137739", "type": "CDM"}], "standard_charges": [{"gross_charge": 9058.0, "discounted_cash": 6793.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP SPACER HUMERAL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137860", "type": "CDM"}], "standard_charges": [{"gross_charge": 5341.0, "discounted_cash": 4005.75, "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": 12549.0, "discounted_cash": 9411.75, "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": 40939.0, "discounted_cash": 30704.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP SPACER SHLDR HUMERAL FX", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137748", "type": "CDM"}], "standard_charges": [{"gross_charge": 3888.0, "discounted_cash": 2916.0, "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": 10628.0, "discounted_cash": 7971.0, "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": 23364.0, "discounted_cash": 17523.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP STEM DISTAL TAPERED DPY", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8136428", "type": "CDM"}], "standard_charges": [{"gross_charge": 33161.0, "discounted_cash": 24870.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP STEM EXTENDER STRYKER", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137735", "type": "CDM"}], "standard_charges": [{"gross_charge": 22337.0, "discounted_cash": 16752.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP STEM MD CONICAL DST", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137583", "type": "CDM"}], "standard_charges": [{"gross_charge": 26628.0, "discounted_cash": 19971.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP SYNTHETIC URINARY1ML", "code_information": [{"code": "L8606", "type": "HCPCS"}, {"code": "8130040", "type": "CDM"}], "standard_charges": [{"gross_charge": 8723.0, "discounted_cash": 6542.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP SYS CARDIOSL OCCLDR", "code_information": [{"code": "C1817", "type": "HCPCS"}, {"code": "8241490", "type": "CDM"}], "standard_charges": [{"gross_charge": 73091.0, "discounted_cash": 54818.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP SYS SEPTAL DEFECT IC", "code_information": [{"code": "C1817", "type": "HCPCS"}, {"code": "8240205", "type": "CDM"}], "standard_charges": [{"gross_charge": 85162.0, "discounted_cash": 63871.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP SYS SPN DECOMPRESS", "code_information": [{"code": "C1821", "type": "HCPCS"}, {"code": "4012630", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 86994.0, "discounted_cash": 65245.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP TACK PLLA BANKART", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8247190", "type": "CDM"}], "standard_charges": [{"gross_charge": 493.0, "discounted_cash": 369.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP TENDON ACHILLES", "code_information": [{"code": "C1762", "type": "HCPCS"}, {"code": "8132942", "type": "CDM"}], "standard_charges": [{"gross_charge": 17184.88, "discounted_cash": 12888.66, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP TENDON GRACILIS", "code_information": [{"code": "C1762", "type": "HCPCS"}, {"code": "8137704", "type": "CDM"}], "standard_charges": [{"gross_charge": 14116.0, "discounted_cash": 10587.0, "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": 17924.0, "discounted_cash": 13443.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP TENDON SEMI-TENDNSIS", "code_information": [{"code": "C1762", "type": "HCPCS"}, {"code": "8137705", "type": "CDM"}], "standard_charges": [{"gross_charge": 14110.0, "discounted_cash": 10582.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP TENDON TIBIALIS", "code_information": [{"code": "C1762", "type": "HCPCS"}, {"code": "8132948", "type": "CDM"}], "standard_charges": [{"gross_charge": 14007.0, "discounted_cash": 10505.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP THYROPLASTY", "code_information": [{"code": "C1878", "type": "HCPCS"}, {"code": "4023090", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8156.0, "discounted_cash": 6117.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP TIB BASEPLATE INSERT MED", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137759", "type": "CDM"}], "standard_charges": [{"gross_charge": 27853.0, "discounted_cash": 20889.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP TIB FX NONPOROUS ZIM", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137542", "type": "CDM"}], "standard_charges": [{"gross_charge": 27605.0, "discounted_cash": 20703.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP TIB PSN HLF BLK ZIM", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8136403", "type": "CDM"}], "standard_charges": [{"gross_charge": 11547.0, "discounted_cash": 8660.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP TIBIAL AUGMENT TRIATHLON", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137873", "type": "CDM"}], "standard_charges": [{"gross_charge": 14552.0, "discounted_cash": 10914.0, "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": 27853.0, "discounted_cash": 20889.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP TIBIAL CNE TRABECULINK SM", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137730", "type": "CDM"}], "standard_charges": [{"gross_charge": 55490.0, "discounted_cash": 41617.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP TIBIAL COMP CEMNTLSS", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137706", "type": "CDM"}], "standard_charges": [{"gross_charge": 34920.0, "discounted_cash": 26190.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP TIBIAL ROTATING STRYKER", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137711", "type": "CDM"}], "standard_charges": [{"gross_charge": 24927.0, "discounted_cash": 18695.25, "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": 4331.0, "discounted_cash": 3248.25, "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": 31670.0, "discounted_cash": 23752.5, "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": 18863.0, "discounted_cash": 14147.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP U COLLAGEN 2.5CC", "code_information": [{"code": "L8603", "type": "HCPCS"}, {"code": "8152039", "type": "CDM"}], "standard_charges": [{"gross_charge": 6957.0, "discounted_cash": 5217.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP ULNAR HEAD PARTIAL STEM", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012655", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 51008.0, "discounted_cash": 38256.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMP WEDGE", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8152025", "type": "CDM"}], "standard_charges": [{"gross_charge": 9000.0, "discounted_cash": 6750.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IMPL LOOP RCDR", "code_information": [{"code": "C1764", "type": "HCPCS"}, {"code": "8152018", "type": "CDM"}], "standard_charges": [{"gross_charge": 44601.0, "discounted_cash": 33450.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMPL ORBITAL FLOOR", "code_information": [{"code": "L8610", "type": "HCPCS"}, {"code": "8152010", "type": "CDM"}], "standard_charges": [{"gross_charge": 12337.0, "discounted_cash": 9252.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IMPL SUTURE ANCHOR", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8152038", "type": "CDM"}], "standard_charges": [{"gross_charge": 1790.0, "discounted_cash": 1342.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IMPLANT SPACER", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012604", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 58081.0, "discounted_cash": 43560.75, "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": 2910.0, "discounted_cash": 2182.5, "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": 8267.0, "discounted_cash": 6200.25, "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": 4753.0, "discounted_cash": 3564.75, "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": 2363.0, "discounted_cash": 1772.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IN SITU EA PRB PER SPEC", "code_information": [{"code": "88365", "type": "CPT"}, {"code": "7270092", "type": "CDM"}], "standard_charges": [{"gross_charge": 911.0, "discounted_cash": 683.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IN SITU EA PRB PER SPEC/2", "code_information": [{"code": "88365", "type": "CPT"}, {"code": "7098352", "type": "CDM"}], "standard_charges": [{"gross_charge": 766.0, "discounted_cash": 574.5, "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": 6789.0, "discounted_cash": 5091.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INCISIONAL BX SKIN SGL LES", "code_information": [{"code": "6901108", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3578.0, "discounted_cash": 2683.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INCISIONAL BX SKIN SGL LES", "code_information": [{"code": "6901108", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 3578.0, "discounted_cash": 2683.5, "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": 23.0, "discounted_cash": 17.25, "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": 23.0, "discounted_cash": 17.25, "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": 12327.0, "discounted_cash": 9245.25, "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": 10.0, "discounted_cash": 7.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INDAPAMIDE 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5305977", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 10.0, "discounted_cash": 7.5, "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": 74.0, "discounted_cash": 55.5, "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": 74.0, "discounted_cash": 55.5, "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": 4733.0, "discounted_cash": 3549.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INDOCYANINE GRN 25MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321337", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 735.0, "discounted_cash": 551.25, "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": 755.0, "discounted_cash": 566.25, "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": 755.0, "discounted_cash": 566.25, "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": 1271.0, "discounted_cash": 953.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "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": 3.0, "discounted_cash": 2.25, "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": 12.0, "discounted_cash": 9.0, "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": 12.0, "discounted_cash": 9.0, "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": 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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "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": 117.0, "discounted_cash": 87.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 87.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INDOMETHACIN NEO CMPD IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5321303", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1271.0, "discounted_cash": 953.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INDOMETHACIN NEO CMPD IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5321303", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1271.0, "discounted_cash": 953.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INFANT HEAD ECHO", "code_information": [{"code": "76506", "type": "CPT"}, {"code": "5066828", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1220.0, "discounted_cash": 915.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFANT HEAD ECHO", "code_information": [{"code": "76506", "type": "CPT"}, {"code": "5120007", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1220.0, "discounted_cash": 915.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT DRUG SUSCEPT", "code_information": [{"code": "87900", "type": "CPT"}, {"code": "7257909", "type": "CDM"}], "standard_charges": [{"gross_charge": 1090.0, "discounted_cash": 817.5, "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": 1114.0, "discounted_cash": 835.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS AMP PRB", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "4177799", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 313.0, "discounted_cash": 234.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS AMP PRB", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "7257821", "type": "CDM"}], "standard_charges": [{"gross_charge": 398.0, "discounted_cash": 298.5, "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": 1102.0, "discounted_cash": 826.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS AMP PRB/12", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "7007793", "type": "CDM"}], "standard_charges": [{"gross_charge": 385.0, "discounted_cash": 288.75, "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": 398.0, "discounted_cash": 298.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS AMP PRB/18", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "4107799", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 455.0, "discounted_cash": 341.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS AMP PRB/21", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "7258798", "type": "CDM"}], "standard_charges": [{"gross_charge": 222.0, "discounted_cash": 166.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS AMP PRB/23", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "4107811", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 455.0, "discounted_cash": 341.25, "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": 716.0, "discounted_cash": 537.0, "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": 752.0, "discounted_cash": 564.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS AMP PRB/38", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "7258778", "type": "CDM"}], "standard_charges": [{"gross_charge": 1236.0, "discounted_cash": 927.0, "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": 834.0, "discounted_cash": 625.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS AMP PRB/44", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "7257662", "type": "CDM"}], "standard_charges": [{"gross_charge": 347.0, "discounted_cash": 260.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS AMP PRB/46", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "7257805", "type": "CDM"}], "standard_charges": [{"gross_charge": 2518.0, "discounted_cash": 1888.5, "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": 1156.0, "discounted_cash": 867.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS AMP PRB/49", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "7257813", "type": "CDM"}], "standard_charges": [{"gross_charge": 166.0, "discounted_cash": 124.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS AMP PRB/5", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "4177806", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 563.0, "discounted_cash": 422.25, "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": 716.0, "discounted_cash": 537.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS AMP PRB/50", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "7257798", "type": "CDM"}], "standard_charges": [{"gross_charge": 938.0, "discounted_cash": 703.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS AMP PRB/6", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "7007798", "type": "CDM"}], "standard_charges": [{"gross_charge": 2626.0, "discounted_cash": 1969.5, "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": 194.0, "discounted_cash": 145.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS AMP PRB/8", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "4177798", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 563.0, "discounted_cash": 422.25, "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": 716.0, "discounted_cash": 537.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS DIR OPT", "code_information": [{"code": "87899", "type": "CPT"}, {"code": "4107891", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 89.0, "discounted_cash": 66.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS DIR OPT", "code_information": [{"code": "87899", "type": "CPT"}, {"code": "4177898", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS DIR OPT", "code_information": [{"code": "87899", "type": "CPT"}, {"code": "7257907", "type": "CDM"}], "standard_charges": [{"gross_charge": 101.0, "discounted_cash": 75.75, "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": 213.0, "discounted_cash": 159.75, "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": 247.0, "discounted_cash": 185.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS DIR OPT/16", "code_information": [{"code": "87899", "type": "CPT"}, {"code": "4107909", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 247.0, "discounted_cash": 185.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS DIR OPT/2", "code_information": [{"code": "87899", "type": "CPT"}, {"code": "4108789", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 213.0, "discounted_cash": 159.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS DIR OPT/2", "code_information": [{"code": "87899", "type": "CPT"}, {"code": "4177009", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 168.0, "discounted_cash": 126.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS DIR OPT/3", "code_information": [{"code": "87899", "type": "CPT"}, {"code": "4177008", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 179.0, "discounted_cash": 134.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS DIR OPT/4", "code_information": [{"code": "87899", "type": "CPT"}, {"code": "4178799", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 179.0, "discounted_cash": 134.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS DIR OPT/4", "code_information": [{"code": "87899", "type": "CPT"}, {"code": "7257920", "type": "CDM"}], "standard_charges": [{"gross_charge": 82.0, "discounted_cash": 61.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS DIR OPT/7", "code_information": [{"code": "87899", "type": "CPT"}, {"code": "4106413", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 89.0, "discounted_cash": 66.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS QUANT", "code_information": [{"code": "87799", "type": "CPT"}, {"code": "7000010", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 2339.0, "discounted_cash": 1754.25, "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": 2339.0, "discounted_cash": 1754.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECT AGNT NOS QUANT/3", "code_information": [{"code": "87799", "type": "CPT"}, {"code": "7006234", "type": "CDM"}], "standard_charges": [{"gross_charge": 2626.0, "discounted_cash": 1969.5, "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": 1638.0, "discounted_cash": 1228.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECTIOUS AGNT NOS IA", "code_information": [{"code": "87449", "type": "CPT"}, {"code": "4107449", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 65.0, "discounted_cash": 48.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECTIOUS AGNT NOS IA", "code_information": [{"code": "87449", "type": "CPT"}, {"code": "4177221", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECTIOUS AGNT NOS IA", "code_information": [{"code": "87449", "type": "CPT"}, {"code": "7257449", "type": "CDM"}], "standard_charges": [{"gross_charge": 464.0, "discounted_cash": 348.0, "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": 99.0, "discounted_cash": 74.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECTIOUS AGNT NOS IA/2", "code_information": [{"code": "87449", "type": "CPT"}, {"code": "4177456", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 324.0, "discounted_cash": 243.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECTIOUS AGNT NOS IA/2", "code_information": [{"code": "87449", "type": "CPT"}, {"code": "7007912", "type": "CDM"}], "standard_charges": [{"gross_charge": 300.0, "discounted_cash": 225.0, "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": 412.0, "discounted_cash": 309.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECTIOUS AGNT NOS IA/3", "code_information": [{"code": "87449", "type": "CPT"}, {"code": "7257455", "type": "CDM"}], "standard_charges": [{"gross_charge": 161.0, "discounted_cash": 120.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECTIOUS AGNT NOS IA/4", "code_information": [{"code": "87449", "type": "CPT"}, {"code": "4107912", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECTIOUS AGNT NOS IA/4", "code_information": [{"code": "87449", "type": "CPT"}, {"code": "4177448", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFECTIOUS AGNT NOS IA/5", "code_information": [{"code": "87449", "type": "CPT"}, {"code": "4176938", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 608.0, "discounted_cash": 456.0, "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": 774.0, "discounted_cash": 580.5, "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": 4093.0, "discounted_cash": 3069.75, "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": 4093.0, "discounted_cash": 3069.75, "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": 495.0, "discounted_cash": 371.25, "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": 495.0, "discounted_cash": 371.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLIXIMAB/3", "code_information": [{"code": "80230", "type": "CPT"}, {"code": "7250321", "type": "CDM"}], "standard_charges": [{"gross_charge": 735.0, "discounted_cash": 551.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLU EA ADD TYPE/SUB", "code_information": [{"code": "87503", "type": "CPT"}, {"code": "4107503", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 541.0, "discounted_cash": 405.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA 1ST 2 TYPE/SUB", "code_information": [{"code": "87502", "type": "CPT"}, {"code": "4107502", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1898.0, "discounted_cash": 1423.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA A DFA", "code_information": [{"code": "87276", "type": "CPT"}, {"code": "4177276", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA A DFA", "code_information": [{"code": "87276", "type": "CPT"}, {"code": "7007276", "type": "CDM"}], "standard_charges": [{"gross_charge": 275.0, "discounted_cash": 206.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA A DFA", "code_information": [{"code": "87276", "type": "CPT"}, {"code": "7257276", "type": "CDM"}], "standard_charges": [{"gross_charge": 114.0, "discounted_cash": 85.5, "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": 481.0, "discounted_cash": 360.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA A/B IA", "code_information": [{"code": "87400", "type": "CPT"}, {"code": "4178347", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 378.0, "discounted_cash": 283.5, "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": 481.0, "discounted_cash": 360.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA A/B IA/2", "code_information": [{"code": "87400", "type": "CPT"}, {"code": "4177455", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 378.0, "discounted_cash": 283.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA B DFA", "code_information": [{"code": "87275", "type": "CPT"}, {"code": "4177275", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA B DFA", "code_information": [{"code": "87275", "type": "CPT"}, {"code": "7007275", "type": "CDM"}], "standard_charges": [{"gross_charge": 275.0, "discounted_cash": 206.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA B DFA", "code_information": [{"code": "87275", "type": "CPT"}, {"code": "7257275", "type": "CDM"}], "standard_charges": [{"gross_charge": 114.0, "discounted_cash": 85.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA DIR OPT", "code_information": [{"code": "87804", "type": "CPT"}, {"code": "4107804", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 114.0, "discounted_cash": 85.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA DIR OPT", "code_information": [{"code": "87804", "type": "CPT"}, {"code": "4177804", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA DIR OPT/2", "code_information": [{"code": "87804", "type": "CPT"}, {"code": "4107805", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 114.0, "discounted_cash": 85.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA DIR OPT/2", "code_information": [{"code": "87804", "type": "CPT"}, {"code": "4177805", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "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": 261.0, "discounted_cash": 195.75, "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": 261.0, "discounted_cash": 195.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA VACC ADMIN", "code_information": [{"code": "G0008", "type": "HCPCS"}, {"code": "6290008", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 261.0, "discounted_cash": 195.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA VIRUS AB", "code_information": [{"code": "86710", "type": "CPT"}, {"code": "7006197", "type": "CDM"}], "standard_charges": [{"gross_charge": 190.0, "discounted_cash": 142.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA VIRUS AB/2", "code_information": [{"code": "86710", "type": "CPT"}, {"code": "7006207", "type": "CDM"}], "standard_charges": [{"gross_charge": 262.0, "discounted_cash": 196.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA VIRUS AB/2", "code_information": [{"code": "86710", "type": "CPT"}, {"code": "7256207", "type": "CDM"}], "standard_charges": [{"gross_charge": 283.0, "discounted_cash": 212.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INFLUENZA VIRUS AB/3", "code_information": [{"code": "86710", "type": "CPT"}, {"code": "7256208", "type": "CDM"}], "standard_charges": [{"gross_charge": 283.0, "discounted_cash": 212.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INHOUSE TRAUMA III-FL TM", "code_information": [{"code": "6119021", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 15094.0, "discounted_cash": 11320.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INHOUSE TRAUMA III-PT TM", "code_information": [{"code": "6119022", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 12415.0, "discounted_cash": 9311.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INHOUSE TRAUMA III-SM TM", "code_information": [{"code": "6119023", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 9736.0, "discounted_cash": 7302.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INIT CHEMO >8 PORT/PMP", "code_information": [{"code": "96416", "type": "CPT"}, {"code": "4546416", "type": "CDM"}, {"code": "335", "type": "RC"}], "standard_charges": [{"gross_charge": 1004.0, "discounted_cash": 753.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INIT INF >8 PORT/PMP", "code_information": [{"code": "C8957", "type": "HCPCS"}, {"code": "4548957", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 824.0, "discounted_cash": 618.0, "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": 2955.0, "discounted_cash": 2216.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ ADD SEQUENTL IVP", "code_information": [{"code": "96375", "type": "CPT"}, {"code": "3100775", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 402.0, "discounted_cash": 301.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ ADD SEQUENTL IVP", "code_information": [{"code": "96375", "type": "CPT"}, {"code": "4540775", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 402.0, "discounted_cash": 301.5, "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": 402.0, "discounted_cash": 301.5, "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": 402.0, "discounted_cash": 301.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ ADD SEQUENTL IVP", "code_information": [{"code": "96375", "type": "CPT"}, {"code": "6290775", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 402.0, "discounted_cash": 301.5, "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": 1513.0, "discounted_cash": 1134.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ ANES PERIPH NERVE", "code_information": [{"code": "4916445", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3048.0, "discounted_cash": 2286.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ ANES SUP HYP PLEX", "code_information": [{"code": "4914517", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5100.0, "discounted_cash": 3825.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ ANESTH CERV/THOR SGL", "code_information": [{"code": "4902325", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3411.0, "discounted_cash": 2558.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ ANESTH CERV/THOR SGL", "code_information": [{"code": "4912313", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3411.0, "discounted_cash": 2558.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ ANESTH LUMB/CAUD SGL", "code_information": [{"code": "4902327", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3544.0, "discounted_cash": 2658.0, "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": 3544.0, "discounted_cash": 2658.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ ANKLE ARTHROGRAM", "code_information": [{"code": "4907605", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 541.0, "discounted_cash": 405.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ ANKLE ARTHROGRAM", "code_information": [{"code": "4917605", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 541.0, "discounted_cash": 405.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ ANTIBIOTIC IM", "code_information": [{"code": "96372", "type": "CPT"}, {"code": "4541636", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 255.0, "discounted_cash": 191.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ ANTIBIOTIC IM", "code_information": [{"code": "96372", "type": "CPT"}, {"code": "4541636", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 255.0, "discounted_cash": 191.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ ANTIBIOTIC IM", "code_information": [{"code": "96372", "type": "CPT"}, {"code": "6100788", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 255.0, "discounted_cash": 191.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ BLADDER RETRO UR", "code_information": [{"code": "4907620", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2178.0, "discounted_cash": 1633.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ BLADDER RETRO UR", "code_information": [{"code": "4917620", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2178.0, "discounted_cash": 1633.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ BULK AGNT URIN 2.5ML", "code_information": [{"code": "L8603", "type": "HCPCS"}, {"code": "8247230", "type": "CDM"}], "standard_charges": [{"gross_charge": 6532.0, "discounted_cash": 4899.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ CELIAC PLEXUS NRV", "code_information": [{"code": "4917610", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5635.0, "discounted_cash": 4226.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ CELIAC PLEXUS NRV", "code_information": [{"code": "5057605", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5635.0, "discounted_cash": 4226.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ CHEMO ADD DRUG IVP", "code_information": [{"code": "96411", "type": "CPT"}, {"code": "4546411", "type": "CDM"}, {"code": "331", "type": "RC"}], "standard_charges": [{"gross_charge": 419.0, "discounted_cash": 314.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ CHEMO INIT DRUG IVP", "code_information": [{"code": "96409", "type": "CPT"}, {"code": "4546409", "type": "CDM"}, {"code": "331", "type": "RC"}], "standard_charges": [{"gross_charge": 444.0, "discounted_cash": 333.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ CM EVAL DTUBE", "code_information": [{"code": "4909466", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1518.0, "discounted_cash": 1138.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ CM EVAL GJTUBE", "code_information": [{"code": "4909468", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1651.0, "discounted_cash": 1238.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ CM EVAL GJTUBE", "code_information": [{"code": "4919468", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1651.0, "discounted_cash": 1238.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ CM EVAL GTUBE", "code_information": [{"code": "4909465", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1518.0, "discounted_cash": 1138.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ CM EVAL GTUBE", "code_information": [{"code": "4919465", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1394.0, "discounted_cash": 1045.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ CM EVAL JTUBE", "code_information": [{"code": "4909467", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1654.0, "discounted_cash": 1240.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ ELBOW ARTHROGRAM", "code_information": [{"code": "4907645", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 962.0, "discounted_cash": 721.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ EPID BLD PATCH", "code_information": [{"code": "4912273", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3367.0, "discounted_cash": 2525.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ EPID CERV/THORC", "code_information": [{"code": "4912298", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4018.0, "discounted_cash": 3013.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ EPID CERV/THORC", "code_information": [{"code": "5052310", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4018.0, "discounted_cash": 3013.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ EPID LUMB/CAUD", "code_information": [{"code": "4910404", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2468.0, "discounted_cash": 1851.0, "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": 524.0, "discounted_cash": 393.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ EVAL PREV PV SHUNT", "code_information": [{"code": "5209427", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1861.0, "discounted_cash": 1395.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ F/CYSTO OR VCUG", "code_information": [{"code": "4907615", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 409.0, "discounted_cash": 306.75, "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": 409.0, "discounted_cash": 306.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ GALACTO/DUCTO PROC", "code_information": [{"code": "5017630", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 639.0, "discounted_cash": 479.25, "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": 741.0, "discounted_cash": 555.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ HIP ARTHRO W/O ANES", "code_information": [{"code": "4917650", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 849.0, "discounted_cash": 636.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ INTERCOSTL NERV SNGL", "code_information": [{"code": "4912299", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3638.0, "discounted_cash": 2728.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ INTERCOSTL NRV EA ADDL LVL", "code_information": [{"code": "4914422", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4138.0, "discounted_cash": 3103.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ LUMB/CAUD EA ADD LVL", "code_information": [{"code": "4902328", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 858.0, "discounted_cash": 643.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ MYELOGRAM LUMBAR", "code_information": [{"code": "4907685", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2618.0, "discounted_cash": 1963.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ MYELOGRAM LUMBAR", "code_information": [{"code": "4917685", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2618.0, "discounted_cash": 1963.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ NEPHROGRM EXIS ACC", "code_information": [{"code": "4917665", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1940.0, "discounted_cash": 1455.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ NEPHROSTOGRAM", "code_information": [{"code": "4907665", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2950.0, "discounted_cash": 2212.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ NEPHROSTOGRAM", "code_information": [{"code": "4910430", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2231.0, "discounted_cash": 1673.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ PERC EXT PSEUDANYSM", "code_information": [{"code": "4616002", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2660.0, "discounted_cash": 1995.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ PERC EXT PSEUDANYSM", "code_information": [{"code": "4636002", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2445.0, "discounted_cash": 1833.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ PERC EXT PSEUDANYSM", "code_information": [{"code": "4916002", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2445.0, "discounted_cash": 1833.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ PROC KNEE ARTHROGRM", "code_information": [{"code": "4907670", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 562.0, "discounted_cash": 421.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ PROC KNEE ARTHROGRM", "code_information": [{"code": "4917670", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 549.0, "discounted_cash": 411.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ PROC SENTINEL NODE", "code_information": [{"code": "5208792", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 447.0, "discounted_cash": 335.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ SHOULDER ARTHROGRAM", "code_information": [{"code": "4907700", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1030.0, "discounted_cash": 772.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ SHOULDER ARTHROGRAM", "code_information": [{"code": "4917700", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1123.0, "discounted_cash": 842.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ SINUS TRACT DIAGNSTC", "code_information": [{"code": "4907705", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 550.0, "discounted_cash": 412.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ SINUS TRACT DIAGNSTC", "code_information": [{"code": "4917705", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 411.0, "discounted_cash": 308.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ SINUS TRCT THERAPEUT", "code_information": [{"code": "4912317", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 572.0, "discounted_cash": 429.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ SNGL TENDON/LIGAMENT", "code_information": [{"code": "4917720", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 868.0, "discounted_cash": 651.0, "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": 317.0, "discounted_cash": 237.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ T/P/D IVP SAME SUBST", "code_information": [{"code": "96376", "type": "CPT"}, {"code": "4540776", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 317.0, "discounted_cash": 237.75, "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": 317.0, "discounted_cash": 237.75, "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": 317.0, "discounted_cash": 237.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ T/P/D IVP SAME SUBST", "code_information": [{"code": "96376", "type": "CPT"}, {"code": "6290776", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 317.0, "discounted_cash": 237.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ TRIGGER PTS 1/2 MUSC", "code_information": [{"code": "5050552", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1885.0, "discounted_cash": 1413.75, "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": 255.0, "discounted_cash": 191.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ TX/PROPH/DX SQ/IM", "code_information": [{"code": "96372", "type": "CPT"}, {"code": "3120782", "type": "CDM"}, {"code": "514", "type": "RC"}], "standard_charges": [{"gross_charge": 255.0, "discounted_cash": 191.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ TX/PROPH/DX SQ/IM", "code_information": [{"code": "96372", "type": "CPT"}, {"code": "4540330", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 255.0, "discounted_cash": 191.25, "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": 255.0, "discounted_cash": 191.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ TX/PROPH/DX SQ/IM", "code_information": [{"code": "96372", "type": "CPT"}, {"code": "6160772", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 255.0, "discounted_cash": 191.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ TX/PROPH/DX SQ/IM", "code_information": [{"code": "96372", "type": "CPT"}, {"code": "6186372", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 255.0, "discounted_cash": 191.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ TX/PROPH/DX SQ/IM", "code_information": [{"code": "96372", "type": "CPT"}, {"code": "6290782", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 255.0, "discounted_cash": 191.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ TX/PROPH/DX SQ/IM", "code_information": [{"code": "96372", "type": "CPT"}, {"code": "6930782", "type": "CDM"}, {"code": "511", "type": "RC"}], "standard_charges": [{"gross_charge": 255.0, "discounted_cash": 191.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ TX/PROPH/DX SQ/IM", "code_information": [{"code": "96372", "type": "CPT"}, {"code": "6930782", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 255.0, "discounted_cash": 191.25, "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": 402.0, "discounted_cash": 301.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ TX/PRPH/DX IVP INT", "code_information": [{"code": "96374", "type": "CPT"}, {"code": "4540774", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 402.0, "discounted_cash": 301.5, "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": 402.0, "discounted_cash": 301.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ TX/PRPH/DX IVP INT", "code_information": [{"code": "96374", "type": "CPT"}, {"code": "6160774", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 402.0, "discounted_cash": 301.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ TX/PRPH/DX IVP INT", "code_information": [{"code": "96374", "type": "CPT"}, {"code": "6290774", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 402.0, "discounted_cash": 301.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ URETER/ILEAL CONDUIT", "code_information": [{"code": "4907735", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1218.0, "discounted_cash": 913.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ URETER/ILEAL CONDUIT", "code_information": [{"code": "4917735", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1004.0, "discounted_cash": 753.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ VENOGRPHY EXTRMTY", "code_information": [{"code": "4617690", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 210.0, "discounted_cash": 157.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ VENOGRPHY EXTRMTY", "code_information": [{"code": "4916005", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 210.0, "discounted_cash": 157.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ WRIST ARTHROGRAM", "code_information": [{"code": "4907745", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1175.0, "discounted_cash": 881.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ&CATH HYSTER/SONOHYST", "code_information": [{"code": "4907740", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2544.0, "discounted_cash": 1908.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INJ&CATH HYSTER/SONOHYST", "code_information": [{"code": "5017740", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2163.0, "discounted_cash": 1622.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJECT PROC SACRO JNT", "code_information": [{"code": "4917096", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1300.0, "discounted_cash": 975.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INJECT PROC SACRO JNT", "code_information": [{"code": "5057096", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1300.0, "discounted_cash": 975.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INJECT SPINE DISK LMBR", "code_information": [{"code": "4907715", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3931.0, "discounted_cash": 2948.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJECT SPINE DISK LMBR", "code_information": [{"code": "4917715", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3931.0, "discounted_cash": 2948.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INJECTABLE BULK AGENT2", "code_information": [{"code": "L8606", "type": "HCPCS"}, {"code": "8182612", "type": "CDM"}], "standard_charges": [{"gross_charge": 6869.0, "discounted_cash": 5151.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 467.0, "discounted_cash": 350.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 467.0, "discounted_cash": 350.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INS ANALG LISP 75/25 3ML", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321397", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 776.0, "discounted_cash": 582.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS ANALG LISP 75/25 3ML", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321397", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 776.0, "discounted_cash": 582.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS ANALG LISP75/25 10ML", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321406", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 569.0, "discounted_cash": 426.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INS ANALG LISP75/25 10ML", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321406", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 569.0, "discounted_cash": 426.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INS ANALGLISP50/5010MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321430", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 727.0, "discounted_cash": 545.25, "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": 727.0, "discounted_cash": 545.25, "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": 592.0, "discounted_cash": 444.0, "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": 592.0, "discounted_cash": 444.0, "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": 592.0, "discounted_cash": 444.0, "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": 592.0, "discounted_cash": 444.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 475.0, "discounted_cash": 356.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 475.0, "discounted_cash": 356.25, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 3.0, "discounted_cash": 2.25, "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": 3.0, "discounted_cash": 2.25, "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": 3.0, "discounted_cash": 2.25, "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": 3.0, "discounted_cash": 2.25, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INS BEARNG KNEE PLY MEDACTA CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013451", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6989.0, "discounted_cash": 5241.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INS BR MD PVDB HGHPRM MCRPT CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013282", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8369.0, "discounted_cash": 6276.75, "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": 31449.0, "discounted_cash": 23586.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INS CATH REN ART 1ST BIL", "code_information": [{"code": "4916252", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 13843.0, "discounted_cash": 10382.25, "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": 24389.0, "discounted_cash": 18291.75, "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": 9064.0, "discounted_cash": 6798.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS CATH REN ART 2ND BIL", "code_information": [{"code": "4616254", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 11388.0, "discounted_cash": 8541.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS CATH REN ART 2ND UNI", "code_information": [{"code": "4616253", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 12753.0, "discounted_cash": 9564.75, "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": 12753.0, "discounted_cash": 9564.75, "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": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "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": 812.0, "discounted_cash": 609.0, "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": 812.0, "discounted_cash": 609.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS DETEMR PER 5U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1815", "type": "HCPCS"}, {"code": "5321258", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INS ENDOVA VENACAVA FILT", "code_information": [{"code": "4617191", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 25467.0, "discounted_cash": 19100.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INS ENDOVA VENACAVA FILT", "code_information": [{"code": "4917191", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 30561.0, "discounted_cash": 22920.75, "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": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS GLARG PER 5U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1815", "type": "HCPCS"}, {"code": "5321260", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "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": 470.0, "discounted_cash": 352.5, "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": 470.0, "discounted_cash": 352.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INS GLARGINE 3ML CART", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321409", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 918.0, "discounted_cash": 688.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INS GLARGINE 3ML CART", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321409", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 918.0, "discounted_cash": 688.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INS GLARGINE 3ML PEN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321419", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1210.0, "discounted_cash": 907.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INS GLARGINE 3ML PEN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321419", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1210.0, "discounted_cash": 907.5, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 35.0, "discounted_cash": 26.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "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": 1030.0, "discounted_cash": 772.5, "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": 1030.0, "discounted_cash": 772.5, "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": 158.0, "discounted_cash": 118.5, "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": 158.0, "discounted_cash": 118.5, "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": 322.0, "discounted_cash": 241.5, "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": 322.0, "discounted_cash": 241.5, "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": 118.0, "discounted_cash": 88.5, "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": 118.0, "discounted_cash": 88.5, "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": 152.0, "discounted_cash": 114.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 152.0, "discounted_cash": 114.0, "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": 241.0, "discounted_cash": 180.75, "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": 241.0, "discounted_cash": 180.75, "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": 13.0, "discounted_cash": 9.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 838.0, "discounted_cash": 628.5, "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": 838.0, "discounted_cash": 628.5, "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": 364.0, "discounted_cash": 273.0, "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": 364.0, "discounted_cash": 273.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS HUM REG VIAL 3ML", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321498", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 322.0, "discounted_cash": 241.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INS HUM REG VIAL 3ML", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321498", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 322.0, "discounted_cash": 241.5, "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": 134.0, "discounted_cash": 100.5, "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": 134.0, "discounted_cash": 100.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INS LINR BEAR HUM ARTHROSRF CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013307", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8369.0, "discounted_cash": 6276.75, "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": 3.0, "discounted_cash": 2.25, "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": 3.0, "discounted_cash": 2.25, "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": 24212.0, "discounted_cash": 18159.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS N/R 70/30 PER 5U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1815", "type": "HCPCS"}, {"code": "5321270", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INS NPH HUM VL 3ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1815", "type": "HCPCS"}, {"code": "5321252", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 322.0, "discounted_cash": 241.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INS NPH HUM VL 3ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1815", "type": "HCPCS"}, {"code": "5321252", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 322.0, "discounted_cash": 241.5, "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": 26209.0, "discounted_cash": 19656.75, "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": 41593.0, "discounted_cash": 31194.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INS REG BF/PK 10ML", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321425", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 251.0, "discounted_cash": 188.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INS REG BF/PK 10ML", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321425", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 251.0, "discounted_cash": 188.25, "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": 245.0, "discounted_cash": 183.75, "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": 245.0, "discounted_cash": 183.75, "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": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INS REG HUM PER 5U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1815", "type": "HCPCS"}, {"code": "5321265", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INS SQ DEFIB ELEC", "code_information": [{"code": "4610320", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 84437.0, "discounted_cash": 63327.75, "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": 4638.0, "discounted_cash": 3478.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INS TUNN INTRAPER CATH", "code_information": [{"code": "4919418", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 12375.0, "discounted_cash": 9281.25, "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": 25260.0, "discounted_cash": 18945.0, "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": 9632.0, "discounted_cash": 7224.0, "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": 28663.0, "discounted_cash": 21497.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INS/PMGEN W/EXISDUALLDS", "code_information": [{"code": "4612505", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 37068.0, "discounted_cash": 27801.0, "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": 61048.0, "discounted_cash": 45786.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INS/RPL PMW/TRNSV LD A-V", "code_information": [{"code": "4613208", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 100019.0, "discounted_cash": 75014.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INSERT ARTICULAR", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012680", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 23206.0, "discounted_cash": 17404.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INSERT HUM LNR BEAR DEPUY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013124", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12350.0, "discounted_cash": 9262.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INSERT HUMERAL STD", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137719", "type": "CDM"}], "standard_charges": [{"gross_charge": 9776.0, "discounted_cash": 7332.0, "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": 15578.0, "discounted_cash": 11683.5, "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": 15689.0, "discounted_cash": 11766.75, "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": 2629.0, "discounted_cash": 1971.75, "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": 2629.0, "discounted_cash": 1971.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INSERT THORACOSTMY TUBE", "code_information": [{"code": "4907772", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3390.0, "discounted_cash": 2542.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INSERT THORACOSTMY TUBE", "code_information": [{"code": "4917772", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3463.0, "discounted_cash": 2597.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INSERT THORACOSTMY TUBE", "code_information": [{"code": "5057576", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3463.0, "discounted_cash": 2597.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INSIT MLTIPLX STAIN CMPT", "code_information": [{"code": "88374", "type": "CPT"}, {"code": "4178375", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 973.0, "discounted_cash": 729.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INSIT MLTIPLX STAIN CMPT", "code_information": [{"code": "88374", "type": "CPT"}, {"code": "7098374", "type": "CDM"}], "standard_charges": [{"gross_charge": 766.0, "discounted_cash": 574.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INSIT MLTIPLX STAIN CMPT", "code_information": [{"code": "88374", "type": "CPT"}, {"code": "7270097", "type": "CDM"}], "standard_charges": [{"gross_charge": 1237.0, "discounted_cash": 927.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INSITU EA ADD SNGL PROBE", "code_information": [{"code": "88364", "type": "CPT"}, {"code": "7098334", "type": "CDM"}], "standard_charges": [{"gross_charge": 296.0, "discounted_cash": 222.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INSITU EA ADD SNGL PROBE", "code_information": [{"code": "88364", "type": "CPT"}, {"code": "7270091", "type": "CDM"}], "standard_charges": [{"gross_charge": 518.0, "discounted_cash": 388.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INSITU EA MULTIPLEX STN", "code_information": [{"code": "88366", "type": "CPT"}, {"code": "7098335", "type": "CDM"}], "standard_charges": [{"gross_charge": 766.0, "discounted_cash": 574.5, "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": 21763.0, "discounted_cash": 16322.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT BEARNG TIB RP AESCULP CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013344", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6722.0, "discounted_cash": 5041.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT BILI DRAIN EXT", "code_information": [{"code": "4917760", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1335.0, "discounted_cash": 1001.25, "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": 2636.0, "discounted_cash": 1977.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT CVAD W PRT 5YRS>", "code_information": [{"code": "4916571", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 17245.0, "discounted_cash": 12933.75, "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": 14435.0, "discounted_cash": 10826.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT KNEE REVSN MEDACTA CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013462", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 19620.0, "discounted_cash": 14715.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT LD VEN LTVENT PREV", "code_information": [{"code": "4613221", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2061.0, "discounted_cash": 1545.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT LNR BEARNG HUM MEDACT CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013468", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9331.0, "discounted_cash": 6998.25, "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": 10460.0, "discounted_cash": 7845.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT NON-TUNNL CV CTH<5", "code_information": [{"code": "4916555", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2517.0, "discounted_cash": 1887.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT NONTUNNL CV CTH 5>", "code_information": [{"code": "4916556", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4158.0, "discounted_cash": 3118.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT PICC NO PRT/PMP<5 NO IMG", "code_information": [{"code": "4916568", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4965.0, "discounted_cash": 3723.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT PICC NO PRT/PMP>5 NO IMG", "code_information": [{"code": "4616569", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5714.0, "discounted_cash": 4285.5, "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": 5714.0, "discounted_cash": 4285.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT PICC NO PRT/PMP>5 NO IMG", "code_information": [{"code": "6296510", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5714.0, "discounted_cash": 4285.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT PICC W/IMG 5+YR", "code_information": [{"code": "4906573", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 10728.0, "discounted_cash": 8046.0, "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": 10728.0, "discounted_cash": 8046.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT PICC W/IMG 5+YR", "code_information": [{"code": "6296573", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5985.0, "discounted_cash": 4488.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT PICC W/IMG <5YR", "code_information": [{"code": "4916572", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4132.0, "discounted_cash": 3099.0, "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": 25901.0, "discounted_cash": 19425.75, "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": 4043.0, "discounted_cash": 3032.25, "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": 8230.0, "discounted_cash": 6172.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT TRAN ELCTRD DUAL", "code_information": [{"code": "4612507", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 19430.0, "discounted_cash": 14572.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT TRAN ELCTRD SNGL", "code_information": [{"code": "4612510", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 39557.0, "discounted_cash": 29667.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT TUNLD PLEURAL CATH", "code_information": [{"code": "4912019", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 10133.0, "discounted_cash": 7599.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT TUNLD PLEURAL CATH", "code_information": [{"code": "5052550", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6075.0, "discounted_cash": 4556.25, "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": 13145.0, "discounted_cash": 9858.75, "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": 9022.0, "discounted_cash": 6766.5, "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": 10387.0, "discounted_cash": 7790.25, "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": 2669.0, "discounted_cash": 2001.75, "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": 6341.0, "discounted_cash": 4755.75, "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": 12631.0, "discounted_cash": 9473.25, "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": 13859.0, "discounted_cash": 10394.25, "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": 172863.0, "discounted_cash": 129647.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INSRT/RPLC AICD & LDS", "code_information": [{"code": "4613249", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 90043.0, "discounted_cash": 67532.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INSTL AGNT VIA CHEST TBE INIT", "code_information": [{"code": "4910015", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1189.0, "discounted_cash": 891.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INSTL AGNT VIA CHEST TBE SUBQ", "code_information": [{"code": "4910016", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1189.0, "discounted_cash": 891.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INSULIN ANTIBODIES", "code_information": [{"code": "86337", "type": "CPT"}, {"code": "7256042", "type": "CDM"}], "standard_charges": [{"gross_charge": 495.0, "discounted_cash": 371.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INSULIN ANTIBODIES/2", "code_information": [{"code": "86337", "type": "CPT"}, {"code": "7006042", "type": "CDM"}], "standard_charges": [{"gross_charge": 611.0, "discounted_cash": 458.25, "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": 4.0, "discounted_cash": 3.0, "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": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INSULIN FREE", "code_information": [{"code": "83527", "type": "CPT"}, {"code": "7253527", "type": "CDM"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "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": 360.0, "discounted_cash": 270.0, "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": 314.0, "discounted_cash": 235.5, "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": 314.0, "discounted_cash": 235.5, "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": 19.0, "discounted_cash": 14.25, "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": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INSULIN TOTAL", "code_information": [{"code": "83525", "type": "CPT"}, {"code": "4173525", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 166.0, "discounted_cash": 124.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INSULIN TOTAL", "code_information": [{"code": "83525", "type": "CPT"}, {"code": "7003525", "type": "CDM"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INSULIN TOTAL", "code_information": [{"code": "83525", "type": "CPT"}, {"code": "7253525", "type": "CDM"}], "standard_charges": [{"gross_charge": 210.0, "discounted_cash": 157.5, "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": 681.0, "discounted_cash": 510.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTEGRA 2LAY 10X12.5 PER SQ CM", "code_information": [{"code": "Q4104", "type": "HCPCS"}, {"code": "4023184", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 681.0, "discounted_cash": 510.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTEGRA 2LAYR MTRX SQ CM", "code_information": [{"code": "Q4104", "type": "HCPCS"}, {"code": "4032750", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 629.0, "discounted_cash": 471.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTEGRA 2LAYR MTRX SQ CM", "code_information": [{"code": "Q4104", "type": "HCPCS"}, {"code": "4032750", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 629.0, "discounted_cash": 471.75, "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": 225.0, "discounted_cash": 168.75, "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": 290.0, "discounted_cash": 217.5, "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": 290.0, "discounted_cash": 217.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INTENSIVE CARE INTERMED", "code_information": [{"code": "1990062", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 7609.0, "discounted_cash": 5706.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTENSIVE CARE INTERMED", "code_information": [{"code": "2000062", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 7609.0, "discounted_cash": 5706.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTENSIVE CARE INTERMED", "code_information": [{"code": "2010062", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 7609.0, "discounted_cash": 5706.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTENSIVE CARE INTERMED", "code_information": [{"code": "2060062", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 7609.0, "discounted_cash": 5706.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTENSIVE CARE INTERMED", "code_information": [{"code": "2100062", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 7609.0, "discounted_cash": 5706.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTENSIVE CARE INTERMED", "code_information": [{"code": "2120062", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 7609.0, "discounted_cash": 5706.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTENSIVE CARE INTERMED", "code_information": [{"code": "2150062", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 7609.0, "discounted_cash": 5706.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTENSIVE CARE INTERMED", "code_information": [{"code": "2310062", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 7609.0, "discounted_cash": 5706.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTENSIVE CARE INTERMED", "code_information": [{"code": "2350062", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 7609.0, "discounted_cash": 5706.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTENSIVE CARE INTERMED", "code_information": [{"code": "2370062", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 7609.0, "discounted_cash": 5706.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTENSIVE CARE TRAUMA", "code_information": [{"code": "1990017", "type": "CDM"}, {"code": "208", "type": "RC"}], "standard_charges": [{"gross_charge": 11961.0, "discounted_cash": 8970.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTENSIVE CARE TRAUMA", "code_information": [{"code": "2000017", "type": "CDM"}, {"code": "208", "type": "RC"}], "standard_charges": [{"gross_charge": 11961.0, "discounted_cash": 8970.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTENSIVE CARE TRAUMA", "code_information": [{"code": "2010017", "type": "CDM"}, {"code": "208", "type": "RC"}], "standard_charges": [{"gross_charge": 11961.0, "discounted_cash": 8970.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTENSIVE CARE TRAUMA", "code_information": [{"code": "2100017", "type": "CDM"}, {"code": "208", "type": "RC"}], "standard_charges": [{"gross_charge": 11961.0, "discounted_cash": 8970.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTENSIVE CARE TRAUMA", "code_information": [{"code": "2120017", "type": "CDM"}, {"code": "208", "type": "RC"}], "standard_charges": [{"gross_charge": 11961.0, "discounted_cash": 8970.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTENSIVE CARE UNIT", "code_information": [{"code": "1990022", "type": "CDM"}, {"code": "200", "type": "RC"}], "standard_charges": [{"gross_charge": 11365.0, "discounted_cash": 8523.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTENSIVE CARE UNIT", "code_information": [{"code": "2000022", "type": "CDM"}, {"code": "200", "type": "RC"}], "standard_charges": [{"gross_charge": 11365.0, "discounted_cash": 8523.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTENSIVE CARE UNIT", "code_information": [{"code": "2010022", "type": "CDM"}, {"code": "200", "type": "RC"}], "standard_charges": [{"gross_charge": 11365.0, "discounted_cash": 8523.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTENSIVE CARE UNIT", "code_information": [{"code": "2060022", "type": "CDM"}, {"code": "200", "type": "RC"}], "standard_charges": [{"gross_charge": 11365.0, "discounted_cash": 8523.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTENSIVE CARE UNIT", "code_information": [{"code": "2100022", "type": "CDM"}, {"code": "200", "type": "RC"}], "standard_charges": [{"gross_charge": 11365.0, "discounted_cash": 8523.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTENSIVE CARE UNIT", "code_information": [{"code": "2120022", "type": "CDM"}, {"code": "200", "type": "RC"}], "standard_charges": [{"gross_charge": 11365.0, "discounted_cash": 8523.75, "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": 2685.0, "discounted_cash": 2013.75, "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": 2685.0, "discounted_cash": 2013.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTERLEUKIN", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7250190", "type": "CDM"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "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": 2496.0, "discounted_cash": 1872.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INTR HEMOSTASIS FASTCATH", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8247250", "type": "CDM"}], "standard_charges": [{"gross_charge": 213.0, "discounted_cash": 159.75, "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": 142.0, "discounted_cash": 106.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INTR SHTH SUPER", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8241503", "type": "CDM"}], "standard_charges": [{"gross_charge": 456.0, "discounted_cash": 342.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INTR SHTH ULTIMUM", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8241507", "type": "CDM"}], "standard_charges": [{"gross_charge": 256.0, "discounted_cash": 192.0, "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": 71245.0, "discounted_cash": 53433.75, "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": 11918.0, "discounted_cash": 8938.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRACRAN ADM AGNT ADD'L", "code_information": [{"code": "4951651", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 16450.0, "discounted_cash": 12337.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRACRAN ADM THERA AGNT", "code_information": [{"code": "4951650", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 20345.0, "discounted_cash": 15258.75, "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": 23977.0, "discounted_cash": 17982.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRINSIC FACTOR ANTIBDY", "code_information": [{"code": "86340", "type": "CPT"}, {"code": "7005536", "type": "CDM"}], "standard_charges": [{"gross_charge": 314.0, "discounted_cash": 235.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRINSIC FACTOR ANTIBDY", "code_information": [{"code": "86340", "type": "CPT"}, {"code": "7255536", "type": "CDM"}], "standard_charges": [{"gross_charge": 371.0, "discounted_cash": 278.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRO COOK CHECKFLO LG", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8241501", "type": "CDM"}], "standard_charges": [{"gross_charge": 2793.0, "discounted_cash": 2094.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRO COOK CHECKFLO XLG", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8241502", "type": "CDM"}], "standard_charges": [{"gross_charge": 2488.0, "discounted_cash": 1866.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRO DIAL AIR GUARD", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8241504", "type": "CDM"}], "standard_charges": [{"gross_charge": 2140.0, "discounted_cash": 1605.0, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRO FLEXOR CHECKFLO", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8241509", "type": "CDM"}], "standard_charges": [{"gross_charge": 530.0, "discounted_cash": 397.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRO LONG GI TUBE", "code_information": [{"code": "4907782", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 371.0, "discounted_cash": 278.25, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRO NDL DIAL-CIRC+S&I", "code_information": [{"code": "4616901", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6181.0, "discounted_cash": 4635.75, "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": 6181.0, "discounted_cash": 4635.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRO PEEL AWAY", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8174943", "type": "CDM"}], "standard_charges": [{"gross_charge": 1674.0, "discounted_cash": 1255.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRO SAFESHEATH II CLS", "code_information": [{"code": "C1892", "type": "HCPCS"}, {"code": "8174938", "type": "CDM"}], "standard_charges": [{"gross_charge": 780.0, "discounted_cash": 585.0, "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": 126.0, "discounted_cash": 94.5, "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": 1442.0, "discounted_cash": 1081.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRO SUPRAPUBC ONE-STEP", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8182690", "type": "CDM"}], "standard_charges": [{"gross_charge": 1109.0, "discounted_cash": 831.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTRODUCER LD NSTIM", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8241511", "type": "CDM"}], "standard_charges": [{"gross_charge": 2706.0, "discounted_cash": 2029.5, "setting": "both", "billing_class": "facility"}]}, {"description": "INTUBATION", "code_information": [{"code": "3110210", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2161.0, "discounted_cash": 1620.75, "setting": "both", "billing_class": "facility"}]}, {"description": "INTUBATION", "code_information": [{"code": "5500205", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2205.0, "discounted_cash": 1653.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IODINE/K IODIDE 30ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315349", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 467.0, "discounted_cash": 350.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IODINE/K IODIDE 30ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315349", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 467.0, "discounted_cash": 350.25, "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": 245.0, "discounted_cash": 183.75, "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": 3072.0, "discounted_cash": 2304.0, "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": 1642.0, "discounted_cash": 1231.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IP HEMODIALYSIS", "code_information": [{"code": "90935", "type": "CPT"}, {"code": "5600976", "type": "CDM"}, {"code": "821", "type": "RC"}], "standard_charges": [{"gross_charge": 1642.0, "discounted_cash": 1231.5, "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": 1652.0, "discounted_cash": 1239.0, "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": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IPRATROPIUM .02%2.5ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331231", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "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": 19.0, "discounted_cash": 14.25, "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": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IPRATROPIUM17MCG12.9GMIH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5331239", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2163.0, "discounted_cash": 1622.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IPRATROPIUM17MCG12.9GMIH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5331239", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2163.0, "discounted_cash": 1622.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 735.0, "discounted_cash": 551.25, "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": 735.0, "discounted_cash": 551.25, "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": 623.0, "discounted_cash": 467.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IPRATROPIUMNAS.03%30MLSP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331233", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 623.0, "discounted_cash": 467.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IRBESARTAN 150MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306051", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 157.0, "discounted_cash": 117.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IRBESARTAN 150MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306051", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 157.0, "discounted_cash": 117.75, "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": 99.0, "discounted_cash": 74.25, "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": 99.0, "discounted_cash": 74.25, "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": 284.0, "discounted_cash": 213.0, "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": 45.0, "discounted_cash": 33.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IRON ASSAY", "code_information": [{"code": "83540", "type": "CPT"}, {"code": "4173540", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 224.0, "discounted_cash": 168.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IRON ASSAY", "code_information": [{"code": "83540", "type": "CPT"}, {"code": "7253540", "type": "CDM"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IRON ASSAY/2", "code_information": [{"code": "83540", "type": "CPT"}, {"code": "7003572", "type": "CDM"}], "standard_charges": [{"gross_charge": 877.0, "discounted_cash": 657.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IRON ASSAY/2", "code_information": [{"code": "83540", "type": "CPT"}, {"code": "7253546", "type": "CDM"}], "standard_charges": [{"gross_charge": 456.0, "discounted_cash": 342.0, "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": 283.0, "discounted_cash": 212.25, "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": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IRON BINDING CAPCTY", "code_information": [{"code": "83550", "type": "CPT"}, {"code": "4173550", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 223.0, "discounted_cash": 167.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IRON BINDING CAPCTY", "code_information": [{"code": "83550", "type": "CPT"}, {"code": "7253550", "type": "CDM"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "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": 10.0, "discounted_cash": 7.5, "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": 10.0, "discounted_cash": 7.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IRRIGATE VASC ACCESS DEV", "code_information": [{"code": "96523", "type": "CPT"}, {"code": "4546523", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 353.0, "discounted_cash": 264.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IRRIGATE VASC ACCESS DEV", "code_information": [{"code": "96523", "type": "CPT"}, {"code": "4546523", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 353.0, "discounted_cash": 264.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ISAVUCONAZONIUM 186MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306080", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 289.0, "discounted_cash": 216.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ISAVUCONAZONIUM 186MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306080", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 289.0, "discounted_cash": 216.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ISAVUCONAZONIUM PER1MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1833", "type": "HCPCS"}, {"code": "5321533", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ISAVUCONAZONIUM PER1MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1833", "type": "HCPCS"}, {"code": "5321533", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ISLET CELL ANTIBODY", "code_information": [{"code": "86341", "type": "CPT"}, {"code": "7256341", "type": "CDM"}], "standard_charges": [{"gross_charge": 225.0, "discounted_cash": 168.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ISLET CELL ANTIBODY/5", "code_information": [{"code": "86341", "type": "CPT"}, {"code": "7256430", "type": "CDM"}], "standard_charges": [{"gross_charge": 194.0, "discounted_cash": 145.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ISLET CELL ANTIBODY/7", "code_information": [{"code": "86341", "type": "CPT"}, {"code": "7258645", "type": "CDM"}], "standard_charges": [{"gross_charge": 148.0, "discounted_cash": 111.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ISOLYTE M D5 1000ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412485", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 734.0, "discounted_cash": 550.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ISOLYTE S 1000ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412520", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ISOLYTE S PH7.4 1L IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412535", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 649.0, "discounted_cash": 486.75, "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": 10.0, "discounted_cash": 7.5, "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": 10.0, "discounted_cash": 7.5, "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": 12.0, "discounted_cash": 9.0, "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": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ISONIAZID 50MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315378", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ISONIAZID 50MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315378", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ISOPROTERENOL .2MG/NS 50ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321547", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 35.25, "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": 98.0, "discounted_cash": 73.5, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ISOSORBIDE DN 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306177", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ISOSORBIDE DN 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306181", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "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": 86.0, "discounted_cash": 64.5, "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": 34.0, "discounted_cash": 25.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "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": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "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": 12.0, "discounted_cash": 9.0, "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": 12.0, "discounted_cash": 9.0, "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": 99.0, "discounted_cash": 74.25, "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": 99.0, "discounted_cash": 74.25, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ISOSORBIDE MN 60MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306186", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ISOSULFAN BLUE PER1MG IJ", "code_information": [{"code": "Q9968", "type": "HCPCS"}, {"code": "5358208", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "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": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ISRADIPINE 10MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306253", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 114.0, "discounted_cash": 85.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ISRADIPINE 10MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306253", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 114.0, "discounted_cash": 85.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ISRADIPINE 5MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306254", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 252.0, "discounted_cash": 189.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ISRADIPINE 5MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306254", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 252.0, "discounted_cash": 189.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ITRACONAZOLE", "code_information": [{"code": "80189", "type": "CPT"}, {"code": "7250077", "type": "CDM"}], "standard_charges": [{"gross_charge": 283.0, "discounted_cash": 212.25, "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": 448.0, "discounted_cash": 336.0, "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": 448.0, "discounted_cash": 336.0, "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": 556.0, "discounted_cash": 417.0, "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": 556.0, "discounted_cash": 417.0, "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": 300.0, "discounted_cash": 225.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF CONCURRENT", "code_information": [{"code": "96368", "type": "CPT"}, {"code": "4540768", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 300.0, "discounted_cash": 225.0, "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": 300.0, "discounted_cash": 225.0, "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": 300.0, "discounted_cash": 225.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF CONCURRENT", "code_information": [{"code": "96368", "type": "CPT"}, {"code": "6290768", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 300.0, "discounted_cash": 225.0, "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": 737.0, "discounted_cash": 552.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF HYD EA ADD HR", "code_information": [{"code": "96361", "type": "CPT"}, {"code": "4540761", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 737.0, "discounted_cash": 552.75, "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": 737.0, "discounted_cash": 552.75, "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": 737.0, "discounted_cash": 552.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF HYD EA ADD HR", "code_information": [{"code": "96361", "type": "CPT"}, {"code": "6290761", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 737.0, "discounted_cash": 552.75, "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": 1197.0, "discounted_cash": 897.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF HYD INIT 31-60MIN", "code_information": [{"code": "96360", "type": "CPT"}, {"code": "4540760", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 1197.0, "discounted_cash": 897.75, "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": 1197.0, "discounted_cash": 897.75, "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": 1197.0, "discounted_cash": 897.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF HYD INIT 31-60MIN", "code_information": [{"code": "96360", "type": "CPT"}, {"code": "6290760", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 1197.0, "discounted_cash": 897.75, "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": 607.0, "discounted_cash": 455.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF SEQUENTL 1 HR", "code_information": [{"code": "96367", "type": "CPT"}, {"code": "4540767", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 512.0, "discounted_cash": 384.0, "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": 607.0, "discounted_cash": 455.25, "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": 607.0, "discounted_cash": 455.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF SEQUENTL 1 HR", "code_information": [{"code": "96367", "type": "CPT"}, {"code": "6290767", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 607.0, "discounted_cash": 455.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF TOCILIZU COV19 1ST DOSE", "code_information": [{"code": "M0249", "type": "HCPCS"}, {"code": "6290018", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 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"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 1960.0, "discounted_cash": 1470.0, "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": 512.0, "discounted_cash": 384.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF TX EA ADD HR", "code_information": [{"code": "96366", "type": "CPT"}, {"code": "4540766", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 512.0, "discounted_cash": 384.0, "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": 512.0, "discounted_cash": 384.0, "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": 512.0, "discounted_cash": 384.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF TX EA ADD HR", "code_information": [{"code": "96366", "type": "CPT"}, {"code": "6290766", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 553.0, "discounted_cash": 414.75, "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": 941.0, "discounted_cash": 705.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF TX INIT <=1 HR", "code_information": [{"code": "96365", "type": "CPT"}, {"code": "4540765", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 941.0, "discounted_cash": 705.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF TX INIT <=1 HR", "code_information": [{"code": "96365", "type": "CPT"}, {"code": "4900780", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 941.0, "discounted_cash": 705.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF TX INIT <=1 HR", "code_information": [{"code": "96365", "type": "CPT"}, {"code": "4910780", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 941.0, "discounted_cash": 705.75, "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": 941.0, "discounted_cash": 705.75, "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": 941.0, "discounted_cash": 705.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IV INF TX INIT <=1 HR", "code_information": [{"code": "96365", "type": "CPT"}, {"code": "6290765", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 941.0, "discounted_cash": 705.75, "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": 39.0, "discounted_cash": 29.25, "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": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IVABRADINE 7.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306259", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IVABRADINE 7.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306259", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "IVERMECTIN 3MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306261", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "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": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "IVIG FLEBOGAM PER500MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1572", "type": "HCPCS"}, {"code": "5321602", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 178.0, "discounted_cash": 133.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IVIG FLEBOGAM PER500MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1572", "type": "HCPCS"}, {"code": "5321602", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 178.0, "discounted_cash": 133.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IVIG GAMUNEX PER 500MG IV IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1561", "type": "HCPCS"}, {"code": "5321603", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 137.0, "discounted_cash": 102.75, "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": 137.0, "discounted_cash": 102.75, "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": 761.0, "discounted_cash": 570.75, "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": 761.0, "discounted_cash": 570.75, "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": 253.0, "discounted_cash": 189.75, "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": 253.0, "discounted_cash": 189.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 511.0, "discounted_cash": 383.25, "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": 511.0, "discounted_cash": 383.25, "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": 7548.0, "discounted_cash": 5661.0, "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": 10064.0, "discounted_cash": 7548.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IVUS NON CORON ADDL VESL", "code_information": [{"code": "4617251", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4866.0, "discounted_cash": 3649.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IVUS NON CORON ADDL VESL", "code_information": [{"code": "4957253", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4866.0, "discounted_cash": 3649.5, "setting": "both", "billing_class": "facility"}]}, {"description": "IVUS NON CORONARY INITL", "code_information": [{"code": "4615944", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4344.0, "discounted_cash": 3258.0, "setting": "both", "billing_class": "facility"}]}, {"description": "IVUS NON CORONARY INITL", "code_information": [{"code": "4957252", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4344.0, "discounted_cash": 3258.0, "setting": "both", "billing_class": "facility"}]}, {"description": "JAK2 GENE TRGT SEQ ALYS", "code_information": [{"code": "81279", "type": "CPT"}, {"code": "7270154", "type": "CDM"}], "standard_charges": [{"gross_charge": 872.0, "discounted_cash": 654.0, "setting": "both", "billing_class": "facility"}]}, {"description": "JAK2 VARIANT", "code_information": [{"code": "81270", "type": "CPT"}, {"code": "7270023", "type": "CDM"}], "standard_charges": [{"gross_charge": 694.0, "discounted_cash": 520.5, "setting": "both", "billing_class": "facility"}]}, {"description": "JAK2 VARIANT/2", "code_information": [{"code": "81270", "type": "CPT"}, {"code": "7259213", "type": "CDM"}], "standard_charges": [{"gross_charge": 1059.0, "discounted_cash": 794.25, "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": 1.0, "discounted_cash": 0.75, "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": 14.0, "discounted_cash": 10.5, "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": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "K IODIDE/IODINE 15ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316106", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "K IODIDE/IODINE 15ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316106", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "K PHOS 15MM 250ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5323565", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 286.0, "discounted_cash": 214.5, "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": 2.0, "discounted_cash": 1.5, "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": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "K WIRE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132955", "type": "CDM"}], "standard_charges": [{"gross_charge": 530.0, "discounted_cash": 397.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KAOLIN-PECTIN 30ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315410", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KAOLIN-PECTIN 30ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315410", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KAPPA LAMBDA LT CHN QUAN", "code_information": [{"code": "83521", "type": "CPT"}, {"code": "4173883", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 62.0, "discounted_cash": 46.5, "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": 78.0, "discounted_cash": 58.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": 2.0, "discounted_cash": 1.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 12.0, "discounted_cash": 9.0, "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": 12.0, "discounted_cash": 9.0, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "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": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KCL PER 2MEQ IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3480", "type": "HCPCS"}, {"code": "5321620", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KCL PER 2MEQ PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3480", "type": "HCPCS"}, {"code": "5321619", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 10.0, "discounted_cash": 7.5, "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": 10.0, "discounted_cash": 7.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KERECIS OMEGA3 1.75X1.75 SQ CM", "code_information": [{"code": "Q4158", "type": "HCPCS"}, {"code": "4023323", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 869.0, "discounted_cash": 651.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KERECIS OMEGA3 1.75X1.75 SQ CM", "code_information": [{"code": "Q4158", "type": "HCPCS"}, {"code": "4023323", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 869.0, "discounted_cash": 651.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KERECIS OMEGA3 3X3.5CM SQ CM", "code_information": [{"code": "Q4158", "type": "HCPCS"}, {"code": "4023320", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 647.0, "discounted_cash": 485.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KERECIS OMEGA3 3X3.5CM SQ CM", "code_information": [{"code": "Q4158", "type": "HCPCS"}, {"code": "4023320", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 647.0, "discounted_cash": 485.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KERECIS OMEGA3 3X7CM PER SQ CM", "code_information": [{"code": "Q4158", "type": "HCPCS"}, {"code": "4023321", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 593.0, "discounted_cash": 444.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KERECIS OMEGA3 3X7CM PER SQ CM", "code_information": [{"code": "Q4158", "type": "HCPCS"}, {"code": "4023321", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 593.0, "discounted_cash": 444.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KERECIS OMEGA3 PER SQ CM", "code_information": [{"code": "Q4158", "type": "HCPCS"}, {"code": "4023326", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 323.0, "discounted_cash": 242.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KERECIS OMEGA3 PER SQ CM", "code_information": [{"code": "Q4158", "type": "HCPCS"}, {"code": "4023326", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 323.0, "discounted_cash": 242.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KERECIS OMG3 WND DSK 1.6X2CM", "code_information": [{"code": "Q4158", "type": "HCPCS"}, {"code": "4023325", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 782.0, "discounted_cash": 586.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KERECIS OMG3 WND DSK 1.6X2CM", "code_information": [{"code": "Q4158", "type": "HCPCS"}, {"code": "4023325", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 782.0, "discounted_cash": 586.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KETAMINE 1000MG/100ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321679", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 264.0, "discounted_cash": 198.0, "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": 339.0, "discounted_cash": 254.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KETAMINE 10MG/1ML 5ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321611", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "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": 1017.0, "discounted_cash": 762.75, "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": 75.0, "discounted_cash": 56.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KETAMINE 200MG/200ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321665", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 124.0, "discounted_cash": 93.0, "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": 34.0, "discounted_cash": 25.5, "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": 467.0, "discounted_cash": 350.25, "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": 58.0, "discounted_cash": 43.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KETOCONAZL SHMP2%120MLSH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336085", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 254.0, "discounted_cash": 190.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KETOCONAZL SHMP2%120MLSH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336085", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 254.0, "discounted_cash": 190.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KETOCONAZOLE 2% 15GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336084", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KETOCONAZOLE 2% 15GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336084", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KETOCONAZOLE 2% 30GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336083", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 423.0, "discounted_cash": 317.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KETOCONAZOLE 2% 30GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336083", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 423.0, "discounted_cash": 317.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KETOCONAZOLE 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306293", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "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": 447.0, "discounted_cash": 335.25, "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": 447.0, "discounted_cash": 335.25, "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": 695.0, "discounted_cash": 521.25, "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": 695.0, "discounted_cash": 521.25, "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": 499.0, "discounted_cash": 374.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KETOROLAC 0.5% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331355", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 499.0, "discounted_cash": 374.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KETOROLAC 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306300", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "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": 20.0, "discounted_cash": 15.0, "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": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KETOSTEROID 17 TOTAL", "code_information": [{"code": "83586", "type": "CPT"}, {"code": "7253586", "type": "CDM"}], "standard_charges": [{"gross_charge": 245.0, "discounted_cash": 183.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KETOSTEROID 17 TOTAL/3", "code_information": [{"code": "83586", "type": "CPT"}, {"code": "7003589", "type": "CDM"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 87.75, "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": 976.0, "discounted_cash": 732.0, "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": 976.0, "discounted_cash": 732.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KID IMG FL/FUN SNG W RX", "code_information": [{"code": "78708", "type": "CPT"}, {"code": "5208706", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 3148.0, "discounted_cash": 2361.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KID IMG FL/FUN SNG WO RX", "code_information": [{"code": "78707", "type": "CPT"}, {"code": "5208707", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 3426.0, "discounted_cash": 2569.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KIDNEY IMG FLW/FNCT W/WO", "code_information": [{"code": "78709", "type": "CPT"}, {"code": "5208709", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 4291.0, "discounted_cash": 3218.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KIT CERCLAGE CLAVICLE FIBULA", "code_information": [{"code": "A4649", "type": "HCPCS"}, {"code": "8182874", "type": "CDM"}], "standard_charges": [{"gross_charge": 716.63, "discounted_cash": 537.47, "setting": "both", "billing_class": "facility"}]}, {"description": "KIT FIRST FRACT STABILIT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8174997", "type": "CDM"}], "standard_charges": [{"gross_charge": 29331.0, "discounted_cash": 21998.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KIT GENE TARGT SEQ ANLS", "code_information": [{"code": "81272", "type": "CPT"}, {"code": "4170078", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 1646.0, "discounted_cash": 1234.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KIT GENE TARGT SEQ ANLS", "code_information": [{"code": "81272", "type": "CPT"}, {"code": "7270024", "type": "CDM"}], "standard_charges": [{"gross_charge": 2093.0, "discounted_cash": 1569.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KIT STIM INTERSTIM TEST", "code_information": [{"code": "C1897", "type": "HCPCS"}, {"code": "8240200", "type": "CDM"}], "standard_charges": [{"gross_charge": 19379.0, "discounted_cash": 14534.25, "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": 11424.0, "discounted_cash": 8568.0, "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": 967.0, "discounted_cash": 725.25, "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": 967.0, "discounted_cash": 725.25, "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": 967.0, "discounted_cash": 725.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KNEE 1-2 VIEWS", "code_information": [{"code": "73560", "type": "CPT"}, {"code": "5123560", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 967.0, "discounted_cash": 725.25, "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": 1557.0, "discounted_cash": 1167.75, "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": 1557.0, "discounted_cash": 1167.75, "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": 1557.0, "discounted_cash": 1167.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KNEE 3 VIEWS", "code_information": [{"code": "73562", "type": "CPT"}, {"code": "5123562", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1557.0, "discounted_cash": 1167.75, "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": 2318.0, "discounted_cash": 1738.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KNEE ARTHROGRAPHY", "code_information": [{"code": "73580", "type": "CPT"}, {"code": "4913580", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2318.0, "discounted_cash": 1738.5, "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": 1369.0, "discounted_cash": 1026.75, "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": 1369.0, "discounted_cash": 1026.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KNEE COMP 4 VW MIN", "code_information": [{"code": "73564", "type": "CPT"}, {"code": "5113564", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1369.0, "discounted_cash": 1026.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KNEE COMP 4 VW MIN", "code_information": [{"code": "73564", "type": "CPT"}, {"code": "5123564", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1369.0, "discounted_cash": 1026.75, "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": 10826.0, "discounted_cash": 8119.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KNEE FEM UNI ZK GENE UNI SN CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012924", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16618.0, "discounted_cash": 12463.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KNEE UNI FEMUR 3PC FEM DPY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012830", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12682.0, "discounted_cash": 9511.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KNEE UNI FEMUR ZIMMER CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013013", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 18946.0, "discounted_cash": 14209.5, "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": 15120.0, "discounted_cash": 11340.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KNEE UNI MCK INSERT STRYKR CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013073", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6480.0, "discounted_cash": 4860.0, "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": 10476.0, "discounted_cash": 7857.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KNEE UNI OXFRD PLY INS ZIM CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013016", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12330.0, "discounted_cash": 9247.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KNEE UNI OXFRD TIB BSE ZIM CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013017", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 17094.0, "discounted_cash": 12820.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KNEE UNI POLY INSRT RP DPY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012831", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 7926.0, "discounted_cash": 5944.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KNEE UNI TIB BASE RP DEPUY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012832", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9058.0, "discounted_cash": 6793.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KNEES/BILAT AP STANDING", "code_information": [{"code": "73565", "type": "CPT"}, {"code": "4903561", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 974.0, "discounted_cash": 730.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KNEES/BILAT AP STANDING", "code_information": [{"code": "73565", "type": "CPT"}, {"code": "5013561", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 974.0, "discounted_cash": 730.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KNEES/BILAT AP STANDING", "code_information": [{"code": "73565", "type": "CPT"}, {"code": "5113565", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 974.0, "discounted_cash": 730.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KNEES/BILAT AP STANDING", "code_information": [{"code": "73565", "type": "CPT"}, {"code": "5123565", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 974.0, "discounted_cash": 730.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KO IMMOBILIZER", "code_information": [{"code": "L1830", "type": "HCPCS"}, {"code": "8130006", "type": "CDM"}], "standard_charges": [{"gross_charge": 2205.0, "discounted_cash": 1653.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KOH SKIN HAIR NAILS", "code_information": [{"code": "87220", "type": "CPT"}, {"code": "4107245", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 161.0, "discounted_cash": 120.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KOH SKIN HAIR NAILS", "code_information": [{"code": "87220", "type": "CPT"}, {"code": "4177222", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 127.0, "discounted_cash": 95.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KRAS GENE VARIANTS EXON 2", "code_information": [{"code": "81275", "type": "CPT"}, {"code": "7270117", "type": "CDM"}], "standard_charges": [{"gross_charge": 1514.0, "discounted_cash": 1135.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KT ACCESSORY SELECTRA", "code_information": [{"code": "C1893", "type": "HCPCS"}, {"code": "8081828", "type": "CDM"}], "standard_charges": [{"gross_charge": 2109.0, "discounted_cash": 1581.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KT ACHILL MIDSUBSTN SPDB", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011769", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10714.0, "discounted_cash": 8035.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KT ANCH SUTR SML JOINT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4013090", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11581.0, "discounted_cash": 8685.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KT ARTERIAL CATHETERIZTN", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8081844", "type": "CDM"}], "standard_charges": [{"gross_charge": 235.0, "discounted_cash": 176.25, "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": 21652.0, "discounted_cash": 16239.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KT BICEP TENODESIS REP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8081866", "type": "CDM"}], "standard_charges": [{"gross_charge": 3723.0, "discounted_cash": 2792.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KT BIOGLUE", "code_information": [{"code": "A4649", "type": "HCPCS"}, {"code": "8182880", "type": "CDM"}], "standard_charges": [{"gross_charge": 11908.0, "discounted_cash": 8931.0, "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": 3977.0, "discounted_cash": 2982.75, "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": 11619.0, "discounted_cash": 8714.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KT CATH ARES ANTIBIOTIC", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8081884", "type": "CDM"}], "standard_charges": [{"gross_charge": 7558.0, "discounted_cash": 5668.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KT CATH BENCHMARK 071", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056973", "type": "CDM"}], "standard_charges": [{"gross_charge": 8023.0, "discounted_cash": 6017.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KT CATH CENT VEN DBL LUM", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8032573", "type": "CDM"}], "standard_charges": [{"gross_charge": 3376.0, "discounted_cash": 2532.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KT CATH CENT VEN SGL LUM", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8032572", "type": "CDM"}], "standard_charges": [{"gross_charge": 5368.0, "discounted_cash": 4026.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KT CATH DIAL CHRN VASCPK", "code_information": [{"code": "C1750", "type": "HCPCS"}, {"code": "8056963", "type": "CDM"}], "standard_charges": [{"gross_charge": 2998.0, "discounted_cash": 2248.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KT CATH PALINDROME PRECISION", "code_information": [{"code": "C1750", "type": "HCPCS"}, {"code": "8056962", "type": "CDM"}], "standard_charges": [{"gross_charge": 13274.0, "discounted_cash": 9955.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KT CATH PLEURAL", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8032569", "type": "CDM"}], "standard_charges": [{"gross_charge": 4116.0, "discounted_cash": 3087.0, "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": 12098.0, "discounted_cash": 9073.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KT CATH REPERFUSION 5MAX JET D", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056959", "type": "CDM"}], "standard_charges": [{"gross_charge": 23104.0, "discounted_cash": 17328.0, "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": 25183.0, "discounted_cash": 18887.25, "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": 33078.0, "discounted_cash": 24808.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KT CATH THERMODILUTION", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8056967", "type": "CDM"}], "standard_charges": [{"gross_charge": 1781.0, "discounted_cash": 1335.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KT CHOLANGIOGRAPHY", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8081921", "type": "CDM"}], "standard_charges": [{"gross_charge": 1055.0, "discounted_cash": 791.25, "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": 47496.0, "discounted_cash": 35622.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KT DACRYOPLSTY PROC UNIL", "code_information": [{"code": "C1726", "type": "HCPCS"}, {"code": "8081949", "type": "CDM"}], "standard_charges": [{"gross_charge": 6351.0, "discounted_cash": 4763.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KT DRILL PIN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4013091", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2329.0, "discounted_cash": 1746.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KT DRN PLEURAL", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8081993", "type": "CDM"}], "standard_charges": [{"gross_charge": 1159.0, "discounted_cash": 869.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KT DRN STARTER PERITONL", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8081996", "type": "CDM"}], "standard_charges": [{"gross_charge": 10101.0, "discounted_cash": 7575.75, "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": 1687.0, "discounted_cash": 1265.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KT FIBRN SUR SLNT VISTASEAL4ML", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "8082073", "type": "CDM"}], "standard_charges": [{"gross_charge": 765.0, "discounted_cash": 573.75, "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": 7630.0, "discounted_cash": 5722.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KT FIXATOR DISTAL RADIUS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132960", "type": "CDM"}], "standard_charges": [{"gross_charge": 29822.0, "discounted_cash": 22366.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KT INSTR ACCESS INTRACEPT", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8081019", "type": "CDM"}], "standard_charges": [{"gross_charge": 23762.0, "discounted_cash": 17821.5, "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": 47071.0, "discounted_cash": 35303.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KT INTRO IMPELLA 14FR", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8082622", "type": "CDM"}], "standard_charges": [{"gross_charge": 3115.0, "discounted_cash": 2336.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KT INTRO MICRO", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8082157", "type": "CDM"}], "standard_charges": [{"gross_charge": 243.0, "discounted_cash": 182.25, "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": 765.0, "discounted_cash": 573.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KT LD 1X8 COMP 977D260", "code_information": [{"code": "C1778", "type": "HCPCS"}, {"code": "4008562", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10269.0, "discounted_cash": 7701.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KT LD MRI 1X8 COMP 977A2", "code_information": [{"code": "C1778", "type": "HCPCS"}, {"code": "4008561", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 20120.0, "discounted_cash": 15090.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KT LD MRI 2X8 COMP 977C2", "code_information": [{"code": "C1778", "type": "HCPCS"}, {"code": "4008585", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 61977.0, "discounted_cash": 46482.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KT LD MRI 8 CNTCT SC2408", "code_information": [{"code": "C1778", "type": "HCPCS"}, {"code": "4008558", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 23486.0, "discounted_cash": 17614.5, "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": 26441.0, "discounted_cash": 19830.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KT LD PERC SENZA 1058", "code_information": [{"code": "C1778", "type": "HCPCS"}, {"code": "4008556", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5178.0, "discounted_cash": 3883.5, "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": 3109.0, "discounted_cash": 2331.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KT LD TRIAL INFINION 16", "code_information": [{"code": "C1778", "type": "HCPCS"}, {"code": "4008557", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 36774.0, "discounted_cash": 27580.5, "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": 4360.0, "discounted_cash": 3270.0, "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": 25587.0, "discounted_cash": 19190.25, "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": 13499.0, "discounted_cash": 10124.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KT MCL INTERNALBRACE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4013121", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10790.0, "discounted_cash": 8092.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KT MENISCAL ROOT REPAIR", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4013122", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 18224.0, "discounted_cash": 13668.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KT MICRO ACCESS", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8175002", "type": "CDM"}], "standard_charges": [{"gross_charge": 1151.0, "discounted_cash": 863.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KT MICROPUNCT INTRO", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8082216", "type": "CDM"}], "standard_charges": [{"gross_charge": 1207.0, "discounted_cash": 905.25, "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": 5218.0, "discounted_cash": 3913.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KT PEC BUTTON LARGE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4013152", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 21648.0, "discounted_cash": 16236.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KT PERCARDIOCNT", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8082360", "type": "CDM"}], "standard_charges": [{"gross_charge": 3980.0, "discounted_cash": 2985.0, "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": 3193.0, "discounted_cash": 2394.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KT PLT BODYCAD FINE OSTEOTOMY", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8081886", "type": "CDM"}], "standard_charges": [{"gross_charge": 53221.0, "discounted_cash": 39915.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KT PLVC FLR RPR PINNACLE", "code_information": [{"code": "C1763", "type": "HCPCS"}, {"code": "4023397", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 14494.0, "discounted_cash": 10870.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KT PROX TENODES IMP SYS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4013146", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8857.0, "discounted_cash": 6642.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KT REPAIR AC TIGHTROPE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132964", "type": "CDM"}], "standard_charges": [{"gross_charge": 12111.0, "discounted_cash": 9083.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KT REPAIR MINI TIGHTROPE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132965", "type": "CDM"}], "standard_charges": [{"gross_charge": 8223.0, "discounted_cash": 6167.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KT REPAIR SYNDESMOSIS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8082451", "type": "CDM"}], "standard_charges": [{"gross_charge": 6869.0, "discounted_cash": 5151.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KT REVISION SUTRLSS PMP", "code_information": [{"code": "E0785", "type": "HCPCS"}, {"code": "8175088", "type": "CDM"}], "standard_charges": [{"gross_charge": 3357.0, "discounted_cash": 2517.75, "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": 9488.0, "discounted_cash": 7116.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KT SEALANT PROGEL PLEURL", "code_information": [{"code": "C2615", "type": "HCPCS"}, {"code": "8038504", "type": "CDM"}], "standard_charges": [{"gross_charge": 7676.0, "discounted_cash": 5757.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KT SHEATH ACCESS RF VERSACRS", "code_information": [{"code": "C1893", "type": "HCPCS"}, {"code": "8185647", "type": "CDM"}], "standard_charges": [{"gross_charge": 3701.0, "discounted_cash": 2775.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KT SHTH INTRO TRANSRADL", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8178117", "type": "CDM"}], "standard_charges": [{"gross_charge": 621.0, "discounted_cash": 465.75, "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": 608.0, "discounted_cash": 456.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KT SHTH LASER GLIDELIGHT", "code_information": [{"code": "C2629", "type": "HCPCS"}, {"code": "8178119", "type": "CDM"}], "standard_charges": [{"gross_charge": 11942.0, "discounted_cash": 8956.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KT SPINEJACK EXPANSION", "code_information": [{"code": "C1062", "type": "HCPCS"}, {"code": "8178112", "type": "CDM"}], "standard_charges": [{"gross_charge": 37610.0, "discounted_cash": 28207.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KT SPRINT PNS DUAL LD SYS", "code_information": [{"code": "C1778", "type": "HCPCS"}, {"code": "8178110", "type": "CDM"}], "standard_charges": [{"gross_charge": 41520.0, "discounted_cash": 31140.0, "setting": "both", "billing_class": "facility"}]}, {"description": "KT SPRINT PNS SNGL LEAD SYS", "code_information": [{"code": "C1778", "type": "HCPCS"}, {"code": "8178111", "type": "CDM"}], "standard_charges": [{"gross_charge": 21203.0, "discounted_cash": 15902.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KT STAPLE BN FIXATION", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137721", "type": "CDM"}], "standard_charges": [{"gross_charge": 13877.0, "discounted_cash": 10407.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KT SUBCHONDROPLASTY KNEE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4013150", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 25138.0, "discounted_cash": 18853.5, "setting": "both", "billing_class": "facility"}]}, {"description": "KT SUTURBRDG IMP W/ANCH", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4013153", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 37439.0, "discounted_cash": 28079.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KT TAVR HRT VLV SAPIEN TRNCTH", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8143270", "type": "CDM"}], "standard_charges": [{"gross_charge": 379079.0, "discounted_cash": 284309.25, "setting": "both", "billing_class": "facility"}]}, {"description": "KT TISSEEL FIBRIN SEALANT", "code_information": [{"code": "A6250", "type": "HCPCS"}, {"code": "8082522", "type": "CDM"}], "standard_charges": [{"gross_charge": 573.0, "discounted_cash": 429.75, "setting": "both", "billing_class": "facility"}]}, {"description": "KY LARYNGECTMY PULM SURG", "code_information": [{"code": "L8509", "type": "HCPCS"}, {"code": "8121013", "type": "CDM"}], "standard_charges": [{"gross_charge": 7465.0, "discounted_cash": 5598.75, "setting": "both", "billing_class": "facility"}]}, {"description": "L RINGERS 1000ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7120", "type": "HCPCS"}, {"code": "5412550", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 475.0, "discounted_cash": 356.25, "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": 475.0, "discounted_cash": 356.25, "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": 9.0, "discounted_cash": 6.75, "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": 9.0, "discounted_cash": 6.75, "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": 419.0, "discounted_cash": 314.25, "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": 398.0, "discounted_cash": 298.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 505.0, "discounted_cash": 378.75, "setting": "both", "billing_class": "facility"}]}, {"description": "L RINGERS 500ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7120", "type": "HCPCS"}, {"code": "5412545", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 505.0, "discounted_cash": 378.75, "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": 2929.0, "discounted_cash": 2196.75, "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": 3909.0, "discounted_cash": 2931.75, "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": 1380.0, "discounted_cash": 1035.0, "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": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "L&D RECOVERY INT 30 MIN", "code_information": [{"code": "3101222", "type": "CDM"}, {"code": "710", "type": "RC"}], "standard_charges": [{"gross_charge": 253.0, "discounted_cash": 189.75, "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": 419.0, "discounted_cash": 314.25, "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": 851.0, "discounted_cash": 638.25, "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": 2575.0, "discounted_cash": 1931.25, "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": 5730.0, "discounted_cash": 4297.5, "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": 2119.0, "discounted_cash": 1589.25, "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": 4771.0, "discounted_cash": 3578.25, "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": 3560.0, "discounted_cash": 2670.0, "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": 7834.0, "discounted_cash": 5875.5, "setting": "both", "billing_class": "facility"}]}, {"description": "L&D TRIAGE EST PT", "code_information": [{"code": "99213", "type": "CPT"}, {"code": "3101201", "type": "CDM"}, {"code": "720", "type": "RC"}], "standard_charges": [{"gross_charge": 849.0, "discounted_cash": 636.75, "setting": "both", "billing_class": "facility"}]}, {"description": "L&D TRIAGE EST PT", "code_information": [{"code": "99213", "type": "CPT"}, {"code": "3101201", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 849.0, "discounted_cash": 636.75, "setting": "both", "billing_class": "facility"}]}, {"description": "L&D TRIAGE NEW PT", "code_information": [{"code": "99203", "type": "CPT"}, {"code": "3101200", "type": "CDM"}, {"code": "720", "type": "RC"}], "standard_charges": [{"gross_charge": 956.0, "discounted_cash": 717.0, "setting": "both", "billing_class": "facility"}]}, {"description": "L&D TRIAGE NEW PT", "code_information": [{"code": "99203", "type": "CPT"}, {"code": "3101200", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 956.0, "discounted_cash": 717.0, "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": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "L. ACIDOPHL/BULGARIC CTB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5306305", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "L. ACIDOPHL/BULGARIC CTB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5306305", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 4577.0, "discounted_cash": 3432.75, "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": 7034.0, "discounted_cash": 5275.5, "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": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LABETALOL 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306320", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LABETALOL 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306321", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "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": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LABOR COMPLEX 1ST HR", "code_information": [{"code": "3101208", "type": "CDM"}, {"code": "720", "type": "RC"}], "standard_charges": [{"gross_charge": 1288.0, "discounted_cash": 966.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LABOR COMPLEX ADD HR", "code_information": [{"code": "3101209", "type": "CDM"}, {"code": "720", "type": "RC"}], "standard_charges": [{"gross_charge": 1030.0, "discounted_cash": 772.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LABOR INTERIM 1ST HR", "code_information": [{"code": "3101206", "type": "CDM"}, {"code": "720", "type": "RC"}], "standard_charges": [{"gross_charge": 1531.0, "discounted_cash": 1148.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LABOR INTERIM ADD HR", "code_information": [{"code": "3101207", "type": "CDM"}, {"code": "720", "type": "RC"}], "standard_charges": [{"gross_charge": 946.0, "discounted_cash": 709.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LABOR SIMPLE 1ST HR", "code_information": [{"code": "3101204", "type": "CDM"}, {"code": "720", "type": "RC"}], "standard_charges": [{"gross_charge": 1492.0, "discounted_cash": 1119.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LABOR SIMPLE ADD HR", "code_information": [{"code": "3101205", "type": "CDM"}, {"code": "720", "type": "RC"}], "standard_charges": [{"gross_charge": 1071.0, "discounted_cash": 803.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LACOSAMIDE", "code_information": [{"code": "80235", "type": "CPT"}, {"code": "7250022", "type": "CDM"}], "standard_charges": [{"gross_charge": 197.0, "discounted_cash": 147.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LACOSAMIDE", "code_information": [{"code": "80235", "type": "CPT"}, {"code": "7252554", "type": "CDM"}], "standard_charges": [{"gross_charge": 486.0, "discounted_cash": 364.5, "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": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 58.0, "discounted_cash": 43.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 58.0, "discounted_cash": 43.5, "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": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "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": 23.0, "discounted_cash": 17.25, "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": 23.0, "discounted_cash": 17.25, "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": 440.0, "discounted_cash": 330.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LACTATE(LACTIC ACID)", "code_information": [{"code": "83605", "type": "CPT"}, {"code": "4173605", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 346.0, "discounted_cash": 259.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LACTATE(LACTIC ACID)/2", "code_information": [{"code": "83605", "type": "CPT"}, {"code": "7258380", "type": "CDM"}], "standard_charges": [{"gross_charge": 157.0, "discounted_cash": 117.75, "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": 19.0, "discounted_cash": 14.25, "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": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LACTOBACILLUS GR 1GM PK", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315440", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LACTOBACILLUS GR 1GM PK", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315440", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LACTOBACILLUS TB/CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306343", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LACTOBACILLUS TB/CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306343", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LACTOFERRIN FECAL QNT", "code_information": [{"code": "83631", "type": "CPT"}, {"code": "7253631", "type": "CDM"}], "standard_charges": [{"gross_charge": 616.0, "discounted_cash": 462.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LACTOFERRIN FECAL QUAL", "code_information": [{"code": "83630", "type": "CPT"}, {"code": "4103630", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 100.0, "discounted_cash": 75.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LACTULOSE 10/15 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315451", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.43, "discounted_cash": 0.32, "setting": "both", "billing_class": "facility"}]}, {"description": "LACTULOSE 10/15 1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315451", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 0.43, "discounted_cash": 0.32, "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": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LACTULOSE 10/15 30ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315459", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LACTULOSE 10/15 480ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315458", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 261.0, "discounted_cash": 195.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LACTULOSE 10/15 480ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315458", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 261.0, "discounted_cash": 195.75, "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": 28.0, "discounted_cash": 21.0, "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": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LAMIVUDINE 150MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306345", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 383.0, "discounted_cash": 287.25, "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": 383.0, "discounted_cash": 287.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LAMIVUDINE10M/ML 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315467", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 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": 2.0, "discounted_cash": 1.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LAMOTRIGINE 25MG CTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306358", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 339.0, "discounted_cash": 254.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LAMOTRIGINE 25MG CTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306358", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 339.0, "discounted_cash": 254.25, "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": 296.0, "discounted_cash": 222.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LAMOTRIGINE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306346", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 296.0, "discounted_cash": 222.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LAMOTRIGINE 5MG CTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306353", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LAMOTRIGINE 5MG CTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306353", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LAMOTRIGINE QNT SNGL", "code_information": [{"code": "80175", "type": "CPT"}, {"code": "7000038", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 554.0, "discounted_cash": 415.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LAMOTRIGINE QUANT", "code_information": [{"code": "80175", "type": "CPT"}, {"code": "7250040", "type": "CDM"}], "standard_charges": [{"gross_charge": 230.0, "discounted_cash": 172.5, "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": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LANOLIN 7.5GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336125", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LANSOPRAZOLE 15MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306351", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 114.0, "discounted_cash": 85.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LANSOPRAZOLE 15MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306351", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 114.0, "discounted_cash": 85.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LANSOPRAZOLE 30MG DT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306355", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 295.0, "discounted_cash": 221.25, "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": 295.0, "discounted_cash": 221.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LANSOPRAZOLE 30MG PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315492", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 385.0, "discounted_cash": 288.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LANSOPRAZOLE 30MG PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315492", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 385.0, "discounted_cash": 288.75, "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": 438.0, "discounted_cash": 328.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LANSOPRAZOLE 30MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306352", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 438.0, "discounted_cash": 328.5, "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": 292.0, "discounted_cash": 219.0, "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": 292.0, "discounted_cash": 219.0, "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": 207.0, "discounted_cash": 155.25, "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": 207.0, "discounted_cash": 155.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LD ACUITY X4 SPRL L 4677", "code_information": [{"code": "C1900", "type": "HCPCS"}, {"code": "4008569", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 29430.0, "discounted_cash": 22072.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD ACUITY X4 SPRL L 4678", "code_information": [{"code": "C1900", "type": "HCPCS"}, {"code": "4000378", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 29430.0, "discounted_cash": 22072.5, "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": 29430.0, "discounted_cash": 22072.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD ACUITY X4 SPRL S 4675", "code_information": [{"code": "C1900", "type": "HCPCS"}, {"code": "4008574", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 29430.0, "discounted_cash": 22072.5, "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": 29430.0, "discounted_cash": 22072.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD ACUITYX4 QUAD LV 4672", "code_information": [{"code": "C1900", "type": "HCPCS"}, {"code": "4008573", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 29430.0, "discounted_cash": 22072.5, "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": 20883.0, "discounted_cash": 15662.25, "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": 20258.0, "discounted_cash": 15193.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD ATTAIN ABLTY STR 4396", "code_information": [{"code": "C1900", "type": "HCPCS"}, {"code": "4008566", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 20258.0, "discounted_cash": 15193.5, "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": 21073.0, "discounted_cash": 15804.75, "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": 19511.0, "discounted_cash": 14633.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LD COROX OTW 354807", "code_information": [{"code": "C1900", "type": "HCPCS"}, {"code": "4000369", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16510.0, "discounted_cash": 12382.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD COROX OTW L75 368345", "code_information": [{"code": "C1900", "type": "HCPCS"}, {"code": "4000375", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16493.0, "discounted_cash": 12369.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LD COROX OTW L85 368346", "code_information": [{"code": "C1900", "type": "HCPCS"}, {"code": "4000374", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16493.0, "discounted_cash": 12369.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DEFB LINOX S65 369818", "code_information": [{"code": "C1777", "type": "HCPCS"}, {"code": "4008605", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 31369.0, "discounted_cash": 23526.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DEFIB LINOX SD 350053", "code_information": [{"code": "C1895", "type": "HCPCS"}, {"code": "4000382", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 33025.0, "discounted_cash": 24768.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DEFIB LINOX SD 359067", "code_information": [{"code": "C1895", "type": "HCPCS"}, {"code": "4008604", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 31369.0, "discounted_cash": 23526.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DEFIB PLEXA MRI S60 402265", "code_information": [{"code": "C1777", "type": "HCPCS"}, {"code": "4008655", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 22684.0, "discounted_cash": 17013.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFB LINOX SD 359068", "code_information": [{"code": "C1895", "type": "HCPCS"}, {"code": "4008610", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 30742.0, "discounted_cash": 23056.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFB LINOX SGL 375012", "code_information": [{"code": "C1777", "type": "HCPCS"}, {"code": "4008609", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 31369.0, "discounted_cash": 23526.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFB OPTISURE LDA210Q", "code_information": [{"code": "C1777", "type": "HCPCS"}, {"code": "4008623", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 32554.0, "discounted_cash": 24415.5, "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": 32554.0, "discounted_cash": 24415.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFB PAMIRA S 428768", "code_information": [{"code": "C1777", "type": "HCPCS"}, {"code": "4000443", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 25888.0, "discounted_cash": 19416.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFB PAMIRA S 428769", "code_information": [{"code": "C1777", "type": "HCPCS"}, {"code": "4000444", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 24312.0, "discounted_cash": 18234.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFB PAMIRA S DX 428775", "code_information": [{"code": "C1777", "type": "HCPCS"}, {"code": "4000446", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 24312.0, "discounted_cash": 18234.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFB PAMIRA S DX 428776", "code_information": [{"code": "C1777", "type": "HCPCS"}, {"code": "4000447", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 24312.0, "discounted_cash": 18234.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFB PLEXA PROMRI SD 402263", "code_information": [{"code": "C1895", "type": "HCPCS"}, {"code": "4008639", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 30730.0, "discounted_cash": 23047.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFB PLEXA S 60 395722", "code_information": [{"code": "C1777", "type": "HCPCS"}, {"code": "4008646", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 24724.0, "discounted_cash": 18543.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFB PLEXA S 65 402266", "code_information": [{"code": "C1777", "type": "HCPCS"}, {"code": "4008637", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 30730.0, "discounted_cash": 23047.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFB PLEXA S DX 65/15 414005", "code_information": [{"code": "C1777", "type": "HCPCS"}, {"code": "4008638", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 23475.0, "discounted_cash": 17606.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFB PLEXA S DX 65/17 414006", "code_information": [{"code": "C1777", "type": "HCPCS"}, {"code": "4008642", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 23475.0, "discounted_cash": 17606.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFB PLEXA S75 402267", "code_information": [{"code": "C1777", "type": "HCPCS"}, {"code": "4008636", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 30730.0, "discounted_cash": 23047.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFB PLEXA SD 65/18 414001", "code_information": [{"code": "C1895", "type": "HCPCS"}, {"code": "4008643", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 23475.0, "discounted_cash": 17606.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFB PROTEGO SD 399408", "code_information": [{"code": "C1895", "type": "HCPCS"}, {"code": "4008628", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 42471.0, "discounted_cash": 31853.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFB PROTEGO SD 399409", "code_information": [{"code": "C1895", "type": "HCPCS"}, {"code": "4008631", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 42471.0, "discounted_cash": 31853.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFB PROTEGO SD 399410", "code_information": [{"code": "C1895", "type": "HCPCS"}, {"code": "4008626", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 42471.0, "discounted_cash": 31853.25, "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": 35231.0, "discounted_cash": 26423.25, "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": 34956.0, "discounted_cash": 26217.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFB SPRNT QUATR 6947M", "code_information": [{"code": "C1895", "type": "HCPCS"}, {"code": "4008622", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 34956.0, "discounted_cash": 26217.0, "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": 16510.0, "discounted_cash": 12382.5, "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 7120Q SJ4", "code_information": [{"code": "C1895", "type": "HCPCS"}, {"code": "4008590", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 41507.0, "discounted_cash": 31130.25, "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": 35484.0, "discounted_cash": 26613.0, "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": 41507.0, "discounted_cash": 31130.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFIB EASYTRAK 4542", "code_information": [{"code": "C1900", "type": "HCPCS"}, {"code": "8241697", "type": "CDM"}], "standard_charges": [{"gross_charge": 16845.0, "discounted_cash": 12633.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFIB EASYTRAK 4549", "code_information": [{"code": "C1900", "type": "HCPCS"}, {"code": "4023600", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16016.0, "discounted_cash": 12012.0, "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": 33537.0, "discounted_cash": 25152.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFIB LINOX SD 359065", "code_information": [{"code": "C1895", "type": "HCPCS"}, {"code": "4008598", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 31369.0, "discounted_cash": 23526.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFIB LINOX SD 359066", "code_information": [{"code": "C1895", "type": "HCPCS"}, {"code": "4008596", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 32982.0, "discounted_cash": 24736.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFIB LINOX SD 363303", "code_information": [{"code": "C1895", "type": "HCPCS"}, {"code": "4000383", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 33025.0, "discounted_cash": 24768.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFIB PROTEGO S 379969", "code_information": [{"code": "C1777", "type": "HCPCS"}, {"code": "4008625", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 30742.0, "discounted_cash": 23056.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFIB PROTEGO S 379970", "code_information": [{"code": "C1777", "type": "HCPCS"}, {"code": "4008624", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 42471.0, "discounted_cash": 31853.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFIB QUICKFLEX 1156T", "code_information": [{"code": "C1900", "type": "HCPCS"}, {"code": "4000394", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 22408.0, "discounted_cash": 16806.0, "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": 22408.0, "discounted_cash": 16806.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFIB RELIANCE END0184", "code_information": [{"code": "C1895", "type": "HCPCS"}, {"code": "8241744", "type": "CDM"}], "standard_charges": [{"gross_charge": 43385.0, "discounted_cash": 32538.75, "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": 37241.0, "discounted_cash": 27930.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFIB SPRINT 6947", "code_information": [{"code": "C1895", "type": "HCPCS"}, {"code": "8240247", "type": "CDM"}], "standard_charges": [{"gross_charge": 51614.0, "discounted_cash": 38710.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD DFIB TRANSVENE 6937", "code_information": [{"code": "C1896", "type": "HCPCS"}, {"code": "8241740", "type": "CDM"}], "standard_charges": [{"gross_charge": 9389.67, "discounted_cash": 7042.25, "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": 7084.0, "discounted_cash": 5313.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LD LFT VENT COR VEN SYS2", "code_information": [{"code": "C1900", "type": "HCPCS"}, {"code": "8241776", "type": "CDM"}], "standard_charges": [{"gross_charge": 30807.0, "discounted_cash": 23105.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LD NEURO EXT", "code_information": [{"code": "C1883", "type": "HCPCS"}, {"code": "8175146", "type": "CDM"}], "standard_charges": [{"gross_charge": 6615.0, "discounted_cash": 4961.25, "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": 25050.0, "discounted_cash": 18787.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD NSTIM INTERSTIM 3889", "code_information": [{"code": "C1778", "type": "HCPCS"}, {"code": "4008698", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 33934.0, "discounted_cash": 25450.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD NSTIM LAMITRODE 3219", "code_information": [{"code": "C1778", "type": "HCPCS"}, {"code": "4008694", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 47593.0, "discounted_cash": 35694.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LD NSTIM OCTAD 3778", "code_information": [{"code": "C1778", "type": "HCPCS"}, {"code": "8241815", "type": "CDM"}], "standard_charges": [{"gross_charge": 29688.0, "discounted_cash": 22266.0, "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": 45012.0, "discounted_cash": 33759.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LD NSTIM PISCES QD 3487A", "code_information": [{"code": "C1778", "type": "HCPCS"}, {"code": "8241838", "type": "CDM"}], "standard_charges": [{"gross_charge": 19742.0, "discounted_cash": 14806.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD NSTIM PRELIFE", "code_information": [{"code": "C1778", "type": "HCPCS"}, {"code": "8247356", "type": "CDM"}], "standard_charges": [{"gross_charge": 0.01, "discounted_cash": 0.01, "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": 61977.0, "discounted_cash": 46482.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LD NSTIM TRIAL 3086", "code_information": [{"code": "C1897", "type": "HCPCS"}, {"code": "4008700", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10038.0, "discounted_cash": 7528.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD NSTIM VAGUS NRV", "code_information": [{"code": "C1778", "type": "HCPCS"}, {"code": "4023751", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 56293.0, "discounted_cash": 42219.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LD NSTM LINEAR ST SC2218", "code_information": [{"code": "C1778", "type": "HCPCS"}, {"code": "4023741", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10038.0, "discounted_cash": 7528.5, "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": 25493.0, "discounted_cash": 19119.75, "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": 30722.0, "discounted_cash": 23041.5, "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": 25493.0, "discounted_cash": 19119.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PLEXA PROMRI DF-1 S 413997", "code_information": [{"code": "C1777", "type": "HCPCS"}, {"code": "4008718", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 25285.0, "discounted_cash": 18963.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PLEXA PROMRI S DX 436909", "code_information": [{"code": "C1777", "type": "HCPCS"}, {"code": "4000416", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 25285.0, "discounted_cash": 18963.75, "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": 22684.0, "discounted_cash": 17013.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM 5038S", "code_information": [{"code": "C1779", "type": "HCPCS"}, {"code": "8240234", "type": "CDM"}], "standard_charges": [{"gross_charge": 4883.0, "discounted_cash": 3662.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM ADAPTOR", "code_information": [{"code": "C1883", "type": "HCPCS"}, {"code": "8240258", "type": "CDM"}], "standard_charges": [{"gross_charge": 4369.0, "discounted_cash": 3276.75, "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": 6057.0, "discounted_cash": 4542.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM CAPSURE FIX", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "8240212", "type": "CDM"}], "standard_charges": [{"gross_charge": 8430.0, "discounted_cash": 6322.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM CAPSURE SP NOV5092", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "4008705", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5617.0, "discounted_cash": 4212.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM CAPSURE SP NOVUS", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "8240236", "type": "CDM"}], "standard_charges": [{"gross_charge": 7993.0, "discounted_cash": 5994.75, "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": 12549.0, "discounted_cash": 9411.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM CAPSURFX NOVUS4076", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "8241867", "type": "CDM"}], "standard_charges": [{"gross_charge": 8430.0, "discounted_cash": 6322.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM CAPSURFX NOVUS5076", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "8241865", "type": "CDM"}], "standard_charges": [{"gross_charge": 8430.0, "discounted_cash": 6322.5, "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": 7530.0, "discounted_cash": 5647.5, "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": 7315.0, "discounted_cash": 5486.25, "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": 7315.0, "discounted_cash": 5486.25, "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": 4974.0, "discounted_cash": 3730.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM FINELN2 EZSTER4470", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "8247412", "type": "CDM"}], "standard_charges": [{"gross_charge": 3305.16, "discounted_cash": 2478.87, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM FLEXTEND 4087", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "8241922", "type": "CDM"}], "standard_charges": [{"gross_charge": 5751.0, "discounted_cash": 4313.25, "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": 7084.0, "discounted_cash": 5313.0, "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": 7084.0, "discounted_cash": 5313.0, "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": 3928.0, "discounted_cash": 2946.0, "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": 3928.0, "discounted_cash": 2946.0, "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": 3928.0, "discounted_cash": 2946.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM MYOPORE EPI 511212", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "4000413", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12485.0, "discounted_cash": 9363.75, "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": 10324.0, "discounted_cash": 7743.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM SELECTSECURE 3830", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "8241943", "type": "CDM"}], "standard_charges": [{"gross_charge": 3589.0, "discounted_cash": 2691.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM SELOX JT45", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "8241944", "type": "CDM"}], "standard_charges": [{"gross_charge": 4751.0, "discounted_cash": 3563.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM SELOX ST53", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "8241945", "type": "CDM"}], "standard_charges": [{"gross_charge": 4751.0, "discounted_cash": 3563.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM SETROX S45", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "8241947", "type": "CDM"}], "standard_charges": [{"gross_charge": 9210.0, "discounted_cash": 6907.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM SETROX S53", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "8241948", "type": "CDM"}], "standard_charges": [{"gross_charge": 9210.0, "discounted_cash": 6907.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM SETROX S60", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "8241949", "type": "CDM"}], "standard_charges": [{"gross_charge": 9210.0, "discounted_cash": 6907.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM SIELLO S", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "4008732", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6274.0, "discounted_cash": 4705.5, "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": 5248.0, "discounted_cash": 3936.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM TENDRIL SDX 1688TC", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "8241926", "type": "CDM"}], "standard_charges": [{"gross_charge": 10436.0, "discounted_cash": 7827.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PM TENDRIL ST 1888TC", "code_information": [{"code": "C1898", "type": "HCPCS"}, {"code": "8242023", "type": "CDM"}], "standard_charges": [{"gross_charge": 10436.0, "discounted_cash": 7827.0, "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": 7530.0, "discounted_cash": 5647.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD PRESSURE SENSING INSPIRE", "code_information": [{"code": "C1778", "type": "HCPCS"}, {"code": "4008750", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 18782.0, "discounted_cash": 14086.5, "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": 22185.0, "discounted_cash": 16638.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LD SENTUS PROMRI OTW 406081", "code_information": [{"code": "C1900", "type": "HCPCS"}, {"code": "4008835", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16769.0, "discounted_cash": 12576.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LD SENTUS PROMRI OTW 406082", "code_information": [{"code": "C1900", "type": "HCPCS"}, {"code": "4008836", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 20660.0, "discounted_cash": 15495.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LD SENTUS PROMRI OTW 408718", "code_information": [{"code": "C1900", "type": "HCPCS"}, {"code": "4008837", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 20660.0, "discounted_cash": 15495.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LD SENTUS PROMRI OTW 408719", "code_information": [{"code": "C1900", "type": "HCPCS"}, {"code": "4008838", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 21174.0, "discounted_cash": 15880.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LD STIMULATING AIRWAY INSPIRE", "code_information": [{"code": "C1778", "type": "HCPCS"}, {"code": "4008751", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 32507.0, "discounted_cash": 24380.25, "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": 40332.0, "discounted_cash": 30249.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LDH-ISOENZYMES ELCTROPHR", "code_information": [{"code": "83625", "type": "CPT"}, {"code": "7003625", "type": "CDM"}], "standard_charges": [{"gross_charge": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LDH-ISOENZYMES ELCTROPHR", "code_information": [{"code": "83625", "type": "CPT"}, {"code": "7253625", "type": "CDM"}], "standard_charges": [{"gross_charge": 58.0, "discounted_cash": 43.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LDH-LACTIC DEHYDROGENASE", "code_information": [{"code": "83615", "type": "CPT"}, {"code": "4103615", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 301.0, "discounted_cash": 225.75, "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": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LDH-LACTIC DEHYDROGENASE", "code_information": [{"code": "83615", "type": "CPT"}, {"code": "4173615", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 237.0, "discounted_cash": 177.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LDH-LACTIC DEHYDROGENASE", "code_information": [{"code": "83615", "type": "CPT"}, {"code": "7003615", "type": "CDM"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LDH-LACTIC DEHYDROGENASE", "code_information": [{"code": "83615", "type": "CPT"}, {"code": "7253615", "type": "CDM"}], "standard_charges": [{"gross_charge": 123.0, "discounted_cash": 92.25, "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": 120.0, "discounted_cash": 90.0, "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": 74.0, "discounted_cash": 55.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LDL CHOLESTOROL", "code_information": [{"code": "83721", "type": "CPT"}, {"code": "4172476", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 94.0, "discounted_cash": 70.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LDL CHOLESTOROL", "code_information": [{"code": "83721", "type": "CPT"}, {"code": "7003721", "type": "CDM"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LDL CHOLESTOROL", "code_information": [{"code": "83721", "type": "CPT"}, {"code": "7253721", "type": "CDM"}], "standard_charges": [{"gross_charge": 189.0, "discounted_cash": 141.75, "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": 2987.0, "discounted_cash": 2240.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LE ART IMAGING COMP BILAT", "code_information": [{"code": "93925", "type": "CPT"}, {"code": "5123925", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 2987.0, "discounted_cash": 2240.25, "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": 2279.0, "discounted_cash": 1709.25, "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": 2279.0, "discounted_cash": 1709.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LE ART IMAGING UNI/LTD", "code_information": [{"code": "93926", "type": "CPT"}, {"code": "5123926", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 2279.0, "discounted_cash": 1709.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LEAD QUANTITATIVE", "code_information": [{"code": "83655", "type": "CPT"}, {"code": "4173670", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 278.0, "discounted_cash": 208.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LEAD QUANTITATIVE", "code_information": [{"code": "83655", "type": "CPT"}, {"code": "7003655", "type": "CDM"}], "standard_charges": [{"gross_charge": 97.0, "discounted_cash": 72.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEAD QUANTITATIVE", "code_information": [{"code": "83655", "type": "CPT"}, {"code": "7253655", "type": "CDM"}], "standard_charges": [{"gross_charge": 353.0, "discounted_cash": 264.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEAD QUANTITATIVE/2", "code_information": [{"code": "83655", "type": "CPT"}, {"code": "7003658", "type": "CDM"}], "standard_charges": [{"gross_charge": 97.0, "discounted_cash": 72.75, "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": 8.0, "discounted_cash": 6.0, "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": 8.0, "discounted_cash": 6.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LEFLUNOMIDE 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306364", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 497.0, "discounted_cash": 372.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEFLUNOMIDE 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306364", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 497.0, "discounted_cash": 372.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEGIONELLA AB", "code_information": [{"code": "86713", "type": "CPT"}, {"code": "7006258", "type": "CDM"}], "standard_charges": [{"gross_charge": 244.0, "discounted_cash": 183.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LEGIONELLA AB/2", "code_information": [{"code": "86713", "type": "CPT"}, {"code": "7256724", "type": "CDM"}], "standard_charges": [{"gross_charge": 290.0, "discounted_cash": 217.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LEGIONELLA PNEUMOPHILA", "code_information": [{"code": "87278", "type": "CPT"}, {"code": "7007278", "type": "CDM"}], "standard_charges": [{"gross_charge": 865.0, "discounted_cash": 648.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEGIONELLA PNEUMOPHILA/2", "code_information": [{"code": "87278", "type": "CPT"}, {"code": "7257278", "type": "CDM"}], "standard_charges": [{"gross_charge": 621.0, "discounted_cash": 465.75, "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": 367.0, "discounted_cash": 275.25, "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": 367.0, "discounted_cash": 275.25, "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": 74.0, "discounted_cash": 55.5, "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": 74.0, "discounted_cash": 55.5, "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": 232.0, "discounted_cash": 174.0, "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": 232.0, "discounted_cash": 174.0, "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": 238.0, "discounted_cash": 178.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LEUKO ASSMT FECAL QL/SQN", "code_information": [{"code": "89055", "type": "CPT"}, {"code": "4177203", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 187.0, "discounted_cash": 140.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LEUKOCYTE ALKA-PHSPHTASE", "code_information": [{"code": "85540", "type": "CPT"}, {"code": "7005540", "type": "CDM"}], "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": "7255540", "type": "CDM"}], "standard_charges": [{"gross_charge": 242.0, "discounted_cash": 181.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 6481.0, "discounted_cash": 4860.75, "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": 6481.0, "discounted_cash": 4860.75, "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": 9595.0, "discounted_cash": 7196.25, "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": 9595.0, "discounted_cash": 7196.25, "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": 76.0, "discounted_cash": 57.0, "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": 76.0, "discounted_cash": 57.0, "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": 334.0, "discounted_cash": 250.5, "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": 334.0, "discounted_cash": 250.5, "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": 254.0, "discounted_cash": 190.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 254.0, "discounted_cash": 190.5, "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": 1053.0, "discounted_cash": 789.75, "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": 1053.0, "discounted_cash": 789.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVETIRACETAM", "code_information": [{"code": "80177", "type": "CPT"}, {"code": "7250016", "type": "CDM"}], "standard_charges": [{"gross_charge": 58.0, "discounted_cash": 43.5, "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": 242.0, "discounted_cash": 181.5, "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": 242.0, "discounted_cash": 181.5, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVETIRACETAM PER10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1953", "type": "HCPCS"}, {"code": "5321696", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "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": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVETIRACETAM/3", "code_information": [{"code": "80177", "type": "CPT"}, {"code": "7258327", "type": "CDM"}], "standard_charges": [{"gross_charge": 230.0, "discounted_cash": 172.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 209.0, "discounted_cash": 156.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVETIRACETAM500MG/5MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315478", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 209.0, "discounted_cash": 156.75, "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": 348.0, "discounted_cash": 261.0, "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": 348.0, "discounted_cash": 261.0, "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": 133.0, "discounted_cash": 99.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOFLOXAC PER250MGPMXIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1956", "type": "HCPCS"}, {"code": "5321712", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 438.0, "discounted_cash": 328.5, "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": 438.0, "discounted_cash": 328.5, "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": 435.0, "discounted_cash": 326.25, "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": 435.0, "discounted_cash": 326.25, "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": 531.0, "discounted_cash": 398.25, "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": 531.0, "discounted_cash": 398.25, "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": 853.0, "discounted_cash": 639.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOFLOXACIN 750MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306428", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 853.0, "discounted_cash": 639.75, "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": 403.0, "discounted_cash": 302.25, "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": 403.0, "discounted_cash": 302.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVONORGESTREL 1.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306433", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 536.0, "discounted_cash": 402.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVONORGESTREL 1.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306433", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 536.0, "discounted_cash": 402.0, "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": 10.0, "discounted_cash": 7.5, "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": 10.0, "discounted_cash": 7.5, "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": 34.0, "discounted_cash": 25.5, "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": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOTHYROXIN .075MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306454", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "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": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOTHYROXIN .088MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306435", "type": "CDM"}, {"code": "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": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOTHYROXIN .112MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306456", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOTHYROXIN .125MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306458", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 44.0, "discounted_cash": 33.0, "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": 44.0, "discounted_cash": 33.0, "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": 13.0, "discounted_cash": 9.75, "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": 13.0, "discounted_cash": 9.75, "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": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOTHYROXIN .15MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306455", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "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": 3.0, "discounted_cash": 2.25, "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": 3.0, "discounted_cash": 2.25, "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": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOTHYROXIN .1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306459", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOTHYROXIN .2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306463", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 45.0, "discounted_cash": 33.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOTHYROXIN .2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306463", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 45.0, "discounted_cash": 33.75, "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": 116.0, "discounted_cash": 87.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 116.0, "discounted_cash": 87.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LEVOTHYROXINE NOS PER 10MCG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0650", "type": "HCPCS"}, {"code": "5321693", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDO/EPI/TETRA 3ML TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5336207", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 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": 173.0, "discounted_cash": 129.75, "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": 190.0, "discounted_cash": 142.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDOC/TETRA 70MG/70MG TD", "code_information": [{"code": "C9285", "type": "HCPCS"}, {"code": "5336225", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 123.0, "discounted_cash": 92.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDOC/TETRA 70MG/70MG TD", "code_information": [{"code": "C9285", "type": "HCPCS"}, {"code": "5336225", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 123.0, "discounted_cash": 92.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDOCAINE", "code_information": [{"code": "80176", "type": "CPT"}, {"code": "4174625", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 364.0, "discounted_cash": 273.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDOCAINE", "code_information": [{"code": "80176", "type": "CPT"}, {"code": "7253610", "type": "CDM"}], "standard_charges": [{"gross_charge": 462.0, "discounted_cash": 346.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDOCAINE 1% BUFF CMD IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5321733", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDOCAINE 1% BUFF CMD IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5321733", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDOCAINE 2% 11ML GL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336234", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "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": 20.0, "discounted_cash": 15.0, "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": 1.0, "discounted_cash": 0.75, "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": 58.0, "discounted_cash": 43.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDOCAINE 2% 5ML GL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336202", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 74.0, "discounted_cash": 55.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDOCAINE 2% 6ML GL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336236", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "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": 17.0, "discounted_cash": 12.75, "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": 226.0, "discounted_cash": 169.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDOCAINE 4% 5GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336211", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 190.0, "discounted_cash": 142.5, "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": 461.0, "discounted_cash": 345.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDOCAINE 4% PATCH TD", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336240", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 9.0, "discounted_cash": 6.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDOCAINE 4% PATCH TD", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336240", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 9.0, "discounted_cash": 6.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDOCAINE 4% TRACH KT IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321825", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 161.0, "discounted_cash": 120.75, "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": 12.0, "discounted_cash": 9.0, "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": 391.0, "discounted_cash": 293.25, "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": 0.01, "discounted_cash": 0.01, "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": 0.01, "discounted_cash": 0.01, "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": 0.02, "discounted_cash": 0.02, "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": 0.02, "discounted_cash": 0.02, "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": 0.04, "discounted_cash": 0.03, "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": 0.04, "discounted_cash": 0.03, "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": 0.11, "discounted_cash": 0.08, "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": 0.11, "discounted_cash": 0.08, "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": 11.0, "discounted_cash": 8.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDOCAINE VISC 2% 15MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315506", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 11.0, "discounted_cash": 8.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDOCAINE VISC 2% 20 LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315503", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LIDOCAINE VISC 2% 20 LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315503", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "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": 592.0, "discounted_cash": 444.0, "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": 71.0, "discounted_cash": 53.25, "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": 77.0, "discounted_cash": 57.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "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": 92.0, "discounted_cash": 69.0, "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": 92.0, "discounted_cash": 69.0, "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": 74.0, "discounted_cash": 55.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 74.0, "discounted_cash": 55.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LINDANE SHAMP 1% 60ML SH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336271", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 348.0, "discounted_cash": 261.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LINDANE SHAMP 1% 60ML SH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336271", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 348.0, "discounted_cash": 261.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LINER ACE PLY MAR ALTX DPY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012804", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 7042.25, "discounted_cash": 5281.69, "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": 9022.0, "discounted_cash": 6766.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LINER ACETB BI MENTUM DEPUY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012807", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8604.0, "discounted_cash": 6453.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LINEZOLID 600MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306501", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "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": 17.0, "discounted_cash": 12.75, "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": 1056.0, "discounted_cash": 792.0, "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": 1056.0, "discounted_cash": 792.0, "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": 113.0, "discounted_cash": 84.75, "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": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LIOTHYRONINE 25MCG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306517", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LIOTHYRONINE 25MCG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306517", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "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": 89.0, "discounted_cash": 66.75, "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": 89.0, "discounted_cash": 66.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LIOTRIX 60MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306544", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LIOTRIX 60MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306544", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "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": 350.0, "discounted_cash": 262.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LIPASE", "code_information": [{"code": "83690", "type": "CPT"}, {"code": "4173690", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 275.0, "discounted_cash": 206.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LIPASE", "code_information": [{"code": "83690", "type": "CPT"}, {"code": "7003690", "type": "CDM"}], "standard_charges": [{"gross_charge": 75.0, "discounted_cash": 56.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LIPASE/2", "code_information": [{"code": "83690", "type": "CPT"}, {"code": "4173691", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 115.0, "discounted_cash": 86.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LIPASE/2", "code_information": [{"code": "83690", "type": "CPT"}, {"code": "7253691", "type": "CDM"}], "standard_charges": [{"gross_charge": 146.0, "discounted_cash": 109.5, "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": 498.0, "discounted_cash": 373.5, "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": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LIPID PANEL", "code_information": [{"code": "80061", "type": "CPT"}, {"code": "4170062", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 392.0, "discounted_cash": 294.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LIPID PANEL/2", "code_information": [{"code": "80061", "type": "CPT"}, {"code": "7250160", "type": "CDM"}], "standard_charges": [{"gross_charge": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LIPO ULTRCNTRFGTN/QUAN", "code_information": [{"code": "83701", "type": "CPT"}, {"code": "7003714", "type": "CDM"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 105.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LIPOPROTEIN (A)", "code_information": [{"code": "83695", "type": "CPT"}, {"code": "7003716", "type": "CDM"}], "standard_charges": [{"gross_charge": 352.0, "discounted_cash": 264.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LIPOPROTEIN (A)", "code_information": [{"code": "83695", "type": "CPT"}, {"code": "7253716", "type": "CDM"}], "standard_charges": [{"gross_charge": 251.0, "discounted_cash": 188.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LIPOPROTEIN BLD ELP QN", "code_information": [{"code": "83700", "type": "CPT"}, {"code": "7003715", "type": "CDM"}], "standard_charges": [{"gross_charge": 350.0, "discounted_cash": 262.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LIPOPROTEIN BY NMR", "code_information": [{"code": "83704", "type": "CPT"}, {"code": "7253704", "type": "CDM"}], "standard_charges": [{"gross_charge": 401.0, "discounted_cash": 300.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LISDEXAMFETAMINE 40MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327689", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LISDEXAMFETAMINE 40MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327689", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LISINOPRIL 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306636", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "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": 3.0, "discounted_cash": 2.25, "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": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LISINOPRIL 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306635", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 44.0, "discounted_cash": 33.0, "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": 44.0, "discounted_cash": 33.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LISINOPRL/HCTZ20/12.5 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306640", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LISINOPRL/HCTZ20/12.5 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306640", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LISINOPRL/HCTZ20/25 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306641", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LISINOPRL/HCTZ20/25 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306641", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LITHIUM", "code_information": [{"code": "80178", "type": "CPT"}, {"code": "4103725", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 315.0, "discounted_cash": 236.25, "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": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LITHIUM", "code_information": [{"code": "80178", "type": "CPT"}, {"code": "4173725", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 248.0, "discounted_cash": 186.0, "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": 14.0, "discounted_cash": 10.5, "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": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LITHIUM 300MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306652", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LITHIUM 300MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306652", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 32.0, "discounted_cash": 24.0, "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": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LITHOTRIPSY", "code_information": [{"code": "3080590", "type": "CDM"}, {"code": "790", "type": "RC"}], "standard_charges": [{"gross_charge": 14936.0, "discounted_cash": 11202.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LITHOTRIPSY OTHER", "code_information": [{"code": "3080015", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 14936.0, "discounted_cash": 11202.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LIVER IMAGING STATIC", "code_information": [{"code": "78201", "type": "CPT"}, {"code": "5208201", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 2524.0, "discounted_cash": 1893.0, "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": 3041.0, "discounted_cash": 2280.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LNR AC PLY HGH CRSLNK MDACT CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013439", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9443.0, "discounted_cash": 7082.25, "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": 6750.0, "discounted_cash": 5062.5, "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": 10826.0, "discounted_cash": 8119.5, "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": 12090.0, "discounted_cash": 9067.5, "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": 9022.0, "discounted_cash": 6766.5, "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": 12.0, "discounted_cash": 9.0, "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": 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": "255", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "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": 17.0, "discounted_cash": 12.75, "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": 137.0, "discounted_cash": 102.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LOPERAMIDE 1/5 10ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315527", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 137.0, "discounted_cash": 102.75, "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": 28.0, "discounted_cash": 21.0, "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": 28.0, "discounted_cash": 21.0, "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": 467.0, "discounted_cash": 350.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 467.0, "discounted_cash": 350.25, "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": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LOPINAV/RITONA 200/50 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306731", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LOPINAVIR/RITONAVR5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315500", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 401.0, "discounted_cash": 300.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LOPINAVIR/RITONAVR5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315500", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 401.0, "discounted_cash": 300.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LORATADIN/PSE 5/120XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306741", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LORATADIN/PSE 5/120XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306741", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LORATADIN/PSE10/240XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306742", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 23.0, "discounted_cash": 17.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LORATADIN/PSE10/240XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306742", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 23.0, "discounted_cash": 17.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LORATADINE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306740", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LORATADINE 10MG/10ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315539", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LORATADINE 10MG/10ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315539", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "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": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LORAZEPAM .5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306749", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LORAZEPAM 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306752", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "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": 14.0, "discounted_cash": 10.5, "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": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LORAZEPAM PER 2MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2060", "type": "HCPCS"}, {"code": "5321894", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 106.0, "discounted_cash": 79.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LORAZEPAM PER 2MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2060", "type": "HCPCS"}, {"code": "5321894", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 106.0, "discounted_cash": 79.5, "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": 44.0, "discounted_cash": 33.0, "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": 44.0, "discounted_cash": 33.0, "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": 31.0, "discounted_cash": 23.25, "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": 31.0, "discounted_cash": 23.25, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LOVASTATIN 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306760", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LOVASTATIN 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306760", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LOXAPINE 10MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306779", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LOXAPINE 10MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306779", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 82.0, "discounted_cash": 61.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 82.0, "discounted_cash": 61.5, "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": 1210.0, "discounted_cash": 907.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 152.0, "discounted_cash": 114.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LUBIPROSTONE 24MCG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306795", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 152.0, "discounted_cash": 114.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LUBIPROSTONE 8MCG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306794", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LUMB BENDNG 2 OR 3 VWS", "code_information": [{"code": "72120", "type": "CPT"}, {"code": "4902121", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1218.0, "discounted_cash": 913.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LUMB BENDNG 2 OR 3 VWS", "code_information": [{"code": "72120", "type": "CPT"}, {"code": "5112123", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1218.0, "discounted_cash": 913.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LUMB BENDNG 2 OR 3 VWS", "code_information": [{"code": "72120", "type": "CPT"}, {"code": "5122121", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1218.0, "discounted_cash": 913.5, "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": 2046.0, "discounted_cash": 1534.5, "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": 1941.0, "discounted_cash": 1455.75, "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": 4926.0, "discounted_cash": 3694.5, "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": 2661.0, "discounted_cash": 1995.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LUNG VOL GAS DIL/WASHOUT", "code_information": [{"code": "94727", "type": "CPT"}, {"code": "5504727", "type": "CDM"}, {"code": "460", "type": "RC"}], "standard_charges": [{"gross_charge": 1142.0, "discounted_cash": 856.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LURASIDONE 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306798", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LURASIDONE 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306798", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LUTEINING HORMONE", "code_information": [{"code": "83002", "type": "CPT"}, {"code": "4173002", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 324.0, "discounted_cash": 243.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LUTEINING HORMONE", "code_information": [{"code": "83002", "type": "CPT"}, {"code": "7003002", "type": "CDM"}], "standard_charges": [{"gross_charge": 98.0, "discounted_cash": 73.5, "setting": "both", "billing_class": "facility"}]}, {"description": "LUTEINING HORMONE", "code_information": [{"code": "83002", "type": "CPT"}, {"code": "7253002", "type": "CDM"}], "standard_charges": [{"gross_charge": 412.0, "discounted_cash": 309.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LYME AMP PROBE", "code_information": [{"code": "87476", "type": "CPT"}, {"code": "7257476", "type": "CDM"}], "standard_charges": [{"gross_charge": 800.0, "discounted_cash": 600.0, "setting": "both", "billing_class": "facility"}]}, {"description": "LYME AMP PROBE/2", "code_information": [{"code": "87476", "type": "CPT"}, {"code": "7257136", "type": "CDM"}], "standard_charges": [{"gross_charge": 695.0, "discounted_cash": 521.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LYME DISEASE AB", "code_information": [{"code": "86618", "type": "CPT"}, {"code": "4176257", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 147.0, "discounted_cash": 110.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LYME DISEASE AB", "code_information": [{"code": "86618", "type": "CPT"}, {"code": "7006259", "type": "CDM"}], "standard_charges": [{"gross_charge": 423.0, "discounted_cash": 317.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LYME DISEASE AB", "code_information": [{"code": "86618", "type": "CPT"}, {"code": "7256257", "type": "CDM"}], "standard_charges": [{"gross_charge": 187.0, "discounted_cash": 140.25, "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": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "LYME DISEASE AB/2", "code_information": [{"code": "86618", "type": "CPT"}, {"code": "7256312", "type": "CDM"}], "standard_charges": [{"gross_charge": 569.0, "discounted_cash": 426.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LYME DISEASE AB/3", "code_information": [{"code": "86618", "type": "CPT"}, {"code": "7256591", "type": "CDM"}], "standard_charges": [{"gross_charge": 81.0, "discounted_cash": 60.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LYME DISEASE AB/5", "code_information": [{"code": "86618", "type": "CPT"}, {"code": "7256621", "type": "CDM"}], "standard_charges": [{"gross_charge": 569.0, "discounted_cash": 426.75, "setting": "both", "billing_class": "facility"}]}, {"description": "LYMPHATICS & LYMPH NODES", "code_information": [{"code": "78195", "type": "CPT"}, {"code": "5208195", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 3692.0, "discounted_cash": 2769.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MAFENIDE85MG/GM 57GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336339", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 981.0, "discounted_cash": 735.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MAFENIDE85MG/GM 57GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336339", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 981.0, "discounted_cash": 735.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MAG ANTIBODY", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7250047", "type": "CDM"}], "standard_charges": [{"gross_charge": 135.0, "discounted_cash": 101.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MAG ANTIBODY/2", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7004197", "type": "CDM"}], "standard_charges": [{"gross_charge": 207.0, "discounted_cash": 155.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MAG ANTIBODY/3", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7004198", "type": "CDM"}], "standard_charges": [{"gross_charge": 541.0, "discounted_cash": 405.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MAG SULF NEO PER 1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321983", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 10.0, "discounted_cash": 7.5, "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": 10.0, "discounted_cash": 7.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MAG SULF PEDI DOSE IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3475", "type": "HCPCS"}, {"code": "5321957", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MAG SULF PEDI DOSE IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3475", "type": "HCPCS"}, {"code": "5321957", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "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": 19.0, "discounted_cash": 14.25, "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": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MAG SULF PER 500MG PMXIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3475", "type": "HCPCS"}, {"code": "5321956", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MAG SULF PER 500MG PMXIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3475", "type": "HCPCS"}, {"code": "5321956", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "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": 123.0, "discounted_cash": 92.25, "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": 123.0, "discounted_cash": 92.25, "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": 317.0, "discounted_cash": 237.75, "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": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MAGNESIUM", "code_information": [{"code": "83735", "type": "CPT"}, {"code": "4173735", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 249.0, "discounted_cash": 186.75, "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": 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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MAGNESIUM/2", "code_information": [{"code": "83735", "type": "CPT"}, {"code": "7253737", "type": "CDM"}], "standard_charges": [{"gross_charge": 89.0, "discounted_cash": 66.75, "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": 311.0, "discounted_cash": 233.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MAGNESIUM/4", "code_information": [{"code": "83735", "type": "CPT"}, {"code": "7253755", "type": "CDM"}], "standard_charges": [{"gross_charge": 98.0, "discounted_cash": 73.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MAMMARY DUCT/GALACT SNG", "code_information": [{"code": "77053", "type": "CPT"}, {"code": "5016087", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 3254.0, "discounted_cash": 2440.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MAMMARY IMP", "code_information": [{"code": "L8600", "type": "HCPCS"}, {"code": "8153500", "type": "CDM"}], "standard_charges": [{"gross_charge": 12168.0, "discounted_cash": 9126.0, "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": 1478.0, "discounted_cash": 1108.5, "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": 1478.0, "discounted_cash": 1108.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MANDIBLE 4VW MIN", "code_information": [{"code": "70110", "type": "CPT"}, {"code": "5120110", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1478.0, "discounted_cash": 1108.5, "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": 1006.0, "discounted_cash": 754.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MANDIBLE < 4 VIEWS", "code_information": [{"code": "70100", "type": "CPT"}, {"code": "5120111", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1006.0, "discounted_cash": 754.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MANGANESE", "code_information": [{"code": "83785", "type": "CPT"}, {"code": "7253785", "type": "CDM"}], "standard_charges": [{"gross_charge": 190.0, "discounted_cash": 142.5, "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": 45.0, "discounted_cash": 33.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MANNITOL 20% 500ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412585", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 1174.0, "discounted_cash": 880.5, "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": 0.19, "discounted_cash": 0.14, "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": 0.19, "discounted_cash": 0.14, "setting": "both", "billing_class": "facility"}]}, {"description": "MANUAL BLOOD COUNT/4", "code_information": [{"code": "85032", "type": "CPT"}, {"code": "4105590", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 247.0, "discounted_cash": 185.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MAPROTILINE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306891", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 44.0, "discounted_cash": 33.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MAPROTILINE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306891", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 44.0, "discounted_cash": 33.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MAPROTILINE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306895", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MAPROTILINE 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306895", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MARIJUANA METABOLITE", "code_information": [{"code": "80349", "type": "CPT"}, {"code": "7252542", "type": "CDM"}], "standard_charges": [{"gross_charge": 383.0, "discounted_cash": 287.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MARKER COR BYPASS GRFT", "code_information": [{"code": "A4648", "type": "HCPCS"}, {"code": "4023880", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 339.0, "discounted_cash": 254.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MARKER FIDUCIAL DISP", "code_information": [{"code": "A4648", "type": "HCPCS"}, {"code": "8182907", "type": "CDM"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MARKER TISS MICROMRK11GA", "code_information": [{"code": "A4648", "type": "HCPCS"}, {"code": "8240260", "type": "CDM"}], "standard_charges": [{"gross_charge": 615.0, "discounted_cash": 461.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MATRISTEM MICROMATRI 1MG", "code_information": [{"code": "Q4118", "type": "HCPCS"}, {"code": "4023911", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MATRISTEM MICROMATRI 1MG", "code_information": [{"code": "Q4118", "type": "HCPCS"}, {"code": "4023911", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MATRIX HD PER SQ CM", "code_information": [{"code": "Q4345", "type": "HCPCS"}, {"code": "4023881", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 634.0, "discounted_cash": 475.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MATRIX HD PER SQ CM", "code_information": [{"code": "Q4345", "type": "HCPCS"}, {"code": "4023881", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 634.0, "discounted_cash": 475.5, "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": 11431.0, "discounted_cash": 8573.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MATRX BN CEL VIVIGEN FORM 1CC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4028538", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6867.0, "discounted_cash": 5150.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MATRX BN CEL VIVIGEN FORM 5CC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4028537", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 28870.0, "discounted_cash": 21652.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MATRX COLL REINF INFORCE", "code_information": [{"code": "C1763", "type": "HCPCS"}, {"code": "4023887", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 54773.0, "discounted_cash": 41079.75, "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": 81649.0, "discounted_cash": 61236.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MATRX COLLGN PELV ACEL48", "code_information": [{"code": "C1763", "type": "HCPCS"}, {"code": "8242070", "type": "CDM"}], "standard_charges": [{"gross_charge": 15697.0, "discounted_cash": 11772.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MATRX COLLGN PELV ACEL96", "code_information": [{"code": "C1763", "type": "HCPCS"}, {"code": "8242074", "type": "CDM"}], "standard_charges": [{"gross_charge": 56802.0, "discounted_cash": 42601.5, "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": 2919.0, "discounted_cash": 2189.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MATRX INTEXEN LP", "code_information": [{"code": "C1763", "type": "HCPCS"}, {"code": "4023895", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16985.0, "discounted_cash": 12738.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MATRX OASIS 3-LYR SQ CM", "code_information": [{"code": "Q4124", "type": "HCPCS"}, {"code": "4023913", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 87.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MATRX OASIS 3-LYR SQ CM", "code_information": [{"code": "Q4124", "type": "HCPCS"}, {"code": "4023913", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 87.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MATRX TISS XENFORM", "code_information": [{"code": "C1763", "type": "HCPCS"}, {"code": "8247702", "type": "CDM"}], "standard_charges": [{"gross_charge": 13877.0, "discounted_cash": 10407.75, "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": 4641.0, "discounted_cash": 3480.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MATRX WND ACEL PLST SURG", "code_information": [{"code": "Q4100", "type": "HCPCS"}, {"code": "4023909", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 26539.0, "discounted_cash": 19904.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MATRX WND ACEL PLST SURG", "code_information": [{"code": "Q4100", "type": "HCPCS"}, {"code": "4023909", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 26539.0, "discounted_cash": 19904.25, "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": 7797.0, "discounted_cash": 5847.75, "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": 5006.0, "discounted_cash": 3754.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MCATH ASAHI CORSAIR PRO", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "4033037", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8586.0, "discounted_cash": 6439.5, "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": 5403.0, "discounted_cash": 4052.25, "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": 8652.0, "discounted_cash": 6489.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MCATH DIREXION PL FATHOM", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "4033052", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8441.0, "discounted_cash": 6330.75, "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": 8724.0, "discounted_cash": 6543.0, "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": 13351.0, "discounted_cash": 10013.25, "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": 13351.0, "discounted_cash": 10013.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MCATH FFR RX NAVVUS", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "4033051", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5031.0, "discounted_cash": 3773.25, "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": 5733.0, "discounted_cash": 4299.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MCATH MARATHON", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8240147", "type": "CDM"}], "standard_charges": [{"gross_charge": 10795.0, "discounted_cash": 8096.25, "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": 10778.0, "discounted_cash": 8083.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MCATH PHENOM 21", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "4033089", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 15433.0, "discounted_cash": 11574.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MCATH PROWLER PLUS", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8247775", "type": "CDM"}], "standard_charges": [{"gross_charge": 9242.0, "discounted_cash": 6931.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MCATH PROWLER SM PROFILE", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8247777", "type": "CDM"}], "standard_charges": [{"gross_charge": 13592.0, "discounted_cash": 10194.0, "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": 4949.0, "discounted_cash": 3711.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MDI DEMO AND/OR EVAL", "code_information": [{"code": "94664", "type": "CPT"}, {"code": "5502100", "type": "CDM"}, {"code": "410", "type": "RC"}], "standard_charges": [{"gross_charge": 1761.0, "discounted_cash": 1320.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MDI TREATMENT", "code_information": [{"code": "94640", "type": "CPT"}, {"code": "5502105", "type": "CDM"}, {"code": "410", "type": "RC"}], "standard_charges": [{"gross_charge": 1652.0, "discounted_cash": 1239.0, "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": 700.0, "discounted_cash": 525.0, "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": 700.0, "discounted_cash": 525.0, "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": 14.0, "discounted_cash": 10.5, "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": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MECLIZINE TAB 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306972", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "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": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MED NUTRTN TH INIT 15MIN", "code_information": [{"code": "97802", "type": "CPT"}, {"code": "6570036", "type": "CDM"}, {"code": "942", "type": "RC"}], "standard_charges": [{"gross_charge": 82.0, "discounted_cash": 61.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MED NUTRTN TH REEVAL15MN", "code_information": [{"code": "97803", "type": "CPT"}, {"code": "6570037", "type": "CDM"}, {"code": "942", "type": "RC"}], "standard_charges": [{"gross_charge": 82.0, "discounted_cash": 61.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MED/SURG WITH TELEMETRY", "code_information": [{"code": "1990008", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 7609.0, "discounted_cash": 5706.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MED/SURG WITH TELEMETRY", "code_information": [{"code": "2000008", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 7609.0, "discounted_cash": 5706.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MED/SURG WITH TELEMETRY", "code_information": [{"code": "2010008", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 7609.0, "discounted_cash": 5706.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MED/SURG WITH TELEMETRY", "code_information": [{"code": "2120008", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 7609.0, "discounted_cash": 5706.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MED/SURG WITH TELEMETRY", "code_information": [{"code": "2150008", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 7609.0, "discounted_cash": 5706.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MED/SURG WITH TELEMETRY", "code_information": [{"code": "2310008", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 7609.0, "discounted_cash": 5706.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MED/SURG WITH TELEMETRY", "code_information": [{"code": "2320008", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 7609.0, "discounted_cash": 5706.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MED/SURG WITH TELEMETRY", "code_information": [{"code": "2340008", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 7609.0, "discounted_cash": 5706.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MED/SURG WITH TELEMETRY", "code_information": [{"code": "2350008", "type": "CDM"}, {"code": "206", "type": "RC"}], "standard_charges": [{"gross_charge": 7609.0, "discounted_cash": 5706.75, "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": 31.0, "discounted_cash": 23.25, "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": 31.0, "discounted_cash": 23.25, "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": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MEDROXYPROGEST 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307022", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MEDROXYPROGEST PER 1MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1050", "type": "HCPCS"}, {"code": "5322021", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 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 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": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MEGESTROL 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307076", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MEGESTROL40MG/ML 10ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8999", "type": "HCPCS"}, {"code": "5315568", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 292.0, "discounted_cash": 219.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MEGESTROL40MG/ML 10ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8999", "type": "HCPCS"}, {"code": "5315568", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 292.0, "discounted_cash": 219.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 174.0, "discounted_cash": 130.5, "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": 174.0, "discounted_cash": 130.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MEGESTROL625MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8999", "type": "HCPCS"}, {"code": "5315573", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 284.0, "discounted_cash": 213.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MEGESTROL625MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8999", "type": "HCPCS"}, {"code": "5315573", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 284.0, "discounted_cash": 213.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MELATONIN 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307082", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MELATONIN 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307082", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 342.0, "discounted_cash": 256.5, "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": 342.0, "discounted_cash": 256.5, "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": 114.0, "discounted_cash": 85.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 114.0, "discounted_cash": 85.5, "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": 172.0, "discounted_cash": 129.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 172.0, "discounted_cash": 129.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MEMANTINE 14MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307113", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 74.0, "discounted_cash": 55.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MEMANTINE 14MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307113", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 74.0, "discounted_cash": 55.5, "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": 77.0, "discounted_cash": 57.75, "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": 77.0, "discounted_cash": 57.75, "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": 172.0, "discounted_cash": 129.0, "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": 172.0, "discounted_cash": 129.0, "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": 97.0, "discounted_cash": 72.75, "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": 97.0, "discounted_cash": 72.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MENINGO VAC IM RCMB LIPO PFSIJ", "code_information": [{"code": "90621", "type": "CPT"}, {"code": "5322054", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 606.0, "discounted_cash": 454.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MENINGO VAC IM RCMB LIPO PFSIJ", "code_information": [{"code": "90621", "type": "CPT"}, {"code": "5322054", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 606.0, "discounted_cash": 454.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MENINGOCOCCAL B OMV VAC PFSIJ", "code_information": [{"code": "90620", "type": "CPT"}, {"code": "5322056", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1107.0, "discounted_cash": 830.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MENINGOCOCCAL B OMV VAC PFSIJ", "code_information": [{"code": "90620", "type": "CPT"}, {"code": "5322056", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1107.0, "discounted_cash": 830.25, "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": 600.0, "discounted_cash": 450.0, "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": 600.0, "discounted_cash": 450.0, "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": 2012.0, "discounted_cash": 1509.0, "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": 2012.0, "discounted_cash": 1509.0, "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": 293.0, "discounted_cash": 219.75, "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": 293.0, "discounted_cash": 219.75, "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": "MEPERID/PROMETH 50/25 CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327651", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MEPERID/PROMETH 50/25 CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327651", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "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": 63.0, "discounted_cash": 47.25, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "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": 62.0, "discounted_cash": 46.5, "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": 62.0, "discounted_cash": 46.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "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": 68.0, "discounted_cash": 51.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 89.0, "discounted_cash": 66.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MEPERIDINE PER 100MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2175", "type": "HCPCS"}, {"code": "5327637", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 89.0, "discounted_cash": 66.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MEPERIDINE PER 100MG PCA", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2175", "type": "HCPCS"}, {"code": "5327647", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "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": 92.0, "discounted_cash": 69.0, "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": 92.0, "discounted_cash": 69.0, "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": 28.0, "discounted_cash": 21.0, "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": 28.0, "discounted_cash": 21.0, "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": 204.0, "discounted_cash": 153.0, "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": 204.0, "discounted_cash": 153.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MEPROBAMATE 400MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307249", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 204.0, "discounted_cash": 153.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MEPROBAMATE 400MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307249", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 204.0, "discounted_cash": 153.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MERCAPTOPURINE", "code_information": [{"code": "80299", "type": "CPT"}, {"code": "7000370", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1480.0, "discounted_cash": 1110.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MERCAPTOPURINE", "code_information": [{"code": "80375", "type": "CPT"}, {"code": "7250370", "type": "CDM"}], "standard_charges": [{"gross_charge": 858.0, "discounted_cash": 643.5, "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": 76.0, "discounted_cash": 57.0, "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": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MERCURY QUANTITATIVE", "code_information": [{"code": "83825", "type": "CPT"}, {"code": "7003825", "type": "CDM"}], "standard_charges": [{"gross_charge": 209.0, "discounted_cash": 156.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MERCURY QUANTITATIVE", "code_information": [{"code": "83825", "type": "CPT"}, {"code": "7253825", "type": "CDM"}], "standard_charges": [{"gross_charge": 455.0, "discounted_cash": 341.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MERCURY QUANTITATIVE/4", "code_information": [{"code": "83825", "type": "CPT"}, {"code": "7003830", "type": "CDM"}], "standard_charges": [{"gross_charge": 229.0, "discounted_cash": 171.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MESALAMINE 1000MG SU", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338512", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 546.0, "discounted_cash": 409.5, "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": 546.0, "discounted_cash": 409.5, "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": 62.0, "discounted_cash": 46.5, "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": 62.0, "discounted_cash": 46.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MESALAMINE 400MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307278", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MESALAMINE 400MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307278", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "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": 160.0, "discounted_cash": 120.0, "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": 160.0, "discounted_cash": 120.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MESALAMINE 500MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307279", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 97.0, "discounted_cash": 72.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MESALAMINE 500MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307279", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 97.0, "discounted_cash": 72.75, "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": 165.0, "discounted_cash": 123.75, "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": 165.0, "discounted_cash": 123.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH BARD 3DMAX LG", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8242076", "type": "CDM"}], "standard_charges": [{"gross_charge": 2649.0, "discounted_cash": 1986.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH BARD 3DMAX MED", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8242078", "type": "CDM"}], "standard_charges": [{"gross_charge": 3426.0, "discounted_cash": 2569.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH COMPOSIX 12X12", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8142104", "type": "CDM"}], "standard_charges": [{"gross_charge": 19379.0, "discounted_cash": 14534.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH COMPOSIX 3X6", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8142106", "type": "CDM"}], "standard_charges": [{"gross_charge": 3116.0, "discounted_cash": 2337.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH COMPOSIX 4X8", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8142102", "type": "CDM"}], "standard_charges": [{"gross_charge": 9092.0, "discounted_cash": 6819.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH COMPOSIX 8X10", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8142107", "type": "CDM"}], "standard_charges": [{"gross_charge": 18051.0, "discounted_cash": 13538.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH GRTX DUAL 285CM1OVL", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8242102", "type": "CDM"}], "standard_charges": [{"gross_charge": 19379.0, "discounted_cash": 14534.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH GRTX DUAL 96CM 1THK", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8242112", "type": "CDM"}], "standard_charges": [{"gross_charge": 11608.0, "discounted_cash": 8706.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH H PROLENE 15X15", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8242147", "type": "CDM"}], "standard_charges": [{"gross_charge": 11126.0, "discounted_cash": 8344.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH H PROLENE 4X6", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8242145", "type": "CDM"}], "standard_charges": [{"gross_charge": 10905.0, "discounted_cash": 8178.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH H PTCH BARDKUG LC12", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8247840", "type": "CDM"}], "standard_charges": [{"gross_charge": 8103.0, "discounted_cash": 6077.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH H PTCH BARDKUGL SC8", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8247846", "type": "CDM"}], "standard_charges": [{"gross_charge": 5559.0, "discounted_cash": 4169.25, "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": 4232.0, "discounted_cash": 3174.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH HERNIA COMPOSIX 140", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8242082", "type": "CDM"}], "standard_charges": [{"gross_charge": 19379.0, "discounted_cash": 14534.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH HERNIA PROLENE", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8242150", "type": "CDM"}], "standard_charges": [{"gross_charge": 3599.0, "discounted_cash": 2699.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH HERNIA VENT", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8153510", "type": "CDM"}], "standard_charges": [{"gross_charge": 14330.0, "discounted_cash": 10747.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH HERNIA VENT 2", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8153511", "type": "CDM"}], "standard_charges": [{"gross_charge": 8776.0, "discounted_cash": 6582.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH INTEPRO PERIGEE", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4021500", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 15319.0, "discounted_cash": 11489.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH MARLEX PERFIX PLUG", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8142076", "type": "CDM"}], "standard_charges": [{"gross_charge": 4359.0, "discounted_cash": 3269.25, "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": 7445.0, "discounted_cash": 5583.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH PLUG PERFIX BARD", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8247860", "type": "CDM"}], "standard_charges": [{"gross_charge": 5068.0, "discounted_cash": 3801.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH POLYPRO AVAULTA", "code_information": [{"code": "C1763", "type": "HCPCS"}, {"code": "4024190", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 13925.0, "discounted_cash": 10443.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH POLYPRO FLAT 3X6", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4024191", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1282.0, "discounted_cash": 961.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH POLYPRO FLAT 6X6", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4024192", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1612.0, "discounted_cash": 1209.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH PROCEED", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4024204", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4770.0, "discounted_cash": 3577.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH PROCEED 10X13", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4024206", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 24206.0, "discounted_cash": 18154.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH PROCEED 15X20", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4024207", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 13445.0, "discounted_cash": 10083.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH PROCEED 20X30", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4024208", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 15866.0, "discounted_cash": 11899.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH PROCEED 2X4", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4024203", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3689.0, "discounted_cash": 2766.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH PROCEED 8X10", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4024205", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 14542.0, "discounted_cash": 10906.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH PROCEED VENTRL PTCH", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4024245", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5007.0, "discounted_cash": 3755.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH PROLENE SOFT", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8247865", "type": "CDM"}], "standard_charges": [{"gross_charge": 7699.0, "discounted_cash": 5774.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH ULTRAPRO 15X15CM", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8242098", "type": "CDM"}], "standard_charges": [{"gross_charge": 3856.0, "discounted_cash": 2892.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH ULTRAPRO 30X30CM", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4024240", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5663.0, "discounted_cash": 4247.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH ULTRAPRO 3X6IN", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4024239", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2883.0, "discounted_cash": 2162.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MESH VICRYL", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8142108", "type": "CDM"}], "standard_charges": [{"gross_charge": 13877.0, "discounted_cash": 10407.75, "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": 435.0, "discounted_cash": 326.25, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 435.0, "discounted_cash": 326.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METANEPHRINES", "code_information": [{"code": "83835", "type": "CPT"}, {"code": "7003835", "type": "CDM"}], "standard_charges": [{"gross_charge": 752.0, "discounted_cash": 564.0, "setting": "both", "billing_class": "facility"}]}, {"description": "METANEPHRINES", "code_information": [{"code": "83835", "type": "CPT"}, {"code": "7253836", "type": "CDM"}], "standard_charges": [{"gross_charge": 656.0, "discounted_cash": 492.0, "setting": "both", "billing_class": "facility"}]}, {"description": "METANEPHRINES/2", "code_information": [{"code": "83835", "type": "CPT"}, {"code": "7253837", "type": "CDM"}], "standard_charges": [{"gross_charge": 80.0, "discounted_cash": 60.0, "setting": "both", "billing_class": "facility"}]}, {"description": "METANEPHRINES/3", "code_information": [{"code": "83835", "type": "CPT"}, {"code": "7253838", "type": "CDM"}], "standard_charges": [{"gross_charge": 201.0, "discounted_cash": 150.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METANEPHRINES/5", "code_information": [{"code": "83835", "type": "CPT"}, {"code": "7004901", "type": "CDM"}], "standard_charges": [{"gross_charge": 168.0, "discounted_cash": 126.0, "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": 232.0, "discounted_cash": 174.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 232.0, "discounted_cash": 174.0, "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": 12549.0, "discounted_cash": 9411.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METAXOLONE 400MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307330", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METAXOLONE 400MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307330", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METAXOLONE 800MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307331", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 261.0, "discounted_cash": 195.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METAXOLONE 800MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307331", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 261.0, "discounted_cash": 195.75, "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": 17.0, "discounted_cash": 12.75, "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": 17.0, "discounted_cash": 12.75, "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": 12.0, "discounted_cash": 9.0, "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": 12.0, "discounted_cash": 9.0, "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": 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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "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": 13.0, "discounted_cash": 9.75, "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": 13.0, "discounted_cash": 9.75, "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": 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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METHADONE QUANT", "code_information": [{"code": "80358", "type": "CPT"}, {"code": "7053840", "type": "CDM"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METHADONE QUANT/2", "code_information": [{"code": "80358", "type": "CPT"}, {"code": "7253840", "type": "CDM"}], "standard_charges": [{"gross_charge": 234.0, "discounted_cash": 175.5, "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": 32.0, "discounted_cash": 24.0, "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": 32.0, "discounted_cash": 24.0, "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": 39.0, "discounted_cash": 29.25, "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": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METHENA NA PHS 500/500TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307471", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METHENA NA PHS 500/500TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307471", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "METHENAMINE HIP 1GM TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307480", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "METHENAMINE HIP 1GM TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307480", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "METHENAMINE MAN 1GM TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307476", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METHENAMINE MAN 1GM TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307476", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "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": 168.0, "discounted_cash": 126.0, "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": 168.0, "discounted_cash": 126.0, "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": 16.0, "discounted_cash": 12.0, "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": 16.0, "discounted_cash": 12.0, "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": 16.0, "discounted_cash": 12.0, "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": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "METHOCARBAMOL UPTO10MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2800", "type": "HCPCS"}, {"code": "5322185", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 501.0, "discounted_cash": 375.75, "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": 501.0, "discounted_cash": 375.75, "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": 255.0, "discounted_cash": 191.25, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "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": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METHOTREXATE PER 50MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9260", "type": "HCPCS"}, {"code": "5318089", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METHOTREXATE QUANT", "code_information": [{"code": "80204", "type": "CPT"}, {"code": "7250378", "type": "CDM"}], "standard_charges": [{"gross_charge": 196.0, "discounted_cash": 147.0, "setting": "both", "billing_class": "facility"}]}, {"description": "METHSCOPALAMINE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307568", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "METHSCOPALAMINE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307568", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYCLOTHIAZIDE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307577", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 44.0, "discounted_cash": 33.0, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYCLOTHIAZIDE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307577", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 44.0, "discounted_cash": 33.0, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYL SAL MENTH 150G CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336472", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 468.0, "discounted_cash": 351.0, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYL SAL MENTH 150G CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336472", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 468.0, "discounted_cash": 351.0, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYL SAL MENTH 57GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336473", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 87.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYL SAL MENTH 57GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336473", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 87.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYL SAL MENTH 60ML LT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336471", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 174.0, "discounted_cash": 130.5, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYL SAL MENTH 60ML LT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336471", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 174.0, "discounted_cash": 130.5, "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": 10.0, "discounted_cash": 7.5, "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": 10.0, "discounted_cash": 7.5, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLCELLULS 2GM PWLQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5307572", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLCELLULS 2GM PWLQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5307572", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLDOP/HCTZ 250/15 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307604", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLDOP/HCTZ 250/15 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307604", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "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": 12.0, "discounted_cash": 9.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "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": 20.0, "discounted_cash": 15.0, "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": 594.0, "discounted_cash": 445.5, "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": 594.0, "discounted_cash": 445.5, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLEN BLUE PER 1MG IJ", "code_information": [{"code": "Q9968", "type": "HCPCS"}, {"code": "5358207", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLERGONOV UPTO.2MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2210", "type": "HCPCS"}, {"code": "5322269", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 475.0, "discounted_cash": 356.25, "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": 475.0, "discounted_cash": 356.25, "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": 70.0, "discounted_cash": 52.5, "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": 70.0, "discounted_cash": 52.5, "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": 10.0, "discounted_cash": 7.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 10.0, "discounted_cash": 7.5, "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": 307.0, "discounted_cash": 230.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 307.0, "discounted_cash": 230.25, "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": 14.0, "discounted_cash": 10.5, "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": 14.0, "discounted_cash": 10.5, "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": 261.0, "discounted_cash": 195.75, "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": 261.0, "discounted_cash": 195.75, "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": 14.0, "discounted_cash": 10.5, "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": 14.0, "discounted_cash": 10.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 58.0, "discounted_cash": 43.5, "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": 58.0, "discounted_cash": 43.5, "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": 396.0, "discounted_cash": 297.0, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLPRED 4MG 21 PK TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307662", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 396.0, "discounted_cash": 297.0, "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": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLPRED 4MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307658", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLPRED A PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1010", "type": "HCPCS"}, {"code": "5322296", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METHYLPRED SS PER 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2919", "type": "HCPCS"}, {"code": "5322313", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.5, "discounted_cash": 0.38, "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": 0.5, "discounted_cash": 0.38, "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": 384.0, "discounted_cash": 288.0, "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": 384.0, "discounted_cash": 288.0, "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": 45.0, "discounted_cash": 33.75, "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": 45.0, "discounted_cash": 33.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METOCLOPRAM5/5 10ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315668", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "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": 28.0, "discounted_cash": 21.0, "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": 10.0, "discounted_cash": 7.5, "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": 10.0, "discounted_cash": 7.5, "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": 21.0, "discounted_cash": 15.75, "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": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "METOLAZONE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307762", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 187.0, "discounted_cash": 140.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 187.0, "discounted_cash": 140.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "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": 3.0, "discounted_cash": 2.25, "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": 131.0, "discounted_cash": 98.25, "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": 131.0, "discounted_cash": 98.25, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 10.0, "discounted_cash": 7.5, "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": 10.0, "discounted_cash": 7.5, "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": 89.0, "discounted_cash": 66.75, "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": 89.0, "discounted_cash": 66.75, "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": 5.0, "discounted_cash": 3.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "METOPROLOL 50MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307786", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "METOPROLOL PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0616", "type": "HCPCS"}, {"code": "5322380", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "METOPROLOL PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0616", "type": "HCPCS"}, {"code": "5322380", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "METRONIDAZOLE 1% 60GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336564", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2554.0, "discounted_cash": 1915.5, "setting": "both", "billing_class": "facility"}]}, {"description": "METRONIDAZOLE 1% 60GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336564", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2554.0, "discounted_cash": 1915.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "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": 3.0, "discounted_cash": 2.25, "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": 20.0, "discounted_cash": 15.0, "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": 20.0, "discounted_cash": 15.0, "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": 0.25, "discounted_cash": 0.19, "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": 0.25, "discounted_cash": 0.19, "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": 1826.0, "discounted_cash": 1369.5, "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": 1826.0, "discounted_cash": 1369.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 448.0, "discounted_cash": 336.0, "setting": "both", "billing_class": "facility"}]}, {"description": "METRONIDAZOLE.75%70GMVGL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336560", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 448.0, "discounted_cash": 336.0, "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": 20.0, "discounted_cash": 15.0, "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": 20.0, "discounted_cash": 15.0, "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": 26.0, "discounted_cash": 19.5, "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": 26.0, "discounted_cash": 19.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MG CL 64MG XR TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5306832", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MG GLUCONATE 500MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5306856", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MG GLUCONATE 500MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5306856", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MG OH 8% 30ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315742", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MG SULFATE 120GM PW", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336354", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MG SULFATE 120GM PW", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336354", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MGMT GENE ASSAY", "code_information": [{"code": "81287", "type": "CPT"}, {"code": "7270026", "type": "CDM"}], "standard_charges": [{"gross_charge": 1270.0, "discounted_cash": 952.5, "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": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MICAFUNGIN PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2248", "type": "HCPCS"}, {"code": "5322409", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MICONAZOLE 100MG 7PK VSU", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336580", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MICONAZOLE 2% 15GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336593", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MICONAZOLE 2% 15GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336593", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "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": 32.0, "discounted_cash": 24.0, "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": 32.0, "discounted_cash": 24.0, "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": 31.0, "discounted_cash": 23.25, "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": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MICONAZOLE 2%1200MG V KT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336590", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 687.0, "discounted_cash": 515.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MICONAZOLE 2%1200MG V KT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336590", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 687.0, "discounted_cash": 515.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MICONAZOLE 200MG VSU", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336581", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 292.0, "discounted_cash": 219.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MICONAZOLE 200MG VSU", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336581", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 292.0, "discounted_cash": 219.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MICONAZOLE200MG3PK VSU", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336582", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 470.0, "discounted_cash": 352.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MICONAZOLE200MG3PK VSU", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336582", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 470.0, "discounted_cash": 352.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MICRO ALBUMIN URINE QNT", "code_information": [{"code": "82043", "type": "CPT"}, {"code": "4122042", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MICRO ALBUMIN URINE QNT", "code_information": [{"code": "82043", "type": "CPT"}, {"code": "4172042", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 148.0, "discounted_cash": 111.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MICRO ALBUMIN URINE QNT", "code_information": [{"code": "82043", "type": "CPT"}, {"code": "7002043", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 173.0, "discounted_cash": 129.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MICRO ALBUMIN URINE QNT", "code_information": [{"code": "82043", "type": "CPT"}, {"code": "7252043", "type": "CDM"}], "standard_charges": [{"gross_charge": 189.0, "discounted_cash": 141.75, "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": 117.0, "discounted_cash": 87.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MICROHEMATOCRIT SPUN", "code_information": [{"code": "85013", "type": "CPT"}, {"code": "4125054", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MICROSAT INSTABILITY ANL", "code_information": [{"code": "81301", "type": "CPT"}, {"code": "7270031", "type": "CDM"}], "standard_charges": [{"gross_charge": 2213.0, "discounted_cash": 1659.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MICROSOMAL ANTIBODY EA", "code_information": [{"code": "86376", "type": "CPT"}, {"code": "4176376", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 214.0, "discounted_cash": 160.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MICROSOMAL ANTIBODY EA", "code_information": [{"code": "86376", "type": "CPT"}, {"code": "7005559", "type": "CDM"}], "standard_charges": [{"gross_charge": 252.0, "discounted_cash": 189.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MICROSOMAL ANTIBODY EA", "code_information": [{"code": "86376", "type": "CPT"}, {"code": "7255559", "type": "CDM"}], "standard_charges": [{"gross_charge": 271.0, "discounted_cash": 203.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MICROSOMAL ANTIBODY EA/2", "code_information": [{"code": "86376", "type": "CPT"}, {"code": "7256374", "type": "CDM"}], "standard_charges": [{"gross_charge": 359.0, "discounted_cash": 269.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MICROSOMAL ANTIBODY EA/3", "code_information": [{"code": "86376", "type": "CPT"}, {"code": "7006377", "type": "CDM"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MIDAZOLAM 10MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327730", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 159.0, "discounted_cash": 119.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MIDAZOLAM 10MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327730", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 159.0, "discounted_cash": 119.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MIDAZOLAM PER 1MG INF IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2250", "type": "HCPCS"}, {"code": "5327719", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 89.0, "discounted_cash": 66.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MIDAZOLAM PER 1MG INF IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2250", "type": "HCPCS"}, {"code": "5327719", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 89.0, "discounted_cash": 66.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MIDAZOLAM PER 1MG PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2250", "type": "HCPCS"}, {"code": "5327721", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MIDAZOLAM PER 1MG PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2250", "type": "HCPCS"}, {"code": "5327721", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MIDLINE INSERTION 3+YRS", "code_information": [{"code": "6296410", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1780.0, "discounted_cash": 1335.0, "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": 75.0, "discounted_cash": 56.25, "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": 75.0, "discounted_cash": 56.25, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 306.0, "discounted_cash": 229.5, "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": 306.0, "discounted_cash": 229.5, "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": 12.0, "discounted_cash": 9.0, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "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": 23.0, "discounted_cash": 17.25, "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": 23.0, "discounted_cash": 17.25, "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": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MINERAL OIL STER 10ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336644", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "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": 359.0, "discounted_cash": 269.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MINOCYCLINE 100MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307861", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 45.0, "discounted_cash": 33.75, "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": 45.0, "discounted_cash": 33.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MINOXIDIL 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307889", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "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": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MIRABEGRON 25MG XR24 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307870", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MIRABEGRON 25MG XR24 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307870", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "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": 61.0, "discounted_cash": 45.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "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": 26.0, "discounted_cash": 19.5, "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": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MIRTAZAPINE 15MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307880", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "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": 17.0, "discounted_cash": 12.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "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": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MISOPROSTOL 100MCG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307890", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "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": 83.0, "discounted_cash": 62.25, "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": 83.0, "discounted_cash": 62.25, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MISOPROSTOL 25MCG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307892", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MITCHONDRIAL ANTIBODY", "code_information": [{"code": "86381", "type": "CPT"}, {"code": "7253533", "type": "CDM"}], "standard_charges": [{"gross_charge": 222.0, "discounted_cash": 166.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MITCHONDRIAL ANTIBODY/2", "code_information": [{"code": "86381", "type": "CPT"}, {"code": "7253522", "type": "CDM"}], "standard_charges": [{"gross_charge": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MITOCHONDRIAL AB", "code_information": [{"code": "86381", "type": "CPT"}, {"code": "7006399", "type": "CDM"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 105.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MITOMYCIN PER 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9280", "type": "HCPCS"}, {"code": "5322492", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 970.0, "discounted_cash": 727.5, "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": 970.0, "discounted_cash": 727.5, "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": 2019.0, "discounted_cash": 1514.25, "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": 2019.0, "discounted_cash": 1514.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED OTH EA ADD15", "code_information": [{"code": "99157", "type": "CPT"}, {"code": "4619157", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 460.0, "discounted_cash": 345.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED OTH EA ADD15", "code_information": [{"code": "99157", "type": "CPT"}, {"code": "4909157", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 460.0, "discounted_cash": 345.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED OTH EA ADD15", "code_information": [{"code": "99157", "type": "CPT"}, {"code": "4919157", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 460.0, "discounted_cash": 345.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED OTH EA ADD15", "code_information": [{"code": "99157", "type": "CPT"}, {"code": "5059157", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 460.0, "discounted_cash": 345.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED OTH EA ADD15", "code_information": [{"code": "99157", "type": "CPT"}, {"code": "5060015", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 460.0, "discounted_cash": 345.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED OTH EA ADD15", "code_information": [{"code": "99157", "type": "CPT"}, {"code": "5259157", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 460.0, "discounted_cash": 345.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED OTH EA ADD15", "code_information": [{"code": "99157", "type": "CPT"}, {"code": "6109157", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 460.0, "discounted_cash": 345.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED OTH>5YRS INIT15", "code_information": [{"code": "99156", "type": "CPT"}, {"code": "4619156", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 702.0, "discounted_cash": 526.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED OTH>5YRS INIT15", "code_information": [{"code": "99156", "type": "CPT"}, {"code": "4909156", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 701.0, "discounted_cash": 525.75, "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": 701.0, "discounted_cash": 525.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED OTH>5YRS INIT15", "code_information": [{"code": "99156", "type": "CPT"}, {"code": "5059156", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 701.0, "discounted_cash": 525.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED OTH>5YRS INIT15", "code_information": [{"code": "99156", "type": "CPT"}, {"code": "5060016", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 701.0, "discounted_cash": 525.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED OTH>5YRS INIT15", "code_information": [{"code": "99156", "type": "CPT"}, {"code": "5259156", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 701.0, "discounted_cash": 525.75, "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": 702.0, "discounted_cash": 526.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED SAM>5YRS INIT15", "code_information": [{"code": "99152", "type": "CPT"}, {"code": "5259152", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 747.0, "discounted_cash": 560.25, "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": 433.0, "discounted_cash": 324.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED SAME EA ADD15", "code_information": [{"code": "99153", "type": "CPT"}, {"code": "4909153", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 433.0, "discounted_cash": 324.75, "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": 433.0, "discounted_cash": 324.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED SAME EA ADD15", "code_information": [{"code": "99153", "type": "CPT"}, {"code": "4959153", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 433.0, "discounted_cash": 324.75, "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": 433.0, "discounted_cash": 324.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED SAME EA ADD15", "code_information": [{"code": "99153", "type": "CPT"}, {"code": "5069153", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 433.0, "discounted_cash": 324.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED SAME EA ADD15", "code_information": [{"code": "99153", "type": "CPT"}, {"code": "5259153", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 433.0, "discounted_cash": 324.75, "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": 433.0, "discounted_cash": 324.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED SAME<5YRS INIT15", "code_information": [{"code": "99151", "type": "CPT"}, {"code": "4619151", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 844.0, "discounted_cash": 633.0, "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": 844.0, "discounted_cash": 633.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED SAME<5YRS INIT15", "code_information": [{"code": "99151", "type": "CPT"}, {"code": "5259151", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 844.0, "discounted_cash": 633.0, "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": 844.0, "discounted_cash": 633.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED SAME>5YRS INIT15", "code_information": [{"code": "99152", "type": "CPT"}, {"code": "4619152", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 747.0, "discounted_cash": 560.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED SAME>5YRS INIT15", "code_information": [{"code": "99152", "type": "CPT"}, {"code": "4909152", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 747.0, "discounted_cash": 560.25, "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": 747.0, "discounted_cash": 560.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED SAME>5YRS INIT15", "code_information": [{"code": "99152", "type": "CPT"}, {"code": "4959152", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 747.0, "discounted_cash": 560.25, "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": 747.0, "discounted_cash": 560.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MOD SED SAME>5YRS INIT15", "code_information": [{"code": "99152", "type": "CPT"}, {"code": "5069152", "type": "CDM"}, {"code": "370", "type": "RC"}], "standard_charges": [{"gross_charge": 747.0, "discounted_cash": 560.25, "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": 747.0, "discounted_cash": 560.25, "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": 93.0, "discounted_cash": 69.75, "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": 93.0, "discounted_cash": 69.75, "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": 592.0, "discounted_cash": 444.0, "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": 592.0, "discounted_cash": 444.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MOG AB", "code_information": [{"code": "86362", "type": "CPT"}, {"code": "7250399", "type": "CDM"}], "standard_charges": [{"gross_charge": 2315.0, "discounted_cash": 1736.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MOLD HEAD HIP SPCR W/INS", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4014152", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9243.0, "discounted_cash": 6932.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MOLEC CYTOGEN INTPHS 100-300/5", "code_information": [{"code": "88275", "type": "CPT"}, {"code": "7258276", "type": "CDM"}], "standard_charges": [{"gross_charge": 353.0, "discounted_cash": 264.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MOLECULAR PATH LEVEL 2/3", "code_information": [{"code": "81401", "type": "CPT"}, {"code": "7251401", "type": "CDM"}], "standard_charges": [{"gross_charge": 865.0, "discounted_cash": 648.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MOLECULAR PATH LEVEL 4/3", "code_information": [{"code": "81403", "type": "CPT"}, {"code": "7259214", "type": "CDM"}], "standard_charges": [{"gross_charge": 1379.0, "discounted_cash": 1034.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MOLECULAR PATH LEVEL 6", "code_information": [{"code": "81405", "type": "CPT"}, {"code": "7270047", "type": "CDM"}], "standard_charges": [{"gross_charge": 2796.0, "discounted_cash": 2097.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MOLECULR CYTO DNA PRB EA/4", "code_information": [{"code": "88271", "type": "CPT"}, {"code": "7258841", "type": "CDM"}], "standard_charges": [{"gross_charge": 165.0, "discounted_cash": 123.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MOMET/FORM 100/5 8.8G IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5331499", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1675.0, "discounted_cash": 1256.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MOMET/FORM 100/5 8.8G IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5331499", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1675.0, "discounted_cash": 1256.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MOMET/FORM 200/5 8.8G IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5331498", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2066.0, "discounted_cash": 1549.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MOMET/FORM 200/5 8.8G IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5331498", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2066.0, "discounted_cash": 1549.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MOMETASONE .1% 15GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336680", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 44.0, "discounted_cash": 33.0, "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": 44.0, "discounted_cash": 33.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MOMETASONE .1% 45GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336681", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MOMETASONE .1% 45GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336681", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 89.0, "discounted_cash": 66.75, "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": 89.0, "discounted_cash": 66.75, "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": 925.0, "discounted_cash": 693.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 925.0, "discounted_cash": 693.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MONONUCLEAR CELL AG QNT", "code_information": [{"code": "86356", "type": "CPT"}, {"code": "7256155", "type": "CDM"}], "standard_charges": [{"gross_charge": 171.0, "discounted_cash": 128.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MONTELUKAST 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307903", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MONTELUKAST 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307903", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MONTELUKAST 4MG CTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307905", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 252.0, "discounted_cash": 189.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MONTELUKAST 4MG CTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307905", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 252.0, "discounted_cash": 189.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MONTELUKAST 5MG CTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307904", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 319.0, "discounted_cash": 239.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MONTELUKAST 5MG CTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307904", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 319.0, "discounted_cash": 239.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MORCELLATOR", "code_information": [{"code": "C1782", "type": "HCPCS"}, {"code": "8240264", "type": "CDM"}], "standard_charges": [{"gross_charge": 10631.0, "discounted_cash": 7973.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MORCELLATOR ROTARY", "code_information": [{"code": "C1782", "type": "HCPCS"}, {"code": "8175336", "type": "CDM"}], "standard_charges": [{"gross_charge": 7109.0, "discounted_cash": 5331.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 98.0, "discounted_cash": 73.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MORPH PF EPI/INTR 10MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2274", "type": "HCPCS"}, {"code": "5327712", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 98.0, "discounted_cash": 73.5, "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": 0.77, "discounted_cash": 0.58, "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": 0.77, "discounted_cash": 0.58, "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": 159.0, "discounted_cash": 119.25, "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": 159.0, "discounted_cash": 119.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MORPHINE 10MG/0.5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327715", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MORPHINE 10MG/0.5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327715", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "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": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MORPHINE 10MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327749", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MORPHINE 15MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327777", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 23.0, "discounted_cash": 17.25, "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": 23.0, "discounted_cash": 17.25, "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": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MORPHINE 15MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327780", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MORPHINE 20MG/1ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327755", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "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": 16.0, "discounted_cash": 12.0, "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": 16.0, "discounted_cash": 12.0, "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": 58.0, "discounted_cash": 43.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 58.0, "discounted_cash": 43.5, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MORPHINE NEO IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5322515", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MORPHINE PER 10MG PCA", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2270", "type": "HCPCS"}, {"code": "5327836", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MORPHINE PER 10MG PCA", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2270", "type": "HCPCS"}, {"code": "5327836", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "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": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MORPHOMETRIC NERVE", "code_information": [{"code": "88356", "type": "CPT"}, {"code": "7098354", "type": "CDM"}], "standard_charges": [{"gross_charge": 766.0, "discounted_cash": 574.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MORPHOMETRIC SKEL MUSC", "code_information": [{"code": "88355", "type": "CPT"}, {"code": "7098355", "type": "CDM"}], "standard_charges": [{"gross_charge": 766.0, "discounted_cash": 574.5, "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": 1442.0, "discounted_cash": 1081.5, "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": 150.0, "discounted_cash": 112.5, "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": 150.0, "discounted_cash": 112.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MOXIFLOXACIN 0.16% 1ML OPHT IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331510", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 153.0, "discounted_cash": 114.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MOXIFLOXACIN 400MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307909", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MOXIFLOXACIN 400MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307909", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MOXIFLOXC PER100MG PMXIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2280", "type": "HCPCS"}, {"code": "5312556", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 45.0, "discounted_cash": 33.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MOXIFLOXC PER100MG PMXIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2280", "type": "HCPCS"}, {"code": "5312556", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 45.0, "discounted_cash": 33.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MPL GENE SEQ ALYS EXON 10", "code_information": [{"code": "81339", "type": "CPT"}, {"code": "7270153", "type": "CDM"}], "standard_charges": [{"gross_charge": 1024.0, "discounted_cash": 768.0, "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": 124.0, "discounted_cash": 93.0, "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": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRA ABDOMEN W/O CM", "code_information": [{"code": "74185", "type": "CPT"}, {"code": "5124185", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 6462.0, "discounted_cash": 4846.5, "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": 6462.0, "discounted_cash": 4846.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRA ABDOMEN WO/W CM", "code_information": [{"code": "74185", "type": "CPT"}, {"code": "5124186", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 6462.0, "discounted_cash": 4846.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRA ABDOMEN WO/W CM", "code_information": [{"code": "74185", "type": "CPT"}, {"code": "5258902", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 6462.0, "discounted_cash": 4846.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRA CHEST W/O CONTRAST", "code_information": [{"code": "71555", "type": "CPT"}, {"code": "5121556", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 9237.0, "discounted_cash": 6927.75, "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": 9237.0, "discounted_cash": 6927.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRA CHEST WO/W CONTRAST", "code_information": [{"code": "71555", "type": "CPT"}, {"code": "5258911", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 8247.0, "discounted_cash": 6185.25, "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": 6309.0, "discounted_cash": 4731.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRA HEAD W/O CONTRAST", "code_information": [{"code": "70544", "type": "CPT"}, {"code": "5120544", "type": "CDM"}, {"code": "615", "type": "RC"}], "standard_charges": [{"gross_charge": 7495.0, "discounted_cash": 5621.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRA HEAD W/O CONTRAST", "code_information": [{"code": "70544", "type": "CPT"}, {"code": "5250601", "type": "CDM"}, {"code": "615", "type": "RC"}], "standard_charges": [{"gross_charge": 7495.0, "discounted_cash": 5621.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRA HEAD WO/W CONTRAST", "code_information": [{"code": "70546", "type": "CPT"}, {"code": "5120546", "type": "CDM"}, {"code": "615", "type": "RC"}], "standard_charges": [{"gross_charge": 7982.0, "discounted_cash": 5986.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRA HEAD WO/W CONTRAST", "code_information": [{"code": "70546", "type": "CPT"}, {"code": "5250603", "type": "CDM"}, {"code": "615", "type": "RC"}], "standard_charges": [{"gross_charge": 7339.0, "discounted_cash": 5504.25, "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": 11761.0, "discounted_cash": 8820.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRA LOWR EXTRMTY WO/W CM", "code_information": [{"code": "73725", "type": "CPT"}, {"code": "5258914", "type": "CDM"}, {"code": "616", "type": "RC"}], "standard_charges": [{"gross_charge": 11761.0, "discounted_cash": 8820.75, "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": 6708.0, "discounted_cash": 5031.0, "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": 6638.0, "discounted_cash": 4978.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRA NECK WO/W CONTRAST", "code_information": [{"code": "70549", "type": "CPT"}, {"code": "5120549", "type": "CDM"}, {"code": "615", "type": "RC"}], "standard_charges": [{"gross_charge": 6488.0, "discounted_cash": 4866.0, "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": 8834.0, "discounted_cash": 6625.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRA PELVIS W/O CONTRAST", "code_information": [{"code": "72198", "type": "CPT"}, {"code": "5258919", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 10739.0, "discounted_cash": 8054.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRA PELVIS WO/W CONTRAST", "code_information": [{"code": "72198", "type": "CPT"}, {"code": "5122000", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 10739.0, "discounted_cash": 8054.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRA PELVIS WO/W CONTRAST", "code_information": [{"code": "72198", "type": "CPT"}, {"code": "5258920", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 10739.0, "discounted_cash": 8054.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRA UP EXTRMTY WO/W CM", "code_information": [{"code": "73225", "type": "CPT"}, {"code": "5259585", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 9811.0, "discounted_cash": 7358.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI ABDOMEN W/ CM", "code_information": [{"code": "74182", "type": "CPT"}, {"code": "5250974", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 9046.0, "discounted_cash": 6784.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI ABDOMEN W/O CM", "code_information": [{"code": "74181", "type": "CPT"}, {"code": "5124181", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 7613.0, "discounted_cash": 5709.75, "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": 7613.0, "discounted_cash": 5709.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI ABDOMEN WO/W CM", "code_information": [{"code": "74183", "type": "CPT"}, {"code": "5124183", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 10692.0, "discounted_cash": 8019.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI ABDOMEN WO/W CM", "code_information": [{"code": "74183", "type": "CPT"}, {"code": "5251000", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 10692.0, "discounted_cash": 8019.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI BRAIN W/O CONTRAST", "code_information": [{"code": "70551", "type": "CPT"}, {"code": "5120551", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 8445.0, "discounted_cash": 6333.75, "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": 8445.0, "discounted_cash": 6333.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI BRAIN WITH CONTRAST", "code_information": [{"code": "70552", "type": "CPT"}, {"code": "5120552", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 6947.0, "discounted_cash": 5210.25, "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": 6947.0, "discounted_cash": 5210.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI BRAIN WO/W CONTRAST", "code_information": [{"code": "70553", "type": "CPT"}, {"code": "5120553", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 9678.0, "discounted_cash": 7258.5, "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": 9678.0, "discounted_cash": 7258.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI BREAST BI W/ CM", "code_information": [{"code": "C8906", "type": "HCPCS"}, {"code": "5258906", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 8583.0, "discounted_cash": 6437.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI BREAST UNI W/ CM", "code_information": [{"code": "C8903", "type": "HCPCS"}, {"code": "5258903", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 8583.0, "discounted_cash": 6437.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI BRST W/O CM BILATERAL", "code_information": [{"code": "77047", "type": "CPT"}, {"code": "5258907", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 5569.0, "discounted_cash": 4176.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI BRST W/O CM UNILATERAL", "code_information": [{"code": "77046", "type": "CPT"}, {"code": "5258904", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 6784.0, "discounted_cash": 5088.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI BRST WO&W CM+CAD BI", "code_information": [{"code": "77049", "type": "CPT"}, {"code": "5257049", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 10692.0, "discounted_cash": 8019.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI BRST WO&W CM+CAD UNI", "code_information": [{"code": "77048", "type": "CPT"}, {"code": "5257048", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 8563.0, "discounted_cash": 6422.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI CHEST W/O CONTRAST", "code_information": [{"code": "71550", "type": "CPT"}, {"code": "5121550", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 8443.0, "discounted_cash": 6332.25, "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": 8443.0, "discounted_cash": 6332.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI CHEST WO/W CONTRAST", "code_information": [{"code": "71552", "type": "CPT"}, {"code": "5121552", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 7629.0, "discounted_cash": 5721.75, "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": 7629.0, "discounted_cash": 5721.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI GUIDED NEEDLE PLCMNT", "code_information": [{"code": "77021", "type": "CPT"}, {"code": "5250860", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 3376.0, "discounted_cash": 2532.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI LE JNT WO/W CM", "code_information": [{"code": "73723", "type": "CPT"}, {"code": "5123723", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 10536.0, "discounted_cash": 7902.0, "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": 10536.0, "discounted_cash": 7902.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI LE NONJNT W/CM", "code_information": [{"code": "73719", "type": "CPT"}, {"code": "5123719", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 9509.0, "discounted_cash": 7131.75, "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": 9509.0, "discounted_cash": 7131.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI LE NONJNT W/O CM", "code_information": [{"code": "73718", "type": "CPT"}, {"code": "5123718", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 8878.0, "discounted_cash": 6658.5, "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": 8878.0, "discounted_cash": 6658.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI LE NONJNT WO/W CM", "code_information": [{"code": "73720", "type": "CPT"}, {"code": "5123720", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 8284.0, "discounted_cash": 6213.0, "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": 8284.0, "discounted_cash": 6213.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI LOWR EXT JNT W/ CM", "code_information": [{"code": "73722", "type": "CPT"}, {"code": "5123722", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 10207.0, "discounted_cash": 7655.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI LOWR EXT JNT W/ CM", "code_information": [{"code": "73722", "type": "CPT"}, {"code": "5251006", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 10207.0, "discounted_cash": 7655.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI LOWR EXT JNT W/O CM", "code_information": [{"code": "73721", "type": "CPT"}, {"code": "5123721", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 8109.0, "discounted_cash": 6081.75, "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": 8109.0, "discounted_cash": 6081.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI ORB/FACE/NECK WO CM", "code_information": [{"code": "70540", "type": "CPT"}, {"code": "5120540", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 7046.0, "discounted_cash": 5284.5, "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": 7046.0, "discounted_cash": 5284.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI ORB/FACE/NECK WO/W C", "code_information": [{"code": "70543", "type": "CPT"}, {"code": "5120543", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 7629.0, "discounted_cash": 5721.75, "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": 7629.0, "discounted_cash": 5721.75, "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": 8673.0, "discounted_cash": 6504.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI PELVIS W/O CONTRAST", "code_information": [{"code": "72195", "type": "CPT"}, {"code": "5122195", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 6251.0, "discounted_cash": 4688.25, "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": 6251.0, "discounted_cash": 4688.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI PELVIS WO/W CONTRAST", "code_information": [{"code": "72197", "type": "CPT"}, {"code": "5122197", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 6468.0, "discounted_cash": 4851.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI PELVIS WO/W CONTRAST", "code_information": [{"code": "72197", "type": "CPT"}, {"code": "5250852", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 6468.0, "discounted_cash": 4851.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SAFETY DETER PHYS/QHP", "code_information": [{"code": "76016", "type": "CPT"}, {"code": "5250096", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 456.0, "discounted_cash": 342.0, "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": 476.0, "discounted_cash": 357.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SAFETY IMPLT POS&/IMMOBLJ", "code_information": [{"code": "76019", "type": "CPT"}, {"code": "5250099", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 308.0, "discounted_cash": 231.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SFTY IMPLT&FB 1ST 15MIN", "code_information": [{"code": "76014", "type": "CPT"}, {"code": "5250094", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 127.0, "discounted_cash": 95.25, "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": 1253.0, "discounted_cash": 939.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SFTY MPLT&FB ADD 30MIN", "code_information": [{"code": "76015", "type": "CPT"}, {"code": "5250095", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 127.0, "discounted_cash": 95.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SPINE CERV WO/W CM", "code_information": [{"code": "72156", "type": "CPT"}, {"code": "5122156", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 7629.0, "discounted_cash": 5721.75, "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": 7629.0, "discounted_cash": 5721.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SPINE CERVICAL W/CM", "code_information": [{"code": "72142", "type": "CPT"}, {"code": "5122142", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 6462.0, "discounted_cash": 4846.5, "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": 6462.0, "discounted_cash": 4846.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SPINE CERVICL W/O CM", "code_information": [{"code": "72141", "type": "CPT"}, {"code": "5122141", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 9074.0, "discounted_cash": 6805.5, "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": 9074.0, "discounted_cash": 6805.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SPINE LUMBAR W/CM", "code_information": [{"code": "72149", "type": "CPT"}, {"code": "5122149", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 6462.0, "discounted_cash": 4846.5, "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": 6462.0, "discounted_cash": 4846.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SPINE LUMBAR W/O CM", "code_information": [{"code": "72148", "type": "CPT"}, {"code": "5122148", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 7726.0, "discounted_cash": 5794.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SPINE LUMBAR W/O CM", "code_information": [{"code": "72148", "type": "CPT"}, {"code": "5250692", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 7726.0, "discounted_cash": 5794.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SPINE LUMBAR WO/W CM", "code_information": [{"code": "72158", "type": "CPT"}, {"code": "5122158", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 7629.0, "discounted_cash": 5721.75, "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": 7629.0, "discounted_cash": 5721.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SPINE THOR WO/W CM", "code_information": [{"code": "72157", "type": "CPT"}, {"code": "5122157", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 7629.0, "discounted_cash": 5721.75, "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": 7629.0, "discounted_cash": 5721.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SPINE THORAC W/O CM", "code_information": [{"code": "72146", "type": "CPT"}, {"code": "5122146", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 7613.0, "discounted_cash": 5709.75, "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": 7613.0, "discounted_cash": 5709.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI SPINE THORACIC W/CM", "code_information": [{"code": "72147", "type": "CPT"}, {"code": "5122147", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 6965.0, "discounted_cash": 5223.75, "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": 6965.0, "discounted_cash": 5223.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI TMJ", "code_information": [{"code": "70336", "type": "CPT"}, {"code": "5120336", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 6291.0, "discounted_cash": 4718.25, "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": 6291.0, "discounted_cash": 4718.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI UP EXT JNT W/ CM", "code_information": [{"code": "73222", "type": "CPT"}, {"code": "5123222", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 8997.0, "discounted_cash": 6747.75, "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": 8997.0, "discounted_cash": 6747.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI UP EXT JNT W/O CM", "code_information": [{"code": "73221", "type": "CPT"}, {"code": "5123221", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 9518.0, "discounted_cash": 7138.5, "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": 9518.0, "discounted_cash": 7138.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI UP EXT JNT WO/W CM", "code_information": [{"code": "73223", "type": "CPT"}, {"code": "5123223", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 6792.0, "discounted_cash": 5094.0, "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": 6792.0, "discounted_cash": 5094.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI UP EXT NONJNT W/ CM", "code_information": [{"code": "73219", "type": "CPT"}, {"code": "5123219", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 8635.0, "discounted_cash": 6476.25, "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": 8635.0, "discounted_cash": 6476.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI UP EXT NONJNT W/O CM", "code_information": [{"code": "73218", "type": "CPT"}, {"code": "5123218", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 5328.0, "discounted_cash": 3996.0, "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": 5328.0, "discounted_cash": 3996.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI UP EXT NONJNT WO/WCM", "code_information": [{"code": "73220", "type": "CPT"}, {"code": "5123220", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 5906.0, "discounted_cash": 4429.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRI UP EXT NONJNT WO/WCM", "code_information": [{"code": "73220", "type": "CPT"}, {"code": "5251055", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 5906.0, "discounted_cash": 4429.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MRSA AMP PROBE", "code_information": [{"code": "87641", "type": "CPT"}, {"code": "4107641", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 631.0, "discounted_cash": 473.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MRSA AMP PROBE", "code_information": [{"code": "87641", "type": "CPT"}, {"code": "4177641", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 496.0, "discounted_cash": 372.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MSH CONTAINMENT BONE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4023996", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 48400.0, "discounted_cash": 36300.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MSH H SEPRA/POLY", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4024082", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5663.0, "discounted_cash": 4247.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MSH H SEPRA/POLY 4X8", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4024086", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8470.0, "discounted_cash": 6352.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MSH H SEPRA/POLY 6X8", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4024083", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11481.0, "discounted_cash": 8610.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MSH H SEPRA/POLY 8X12", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4024088", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 13974.0, "discounted_cash": 10480.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MSH LAPAROSCOPIC SLF-FIX", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4024095", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4929.0, "discounted_cash": 3696.75, "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": 16985.0, "discounted_cash": 12738.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MSH POLYPRO PLUG LG", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4024199", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2329.0, "discounted_cash": 1746.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MSH POLYPRO PLUG M", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4024201", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2329.0, "discounted_cash": 1746.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MSH PROLENE", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8175345", "type": "CDM"}], "standard_charges": [{"gross_charge": 4514.0, "discounted_cash": 3385.5, "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": 14478.0, "discounted_cash": 10858.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MSH Y UPSYLON", "code_information": [{"code": "C1763", "type": "HCPCS"}, {"code": "4024243", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11380.66, "discounted_cash": 8535.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MTB AMP PROBE", "code_information": [{"code": "87556", "type": "CPT"}, {"code": "4177556", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 222.0, "discounted_cash": 166.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MTB AMP PROBE", "code_information": [{"code": "87556", "type": "CPT"}, {"code": "7007556", "type": "CDM"}], "standard_charges": [{"gross_charge": 1977.0, "discounted_cash": 1482.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MTB AMP PROBE", "code_information": [{"code": "87556", "type": "CPT"}, {"code": "7257556", "type": "CDM"}], "standard_charges": [{"gross_charge": 282.0, "discounted_cash": 211.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MTH/M BL/NA PH/PH/HYO CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307929", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MTH/M BL/NA PH/PH/HYO CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5307929", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MTHFR COMMON VARIANTS", "code_information": [{"code": "81291", "type": "CPT"}, {"code": "7259210", "type": "CDM"}], "standard_charges": [{"gross_charge": 412.0, "discounted_cash": 309.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MULTI ORGANISMS AMP PRB", "code_information": [{"code": "87801", "type": "CPT"}, {"code": "7257826", "type": "CDM"}], "standard_charges": [{"gross_charge": 1279.0, "discounted_cash": 959.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MULTI ORGANISMS DIR PRB", "code_information": [{"code": "87800", "type": "CPT"}, {"code": "7000042", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 156.0, "discounted_cash": 117.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MULTI ORGANISMS DIR PRB", "code_information": [{"code": "87800", "type": "CPT"}, {"code": "7257812", "type": "CDM"}], "standard_charges": [{"gross_charge": 606.0, "discounted_cash": 454.5, "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": 330.0, "discounted_cash": 247.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MUMPS AB", "code_information": [{"code": "86735", "type": "CPT"}, {"code": "4176180", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 260.0, "discounted_cash": 195.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MUMPS AB", "code_information": [{"code": "86735", "type": "CPT"}, {"code": "7256712", "type": "CDM"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MUMPS AB/2", "code_information": [{"code": "86735", "type": "CPT"}, {"code": "7006712", "type": "CDM"}], "standard_charges": [{"gross_charge": 116.0, "discounted_cash": 87.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 208.0, "discounted_cash": 156.0, "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": 208.0, "discounted_cash": 156.0, "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": 619.0, "discounted_cash": 464.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 619.0, "discounted_cash": 464.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MURAMIDASE", "code_information": [{"code": "85549", "type": "CPT"}, {"code": "7005549", "type": "CDM"}], "standard_charges": [{"gross_charge": 183.0, "discounted_cash": 137.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MURAMIDASE", "code_information": [{"code": "85549", "type": "CPT"}, {"code": "7255546", "type": "CDM"}], "standard_charges": [{"gross_charge": 179.0, "discounted_cash": 134.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MUSK ANTIBODY", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "7250019", "type": "CDM"}], "standard_charges": [{"gross_charge": 5041.0, "discounted_cash": 3780.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MUSK ANTIBODY QUANT", "code_information": [{"code": "83519", "type": "CPT"}, {"code": "7250021", "type": "CDM"}], "standard_charges": [{"gross_charge": 3895.0, "discounted_cash": 2921.25, "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": 368.0, "discounted_cash": 276.0, "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": 102.0, "discounted_cash": 76.5, "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": 14.0, "discounted_cash": 10.5, "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": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI CTB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5307925", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI CTB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5307925", "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": 220.0, "discounted_cash": 165.0, "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": 220.0, "discounted_cash": 165.0, "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": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI FE DROPS 50ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316649", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI FE MIN 30ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315251", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI FE MIN 30ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5315251", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "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": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI MIN CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5307939", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 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": "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI MIN ZINC CTB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5307915", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI MIN ZINC CTB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5307915", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 173.0, "discounted_cash": 129.75, "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 PRENTAL TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5309800", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI PRENTAL TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5309800", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 21.0, "discounted_cash": 15.75, "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": 21.0, "discounted_cash": 15.75, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI VIT B COMPLEX CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312345", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI VIT B COMPLEX CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312345", "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 CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312356", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI VIT B COMPLEX FA CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312356", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI VIT B COMPLEX TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303170", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI VIT B COMPLEX TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5303170", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 3.0, "discounted_cash": 2.25, "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": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI VIT B/VIT C/FA/FE TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5304909", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MVI VIT B/VIT C/FA/FE TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5304909", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "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": 43.0, "discounted_cash": 32.25, "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": 43.0, "discounted_cash": 32.25, "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": 274.0, "discounted_cash": 205.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MYCOPHENOLATE 250MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7517", "type": "HCPCS"}, {"code": "5307956", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 274.0, "discounted_cash": 205.5, "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": 152.0, "discounted_cash": 114.0, "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": 152.0, "discounted_cash": 114.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MYCOPHENOLIC ACID", "code_information": [{"code": "80180", "type": "CPT"}, {"code": "7254055", "type": "CDM"}], "standard_charges": [{"gross_charge": 138.0, "discounted_cash": 103.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MYCOPLASMA AB", "code_information": [{"code": "86738", "type": "CPT"}, {"code": "7006181", "type": "CDM"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 105.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MYCOPLASMA AB/2", "code_information": [{"code": "86738", "type": "CPT"}, {"code": "7006229", "type": "CDM"}], "standard_charges": [{"gross_charge": 423.0, "discounted_cash": 317.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MYCOPLASMA AB/3", "code_information": [{"code": "86738", "type": "CPT"}, {"code": "7256739", "type": "CDM"}], "standard_charges": [{"gross_charge": 387.0, "discounted_cash": 290.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MYCOPLASMA AB/4", "code_information": [{"code": "86738", "type": "CPT"}, {"code": "7256740", "type": "CDM"}], "standard_charges": [{"gross_charge": 387.0, "discounted_cash": 290.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MYCOPLASMA AMP PROBE/2", "code_information": [{"code": "87581", "type": "CPT"}, {"code": "7253869", "type": "CDM"}], "standard_charges": [{"gross_charge": 194.0, "discounted_cash": 145.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MYD88 GENE P.LEU265PRO VRNT", "code_information": [{"code": "81305", "type": "CPT"}, {"code": "7270032", "type": "CDM"}], "standard_charges": [{"gross_charge": 1254.0, "discounted_cash": 940.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MYELIN AB", "code_information": [{"code": "86362", "type": "CPT"}, {"code": "7256073", "type": "CDM"}], "standard_charges": [{"gross_charge": 1619.0, "discounted_cash": 1214.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MYELIN AB/2", "code_information": [{"code": "86362", "type": "CPT"}, {"code": "7256265", "type": "CDM"}], "standard_charges": [{"gross_charge": 242.0, "discounted_cash": 181.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MYELIN BASIC PROTEIN CSF", "code_information": [{"code": "83873", "type": "CPT"}, {"code": "7003874", "type": "CDM"}], "standard_charges": [{"gross_charge": 225.0, "discounted_cash": 168.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MYELIN BASIC PROTEIN CSF", "code_information": [{"code": "83873", "type": "CPT"}, {"code": "7253874", "type": "CDM"}], "standard_charges": [{"gross_charge": 588.0, "discounted_cash": 441.0, "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": 6676.0, "discounted_cash": 5007.0, "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": 6713.0, "discounted_cash": 5034.75, "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": 10368.0, "discounted_cash": 7776.0, "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": 3802.0, "discounted_cash": 2851.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MYELOGRAM CERV S&I", "code_information": [{"code": "72240", "type": "CPT"}, {"code": "4912240", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 3802.0, "discounted_cash": 2851.5, "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": 3802.0, "discounted_cash": 2851.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MYELOGRAM LUMBAR S&I", "code_information": [{"code": "72265", "type": "CPT"}, {"code": "4912250", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 3802.0, "discounted_cash": 2851.5, "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": 3802.0, "discounted_cash": 2851.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MYELOPEROXIDASE (MPO) AB", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "7253531", "type": "CDM"}], "standard_charges": [{"gross_charge": 220.0, "discounted_cash": 165.0, "setting": "both", "billing_class": "facility"}]}, {"description": "MYELOPEROXIDASE (MPO) AB", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7253567", "type": "CDM"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MYELOPEROXIDASE (MPO) AB", "code_information": [{"code": "83876", "type": "CPT"}, {"code": "4173876", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 175.0, "discounted_cash": 131.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MYELOPEROXIDASE (MPO) AB", "code_information": [{"code": "83876", "type": "CPT"}, {"code": "7258352", "type": "CDM"}], "standard_charges": [{"gross_charge": 222.0, "discounted_cash": 166.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MYOCARD INFARCT W/ECT", "code_information": [{"code": "78469", "type": "CPT"}, {"code": "5208469", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 4890.0, "discounted_cash": 3667.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MYOCARDIAL AB", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "7005310", "type": "CDM"}], "standard_charges": [{"gross_charge": 179.0, "discounted_cash": 134.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MYOCARDIAL STRAIN IMAGING", "code_information": [{"code": "93356", "type": "CPT"}, {"code": "4630399", "type": "CDM"}, {"code": "483", "type": "RC"}], "standard_charges": [{"gross_charge": 1131.0, "discounted_cash": 848.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MYOCARDIUM IMG INFARCT", "code_information": [{"code": "78466", "type": "CPT"}, {"code": "5208406", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 3630.0, "discounted_cash": 2722.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MYOGLOBIN", "code_information": [{"code": "83874", "type": "CPT"}, {"code": "4173873", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 167.0, "discounted_cash": 125.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MYOGLOBIN", "code_information": [{"code": "83874", "type": "CPT"}, {"code": "7003873", "type": "CDM"}], "standard_charges": [{"gross_charge": 171.0, "discounted_cash": 128.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MYOGLOBIN", "code_information": [{"code": "83874", "type": "CPT"}, {"code": "7253873", "type": "CDM"}], "standard_charges": [{"gross_charge": 211.0, "discounted_cash": 158.25, "setting": "both", "billing_class": "facility"}]}, {"description": "MYOGLOBIN/2", "code_information": [{"code": "83874", "type": "CPT"}, {"code": "4103875", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 174.0, "discounted_cash": 130.5, "setting": "both", "billing_class": "facility"}]}, {"description": "MYOGLOBIN/2", "code_information": [{"code": "83874", "type": "CPT"}, {"code": "4173875", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 137.0, "discounted_cash": 102.75, "setting": "both", "billing_class": "facility"}]}, {"description": "MYOGLOBIN/2", "code_information": [{"code": "83874", "type": "CPT"}, {"code": "7253875", "type": "CDM"}], "standard_charges": [{"gross_charge": 152.0, "discounted_cash": 114.0, "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": 159.0, "discounted_cash": 119.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NA BICARB 150MEQ 1L IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5324136", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 41.0, "discounted_cash": 30.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NA BICARB 7.5%50ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5324152", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 89.0, "discounted_cash": 66.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NA BICARB 8.4% 10ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5324148", "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%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": 2.0, "discounted_cash": 1.5, "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": 12.0, "discounted_cash": 9.0, "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": 109.0, "discounted_cash": 81.75, "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": 16.0, "discounted_cash": 12.0, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NA BICARBONATE 650MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5310810", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "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": 17.0, "discounted_cash": 12.75, "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": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NA BIPHOSPHATE ADULT RE", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5338726", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "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": 31.0, "discounted_cash": 23.25, "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": 17.0, "discounted_cash": 12.75, "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": 17.0, "discounted_cash": 12.75, "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": 40.0, "discounted_cash": 30.0, "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": 40.0, "discounted_cash": 30.0, "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": 31.0, "discounted_cash": 23.25, "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": 31.0, "discounted_cash": 23.25, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NA CL 1GM TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5310833", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NA FERR GLUC PER12.5MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2916", "type": "HCPCS"}, {"code": "5322669", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 360.0, "discounted_cash": 270.0, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 360.0, "discounted_cash": 270.0, "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": 360.0, "discounted_cash": 270.0, "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": 416.0, "discounted_cash": 312.0, "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": 340.0, "discounted_cash": 255.0, "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": 411.0, "discounted_cash": 308.25, "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": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NA THIOSULFATE PER 100MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0209", "type": "HCPCS"}, {"code": "5324298", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "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": "NA/POT/PHOS NEUT TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309686", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NA/POT/PHOS NEUT TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309686", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "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": "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": "NACL .65% 30ML NASAL SP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5332378", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 296.0, "discounted_cash": 222.0, "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": 296.0, "discounted_cash": 222.0, "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": 3.0, "discounted_cash": 2.25, "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": 3.0, "discounted_cash": 2.25, "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": 19.0, "discounted_cash": 14.25, "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": 19.0, "discounted_cash": 14.25, "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": 23.0, "discounted_cash": 17.25, "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": 45.0, "discounted_cash": 33.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL .9% 15ML IH", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337303", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL .9% 15ML IH", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337303", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL .9% 20ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5324193", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "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": 63.0, "discounted_cash": 47.25, "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": 407.0, "discounted_cash": 305.25, "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": 400.0, "discounted_cash": 300.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 477.0, "discounted_cash": 357.75, "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": 477.0, "discounted_cash": 357.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 392.0, "discounted_cash": 294.0, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 392.0, "discounted_cash": 294.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL 0.9 150ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7050", "type": "HCPCS"}, {"code": "5412650", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 524.0, "discounted_cash": 393.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL 0.9 150ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7050", "type": "HCPCS"}, {"code": "5412650", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 524.0, "discounted_cash": 393.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL 0.9 250ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7050", "type": "HCPCS"}, {"code": "5412655", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 475.0, "discounted_cash": 356.25, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 475.0, "discounted_cash": 356.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 365.0, "discounted_cash": 273.75, "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": 365.0, "discounted_cash": 273.75, "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": 438.0, "discounted_cash": 328.5, "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": 438.0, "discounted_cash": 328.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL 0.9 50ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7050", "type": "HCPCS"}, {"code": "5412635", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 461.0, "discounted_cash": 345.75, "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": 461.0, "discounted_cash": 345.75, "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": 20.0, "discounted_cash": 15.0, "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": 20.0, "discounted_cash": 15.0, "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": 12.0, "discounted_cash": 9.0, "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": 70.0, "discounted_cash": 52.5, "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": 292.0, "discounted_cash": 219.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL 5% 500ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412695", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 619.0, "discounted_cash": 464.25, "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": 10.0, "discounted_cash": 7.5, "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": 10.0, "discounted_cash": 7.5, "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": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL 9% 3ML IS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5332391", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL BACT .9% 30ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5324199", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "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": 292.0, "discounted_cash": 219.0, "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": 68.0, "discounted_cash": 51.0, "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": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL.45 KCL20 1000ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412621", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 94.0, "discounted_cash": 70.5, "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": 425.0, "discounted_cash": 318.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL.9 KCL40 1000ML IVF", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5412685", "type": "CDM"}, {"code": "258", "type": "RC"}], "standard_charges": [{"gross_charge": 123.0, "discounted_cash": 92.25, "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": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NACL/ALOE.65%14GM NAS GL", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337304", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NADOLOL/BENDROFLUM40/5TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308012", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 252.0, "discounted_cash": 189.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NADOLOL/BENDROFLUM40/5TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308012", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 252.0, "discounted_cash": 189.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NAFCILLIN PED CMPD IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5322665", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.58, "discounted_cash": 0.44, "setting": "both", "billing_class": "facility"}]}, {"description": "NAFCILLIN PED CMPD IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5322665", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 0.58, "discounted_cash": 0.44, "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": 0.27, "discounted_cash": 0.2, "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": 0.27, "discounted_cash": 0.2, "setting": "both", "billing_class": "facility"}]}, {"description": "NAFTIFINE 1% 15GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336686", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 841.0, "discounted_cash": 630.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NAFTIFINE 1% 15GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336686", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 841.0, "discounted_cash": 630.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NAIL ANKLE ARTHRODESIS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132999", "type": "CDM"}], "standard_charges": [{"gross_charge": 69940.0, "discounted_cash": 52455.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NAIL HIP FRACTURE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133024", "type": "CDM"}], "standard_charges": [{"gross_charge": 12630.0, "discounted_cash": 9472.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NAIL HUMERAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133025", "type": "CDM"}], "standard_charges": [{"gross_charge": 14373.0, "discounted_cash": 10779.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NAIL INTRAMEDULLARY TYP2", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133002", "type": "CDM"}], "standard_charges": [{"gross_charge": 3599.0, "discounted_cash": 2699.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NAIL INTRAMEDULLARY TYP4", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133004", "type": "CDM"}], "standard_charges": [{"gross_charge": 12630.0, "discounted_cash": 9472.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NAIL TIBIA", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133075", "type": "CDM"}], "standard_charges": [{"gross_charge": 12247.0, "discounted_cash": 9185.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NAIL TIBIA 2", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133076", "type": "CDM"}], "standard_charges": [{"gross_charge": 57345.0, "discounted_cash": 43008.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NAIL TITANIUM ELASTIC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133081", "type": "CDM"}], "standard_charges": [{"gross_charge": 1801.0, "discounted_cash": 1350.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NALMEFENE 100MCG/1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5322700", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 180.0, "discounted_cash": 135.0, "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": 82.0, "discounted_cash": 61.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 82.0, "discounted_cash": 61.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NALOXONE PER 0.01MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2312", "type": "HCPCS"}, {"code": "5322718", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.27, "discounted_cash": 0.2, "setting": "both", "billing_class": "facility"}]}, {"description": "NALOXONE PER 0.01MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2312", "type": "HCPCS"}, {"code": "5322718", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 0.27, "discounted_cash": 0.2, "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": 123.0, "discounted_cash": 92.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 123.0, "discounted_cash": 92.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "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": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NAPROXEN 125MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315834", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NAPROXEN 125MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315834", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "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": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NAPROXEN 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308078", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NAPROXEN 375MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308086", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NAPROXEN 375MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308086", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NAPROXEN 500MG EC TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308081", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 10.0, "discounted_cash": 7.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NAPROXEN 500MG EC TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308081", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 10.0, "discounted_cash": 7.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NAPROXEN 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308088", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "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": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NAPROXEN 500MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308084", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 160.0, "discounted_cash": 120.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NAPROXEN 500MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308084", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 160.0, "discounted_cash": 120.0, "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": 1378.0, "discounted_cash": 1033.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NASAL BONES 3VW MIN", "code_information": [{"code": "70160", "type": "CPT"}, {"code": "5120160", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1378.0, "discounted_cash": 1033.5, "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": 267.0, "discounted_cash": 200.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NASAL SMEAR EOSINOPHILES", "code_information": [{"code": "89190", "type": "CPT"}, {"code": "4179190", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 210.0, "discounted_cash": 157.5, "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": 128.0, "discounted_cash": 96.0, "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": 128.0, "discounted_cash": 96.0, "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": 109.0, "discounted_cash": 81.75, "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": 109.0, "discounted_cash": 81.75, "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 CRYORDCD FFP", "code_information": [{"code": "P9044", "type": "HCPCS"}, {"code": "4500078", "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": "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "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": 21.0, "discounted_cash": 15.75, "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": 21.0, "discounted_cash": 15.75, "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": 1093.0, "discounted_cash": 819.75, "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": 1093.0, "discounted_cash": 819.75, "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": 1093.0, "discounted_cash": 819.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NECK FOR SOFT TISSUES", "code_information": [{"code": "70360", "type": "CPT"}, {"code": "5120360", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1093.0, "discounted_cash": 819.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NECK HUMERAL NEUTRAL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8133082", "type": "CDM"}], "standard_charges": [{"gross_charge": 13598.0, "discounted_cash": 10198.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NEDOCROMIL 2% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331547", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 694.0, "discounted_cash": 520.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NEDOCROMIL 2% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331547", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 694.0, "discounted_cash": 520.5, "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": 45.0, "discounted_cash": 33.75, "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": 45.0, "discounted_cash": 33.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NEG PRESS THRPY <=50CM", "code_information": [{"code": "97605", "type": "CPT"}, {"code": "6907608", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 727.0, "discounted_cash": 545.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NEG PRESS THRPY >50CM", "code_information": [{"code": "97606", "type": "CPT"}, {"code": "6907609", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 862.0, "discounted_cash": 646.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NEG PRESS TX MPD <50CM", "code_information": [{"code": "97607", "type": "CPT"}, {"code": "6900456", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 862.0, "discounted_cash": 646.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NEG PRESS TX MPD >50CM", "code_information": [{"code": "97608", "type": "CPT"}, {"code": "6900457", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 727.0, "discounted_cash": 545.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 288.0, "discounted_cash": 216.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NELFINAVIR 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308099", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 288.0, "discounted_cash": 216.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NEO/BAC/POLY/HC 7.5GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337079", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1441.0, "discounted_cash": 1080.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NEO/BAC/POLY/HC 7.5GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337079", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1441.0, "discounted_cash": 1080.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NEO/BAC/POLYB 30GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336775", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NEO/BAC/POLYB 30GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336775", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 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": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NEO/BAC/POLYB.9GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336777", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NEO/POLY/BAC/HCTS3.5GMOO", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331584", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 784.0, "discounted_cash": 588.0, "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": 784.0, "discounted_cash": 588.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NEOMY/POLY/BACIT3.5GM OO", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331612", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 45.0, "discounted_cash": 33.75, "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": 45.0, "discounted_cash": 33.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NEOMY/POLY/GRAMICD10MLOS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331605", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 423.0, "discounted_cash": 317.25, "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": 423.0, "discounted_cash": 317.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 962.0, "discounted_cash": 721.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 962.0, "discounted_cash": 721.5, "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": 98.0, "discounted_cash": 73.5, "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": 98.0, "discounted_cash": 73.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NEOSTIGMINE 15MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308128", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NEOSTIGMINE 15MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308128", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "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": 20.0, "discounted_cash": 15.0, "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": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NEOX 1K PER SQ CM", "code_information": [{"code": "Q4148", "type": "HCPCS"}, {"code": "4028558", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1969.0, "discounted_cash": 1476.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NEOX 1K PER SQ CM", "code_information": [{"code": "Q4148", "type": "HCPCS"}, {"code": "4028558", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1969.0, "discounted_cash": 1476.75, "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": 403.0, "discounted_cash": 302.25, "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": 403.0, "discounted_cash": 302.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NEUROMATRIX PER 0.5CM", "code_information": [{"code": "C9355", "type": "HCPCS"}, {"code": "4028559", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9788.0, "discounted_cash": 7341.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NEUROMYELITIS OPTICA", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7253501", "type": "CDM"}], "standard_charges": [{"gross_charge": 2257.0, "discounted_cash": 1692.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NEUROMYELITIS OPTICAL AB", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "7256250", "type": "CDM"}], "standard_charges": [{"gross_charge": 2251.0, "discounted_cash": 1688.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NEUROSTIM EXTENSION AXONICS", "code_information": [{"code": "C1883", "type": "HCPCS"}, {"code": "8175142", "type": "CDM"}], "standard_charges": [{"gross_charge": 826.29, "discounted_cash": 619.72, "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": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NEVIRAPINE 10MG/ML 5MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315842", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 431.0, "discounted_cash": 323.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NEVIRAPINE 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308130", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 431.0, "discounted_cash": 323.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NEWBORN LEVEL I", "code_information": [{"code": "1990010", "type": "CDM"}, {"code": "171", "type": "RC"}], "standard_charges": [{"gross_charge": 2616.0, "discounted_cash": 1962.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NEWBORN LEVEL I", "code_information": [{"code": "2550010", "type": "CDM"}, {"code": "171", "type": "RC"}], "standard_charges": [{"gross_charge": 2616.0, "discounted_cash": 1962.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NEWBORN LEVEL II", "code_information": [{"code": "1990012", "type": "CDM"}, {"code": "172", "type": "RC"}], "standard_charges": [{"gross_charge": 6787.0, "discounted_cash": 5090.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NEWBORN LEVEL II", "code_information": [{"code": "2210012", "type": "CDM"}, {"code": "172", "type": "RC"}], "standard_charges": [{"gross_charge": 6787.0, "discounted_cash": 5090.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NEWBORN LEVEL II", "code_information": [{"code": "2550012", "type": "CDM"}, {"code": "172", "type": "RC"}], "standard_charges": [{"gross_charge": 6787.0, "discounted_cash": 5090.25, "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": 5737.0, "discounted_cash": 4302.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NFCT DS CHRNC HCV 6 ASSAYS", "code_information": [{"code": "81596", "type": "CPT"}, {"code": "7251596", "type": "CDM"}], "standard_charges": [{"gross_charge": 367.0, "discounted_cash": 275.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NIACIN 500MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5308247", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NIACIN 500MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5308247", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 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": 19.0, "discounted_cash": 14.25, "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": 19.0, "discounted_cash": 14.25, "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": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "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": 0.21, "discounted_cash": 0.16, "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": 0.21, "discounted_cash": 0.16, "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": 0.25, "discounted_cash": 0.19, "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": 0.25, "discounted_cash": 0.19, "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": 16.0, "discounted_cash": 12.0, "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": 16.0, "discounted_cash": 12.0, "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": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NICOTINE 21MG TD", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336812", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NICOTINE 7MG TD", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5336810", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "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": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NICOTINE CART 10MG IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331618", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2591.0, "discounted_cash": 1943.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NICOTINE CART 10MG IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331618", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2591.0, "discounted_cash": 1943.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NICOTINE GUM 2MG EA", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5308275", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NICOTINE GUM 2MG EA", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5308275", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NICU NB LVL III", "code_information": [{"code": "1990070", "type": "CDM"}, {"code": "173", "type": "RC"}], "standard_charges": [{"gross_charge": 6787.0, "discounted_cash": 5090.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NICU NB LVL III", "code_information": [{"code": "2210070", "type": "CDM"}, {"code": "173", "type": "RC"}], "standard_charges": [{"gross_charge": 6787.0, "discounted_cash": 5090.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NICU NB LVL IV", "code_information": [{"code": "1990020", "type": "CDM"}, {"code": "174", "type": "RC"}], "standard_charges": [{"gross_charge": 8247.0, "discounted_cash": 6185.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NICU NB LVL IV", "code_information": [{"code": "2210020", "type": "CDM"}, {"code": "174", "type": "RC"}], "standard_charges": [{"gross_charge": 8247.0, "discounted_cash": 6185.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "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": 20.0, "discounted_cash": 15.0, "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": 20.0, "discounted_cash": 15.0, "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": 95.0, "discounted_cash": 71.25, "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": 95.0, "discounted_cash": 71.25, "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": 97.0, "discounted_cash": 72.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NIFEDIPINE 60MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308309", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 97.0, "discounted_cash": 72.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NIFEDIPINE 90MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308308", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 179.0, "discounted_cash": 134.25, "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": 179.0, "discounted_cash": 134.25, "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": 142.0, "discounted_cash": 106.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 142.0, "discounted_cash": 106.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NIRSEVIMAB-ALIP RSV MAB 1ML IJ", "code_information": [{"code": "90381", "type": "CPT"}, {"code": "5322871", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 324.0, "discounted_cash": 243.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NIRSEVIMAB-ALIP RSV MAB 1ML IJ", "code_information": [{"code": "90381", "type": "CPT"}, {"code": "5322871", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 324.0, "discounted_cash": 243.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NISOLDIPINE 10MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308325", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 159.0, "discounted_cash": 119.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NISOLDIPINE 10MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308325", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 159.0, "discounted_cash": 119.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NISOLDIPINE 8.5MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308322", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NISOLDIPINE 8.5MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308322", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NITAZOXANIDE 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308395", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 414.0, "discounted_cash": 310.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NITAZOXANIDE 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308395", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 414.0, "discounted_cash": 310.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NITRIC OXIDE <12 HRS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "3113491", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 8207.0, "discounted_cash": 6155.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NITRIC OXIDE <12 HRS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5503491", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 8207.0, "discounted_cash": 6155.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NITRIC OXIDE PER DAY", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "3113490", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 21179.0, "discounted_cash": 15884.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NITRIC OXIDE PER DAY", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5503490", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 21179.0, "discounted_cash": 15884.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROFURANTN25M/5M10MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315866", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 467.0, "discounted_cash": 350.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROFURANTN25M/5M10MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315866", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 467.0, "discounted_cash": 350.25, "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": 327.0, "discounted_cash": 245.25, "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": 327.0, "discounted_cash": 245.25, "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": 33.0, "discounted_cash": 24.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROFURANTOIN 50MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308335", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROFURANTOIN 50MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308335", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "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": 565.0, "discounted_cash": 423.75, "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": 565.0, "discounted_cash": 423.75, "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": 49.0, "discounted_cash": 36.75, "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": 49.0, "discounted_cash": 36.75, "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": 10.0, "discounted_cash": 7.5, "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": 10.0, "discounted_cash": 7.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 216.0, "discounted_cash": 162.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 216.0, "discounted_cash": 162.0, "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": 20.0, "discounted_cash": 15.0, "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": 20.0, "discounted_cash": 15.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 45.0, "discounted_cash": 33.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROGLYCERIN .4MG/HR TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336838", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 45.0, "discounted_cash": 33.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROGLYCERIN .6MG/HR TD", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336840", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "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": 20.0, "discounted_cash": 15.0, "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": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "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": 3.0, "discounted_cash": 2.25, "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": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROGLYCERIN.3MGSL 25TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308375", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 208.0, "discounted_cash": 156.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROGLYCERIN.3MGSL 25TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308375", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 208.0, "discounted_cash": 156.0, "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": 225.0, "discounted_cash": 168.75, "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": 225.0, "discounted_cash": 168.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROGLYCERIN.4MG4.9GMSP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331624", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 941.0, "discounted_cash": 705.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROGLYCERIN.4MG4.9GMSP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331624", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 941.0, "discounted_cash": 705.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "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": 14.0, "discounted_cash": 10.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 336.0, "discounted_cash": 252.0, "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": 336.0, "discounted_cash": 252.0, "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": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROGLYCERIN2% 1GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336888", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "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": 205.0, "discounted_cash": 153.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 205.0, "discounted_cash": 153.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NITROPRUSSIDE 20MG/100ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5322954", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 388.0, "discounted_cash": 291.0, "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": 4297.0, "discounted_cash": 3222.75, "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": 275.0, "discounted_cash": 206.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NIZATADINE 150MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308392", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NIZATADINE 150MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308392", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "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": 3547.0, "discounted_cash": 2660.25, "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": 180.0, "discounted_cash": 135.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NOREPINEPH160MCG/10ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5322908", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 83.25, "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": 858.0, "discounted_cash": 643.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NOREPINEPHRINE 4MG/4MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5321698", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 210.0, "discounted_cash": 157.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NORETHINDRONE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308405", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 134.0, "discounted_cash": 100.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NORETHINDRONE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308405", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 134.0, "discounted_cash": 100.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NORFLOXACIN 400MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308410", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NORFLOXACIN 400MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308410", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "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": 3.0, "discounted_cash": 2.25, "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": 13.0, "discounted_cash": 9.75, "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": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NORTRIPTYLINE 75MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308437", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 398.0, "discounted_cash": 298.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NORTRIPTYLINE 75MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308437", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 398.0, "discounted_cash": 298.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NOS IMMUNOASSAY NON-RIA", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7002662", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 982.0, "discounted_cash": 736.5, "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": 614.0, "discounted_cash": 460.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NOS IMMUNOASSAY NON-RIA/7", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7250210", "type": "CDM"}], "standard_charges": [{"gross_charge": 489.0, "discounted_cash": 366.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NOSE BUTTO", "code_information": [{"code": "L8047", "type": "HCPCS"}, {"code": "8123500", "type": "CDM"}], "standard_charges": [{"gross_charge": 2386.0, "discounted_cash": 1789.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NPM1 EXON 12 VARIANTS", "code_information": [{"code": "81310", "type": "CPT"}, {"code": "7270033", "type": "CDM"}], "standard_charges": [{"gross_charge": 1362.0, "discounted_cash": 1021.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NRV TEASING PREP", "code_information": [{"code": "88362", "type": "CPT"}, {"code": "7098353", "type": "CDM"}], "standard_charges": [{"gross_charge": 3858.0, "discounted_cash": 2893.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NSEL DEB WNDS WO ANES I", "code_information": [{"code": "97602", "type": "CPT"}, {"code": "6907606", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 665.0, "discounted_cash": 498.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NSEL DEB WNDS WO ANES I", "code_information": [{"code": "97602", "type": "CPT"}, {"code": "6907606", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 665.0, "discounted_cash": 498.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NTRK TRANSLOCATION ANALYSIS", "code_information": [{"code": "81194", "type": "CPT"}, {"code": "7270168", "type": "CDM"}], "standard_charges": [{"gross_charge": 2354.0, "discounted_cash": 1765.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NUCLEAR ANTIGEN AB/11", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "7256239", "type": "CDM"}], "standard_charges": [{"gross_charge": 565.0, "discounted_cash": 423.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NUCLEAR ANTIGEN AB/12", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "7006271", "type": "CDM"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NUCLEAR ANTIGEN AB/13", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "7006275", "type": "CDM"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NUCLEAR ANTIGEN AB/15", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "7256271", "type": "CDM"}], "standard_charges": [{"gross_charge": 327.0, "discounted_cash": 245.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NUCLEAR ANTIGEN AB/17", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "7256275", "type": "CDM"}], "standard_charges": [{"gross_charge": 414.0, "discounted_cash": 310.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NUCLEAR ANTIGEN AB/2", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "7004258", "type": "CDM"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NUCLEAR ANTIGEN AB/20", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "7256378", "type": "CDM"}], "standard_charges": [{"gross_charge": 201.0, "discounted_cash": 150.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NUCLEAR ANTIGEN AB/23", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "7258623", "type": "CDM"}], "standard_charges": [{"gross_charge": 205.0, "discounted_cash": 153.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NUCLEAR ANTIGEN AB/24", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "7258626", "type": "CDM"}], "standard_charges": [{"gross_charge": 271.0, "discounted_cash": 203.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NUCLEAR ANTIGEN AB/4", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "4176239", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 494.0, "discounted_cash": 370.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NUCLEAR ANTIGEN AB/4", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "7256224", "type": "CDM"}], "standard_charges": [{"gross_charge": 629.0, "discounted_cash": 471.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NUCLEAR ANTIGEN AB/6", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "7256234", "type": "CDM"}], "standard_charges": [{"gross_charge": 193.0, "discounted_cash": 144.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NUCLEAR ANTIGEN AB/8", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "7006235", "type": "CDM"}], "standard_charges": [{"gross_charge": 387.0, "discounted_cash": 290.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NUCLEAR ANTIGEN AB/9", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "7006239", "type": "CDM"}], "standard_charges": [{"gross_charge": 327.0, "discounted_cash": 245.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NUCLEAR ANTIGEN AB/9", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "7256237", "type": "CDM"}], "standard_charges": [{"gross_charge": 271.0, "discounted_cash": 203.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NUCLEOTIDASE 5-", "code_information": [{"code": "83915", "type": "CPT"}, {"code": "7003905", "type": "CDM"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NUCLEOTIDASE 5-", "code_information": [{"code": "83915", "type": "CPT"}, {"code": "7253905", "type": "CDM"}], "standard_charges": [{"gross_charge": 325.0, "discounted_cash": 243.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NUSHIELD 1.6CM DISC PER SQ CM", "code_information": [{"code": "Q4160", "type": "HCPCS"}, {"code": "4028554", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 933.0, "discounted_cash": 699.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NUSHIELD 1.6CM DISC PER SQ CM", "code_information": [{"code": "Q4160", "type": "HCPCS"}, {"code": "4028554", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 933.0, "discounted_cash": 699.75, "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": 245.0, "discounted_cash": 183.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NYST/HCTS/ZN CMPD15GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336912", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NYST/HCTS/ZN CMPD15GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336912", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "NYST/ZN/LIDOCMPD 15GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336908", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 352.0, "discounted_cash": 264.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NYST/ZN/LIDOCMPD 15GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336908", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 352.0, "discounted_cash": 264.0, "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": 98.0, "discounted_cash": 73.5, "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": 98.0, "discounted_cash": 73.5, "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": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NYSTATIN 15GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336909", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NYSTATIN 15GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336924", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 592.0, "discounted_cash": 444.0, "setting": "both", "billing_class": "facility"}]}, {"description": "NYSTATIN 15GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336924", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 592.0, "discounted_cash": 444.0, "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": 35.0, "discounted_cash": 26.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "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": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NYSTATIN 30GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336929", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 94.0, "discounted_cash": 70.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NYSTATIN 30GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336929", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 94.0, "discounted_cash": 70.5, "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": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NYSTATIN 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315881", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NYSTATIN 60ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315884", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "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": 19.0, "discounted_cash": 14.25, "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": 477.0, "discounted_cash": 357.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NYSTATIN/TRIAMCIN 15GMCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337394", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 477.0, "discounted_cash": 357.75, "setting": "both", "billing_class": "facility"}]}, {"description": "NYSTATIN/TRIAMCIN 15GMOI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337399", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 578.0, "discounted_cash": 433.5, "setting": "both", "billing_class": "facility"}]}, {"description": "NYSTATIN/TRIAMCIN 15GMOI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337399", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 578.0, "discounted_cash": 433.5, "setting": "both", "billing_class": "facility"}]}, {"description": "O/S FEE GRANULOCYTE PHER", "code_information": [{"code": "P9050", "type": "HCPCS"}, {"code": "4501067", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 8761.0, "discounted_cash": 6570.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OASIS WND MATRIX SQ CM", "code_information": [{"code": "Q4102", "type": "HCPCS"}, {"code": "8247996", "type": "CDM"}], "standard_charges": [{"gross_charge": 274.0, "discounted_cash": 205.5, "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": 827.0, "discounted_cash": 620.25, "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": 2454.0, "discounted_cash": 1840.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OB ER VISIT LVL IV", "code_information": [{"code": "99284", "type": "CPT"}, {"code": "6169284", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 3221.0, "discounted_cash": 2415.75, "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": 3683.0, "discounted_cash": 2762.25, "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": 411.0, "discounted_cash": 308.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 201 ICC 1/HR", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6240410", "type": "CDM"}, {"code": "762", "type": "RC"}], "standard_charges": [{"gross_charge": 392.0, "discounted_cash": 294.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 206 CVS 1/HR", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6240526", "type": "CDM"}, {"code": "762", "type": "RC"}], "standard_charges": [{"gross_charge": 251.0, "discounted_cash": 188.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 210 CSI 1/HR", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6240530", "type": "CDM"}, {"code": "762", "type": "RC"}], "standard_charges": [{"gross_charge": 383.0, "discounted_cash": 287.25, "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": 165.0, "discounted_cash": 123.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 212 IP HOLD 1/HR", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6241820", "type": "CDM"}, {"code": "762", "type": "RC"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 105.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 212 IP HOLD DIR ADM", "code_information": [{"code": "G0379", "type": "HCPCS"}, {"code": "6241822", "type": "CDM"}, {"code": "762", "type": "RC"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 105.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 215 DOU 1/HR", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6240652", "type": "CDM"}, {"code": "762", "type": "RC"}], "standard_charges": [{"gross_charge": 296.0, "discounted_cash": 222.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 216 SDU 1/HR", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6240656", "type": "CDM"}, {"code": "762", "type": "RC"}], "standard_charges": [{"gross_charge": 296.0, "discounted_cash": 222.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 230 M/S 1/HR", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6240612", "type": "CDM"}, {"code": "762", "type": "RC"}], "standard_charges": [{"gross_charge": 142.0, "discounted_cash": 106.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 231 M/S 1/HR", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6240614", "type": "CDM"}, {"code": "762", "type": "RC"}], "standard_charges": [{"gross_charge": 116.0, "discounted_cash": 87.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 231 M/S ADD HR", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6240615", "type": "CDM"}, {"code": "762", "type": "RC"}], "standard_charges": [{"gross_charge": 156.0, "discounted_cash": 117.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 232 M/S 1/HR", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6240616", "type": "CDM"}, {"code": "762", "type": "RC"}], "standard_charges": [{"gross_charge": 156.0, "discounted_cash": 117.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 233 M/S 1/HR", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6240619", "type": "CDM"}, {"code": "762", "type": "RC"}], "standard_charges": [{"gross_charge": 142.0, "discounted_cash": 106.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 234 M/S 1/HR", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6240630", "type": "CDM"}, {"code": "762", "type": "RC"}], "standard_charges": [{"gross_charge": 148.0, "discounted_cash": 111.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 235 M/S 1/HR", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6240636", "type": "CDM"}, {"code": "762", "type": "RC"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "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": 156.0, "discounted_cash": 117.0, "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": 123.0, "discounted_cash": 92.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 240 PED 1/HR", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6240800", "type": "CDM"}, {"code": "762", "type": "RC"}], "standard_charges": [{"gross_charge": 241.0, "discounted_cash": 180.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 245 PSY 1/HR", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6240700", "type": "CDM"}, {"code": "762", "type": "RC"}], "standard_charges": [{"gross_charge": 247.0, "discounted_cash": 185.25, "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": 398.0, "discounted_cash": 298.5, "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": 116.0, "discounted_cash": 87.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 624 UNIT 1/HR", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6240100", "type": "CDM"}, {"code": "762", "type": "RC"}], "standard_charges": [{"gross_charge": 392.0, "discounted_cash": 294.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OBS 624 UNIT ADD HR", "code_information": [{"code": "G0378", "type": "HCPCS"}, {"code": "6240305", "type": "CDM"}, {"code": "762", "type": "RC"}], "standard_charges": [{"gross_charge": 149.0, "discounted_cash": 111.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OCCLSN/EMBL CATH CNS", "code_information": [{"code": "4951624", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 27383.0, "discounted_cash": 20537.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OCCLSN/EMBL CATH NON-CNS", "code_information": [{"code": "4617790", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2275.0, "discounted_cash": 1706.25, "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": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OCCULT BLD FECES ONE SPC", "code_information": [{"code": "82272", "type": "CPT"}, {"code": "4172272", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OCCULT BLD OTHR SOURCE", "code_information": [{"code": "82271", "type": "CPT"}, {"code": "4102273", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 105.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OCCULT BLD OTHR SOURCE", "code_information": [{"code": "82271", "type": "CPT"}, {"code": "4172271", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 110.0, "discounted_cash": 82.5, "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": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OCCULT BLD OTHR SOURCE/2", "code_information": [{"code": "82271", "type": "CPT"}, {"code": "4172273", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 89.0, "discounted_cash": 66.75, "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": 174.0, "discounted_cash": 130.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OCCULT BLD STL 1-3", "code_information": [{"code": "82270", "type": "CPT"}, {"code": "4122270", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OCCULT BLD STL 1-3", "code_information": [{"code": "82270", "type": "CPT"}, {"code": "4172270", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 137.0, "discounted_cash": 102.75, "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": 1133.0, "discounted_cash": 849.75, "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": 1133.0, "discounted_cash": 849.75, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}], "modifiers": "JA"}, {"description": "OCULAR IMPLANT", "code_information": [{"code": "L8610", "type": "HCPCS"}, {"code": "8120101", "type": "CDM"}], "standard_charges": [{"gross_charge": 576.0, "discounted_cash": 432.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OCULAR LUB .3ML UD OS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5330480", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OCULAR LUB .3ML UD OS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5330480", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OCULAR LUB 1GM UD OO", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5331751", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OCULAR LUB 1GM UD OO", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5331751", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OCULAR LUB 3.5GM OO", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5331635", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "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": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OCULAR LUB PF 0.7ML UD OS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5330245", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 11.0, "discounted_cash": 8.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OCULAR LUB PF 0.7ML UD OS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5330245", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 11.0, "discounted_cash": 8.25, "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": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OCULAR LUB PF 15ML OS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5330242", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OCULAR LUB PF.4ML UD OS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5332036", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OCULAR LUB PF.4ML UD OS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5332036", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "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": 10.0, "discounted_cash": 7.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OCULAR LUB PRSRV 15ML OS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5332130", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 10.0, "discounted_cash": 7.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OCULAR LUB PRSRV 5ML OS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5331633", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 138.0, "discounted_cash": 103.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OCULAR LUB PRSRV 5ML OS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5331633", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 138.0, "discounted_cash": 103.5, "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": 607.0, "discounted_cash": 455.25, "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": 607.0, "discounted_cash": 455.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OFLOXACIN .3% 5ML OT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330944", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 592.0, "discounted_cash": 444.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OFLOXACIN .3% 5ML OT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5330944", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 592.0, "discounted_cash": 444.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OH PATCH PERICARDL BOVIN", "code_information": [{"code": "C1768", "type": "HCPCS"}, {"code": "8175902", "type": "CDM"}], "standard_charges": [{"gross_charge": 9245.0, "discounted_cash": 6933.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OH RING ANNULOPLASTY", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8143498", "type": "CDM"}], "standard_charges": [{"gross_charge": 17478.0, "discounted_cash": 13108.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OH RING AORTIC", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8143500", "type": "CDM"}], "standard_charges": [{"gross_charge": 22721.0, "discounted_cash": 17040.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OH RING MITRAL", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8143505", "type": "CDM"}], "standard_charges": [{"gross_charge": 28680.0, "discounted_cash": 21510.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OH RNG MITRAL/TRICUSPID", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8143506", "type": "CDM"}], "standard_charges": [{"gross_charge": 21466.0, "discounted_cash": 16099.5, "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": 5036.0, "discounted_cash": 3777.0, "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": 13877.0, "discounted_cash": 10407.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OH VALVE AORTIC", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8143515", "type": "CDM"}], "standard_charges": [{"gross_charge": 97119.0, "discounted_cash": 72839.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OH VALVE CONDUIT", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8143520", "type": "CDM"}], "standard_charges": [{"gross_charge": 60980.0, "discounted_cash": 45735.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OH VALVE MITRAL", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8143525", "type": "CDM"}], "standard_charges": [{"gross_charge": 63651.0, "discounted_cash": 47738.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OH VALVE ST JUDE", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8143529", "type": "CDM"}], "standard_charges": [{"gross_charge": 66061.0, "discounted_cash": 49545.75, "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": 402.0, "discounted_cash": 301.5, "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": 402.0, "discounted_cash": 301.5, "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": 498.0, "discounted_cash": 373.5, "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": 498.0, "discounted_cash": 373.5, "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": 225.0, "discounted_cash": 168.75, "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": 225.0, "discounted_cash": 168.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 623.0, "discounted_cash": 467.25, "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": 623.0, "discounted_cash": 467.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OLANZAPINE 5MG DT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308506", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "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": 12.0, "discounted_cash": 9.0, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OLANZAPINE PER 0.5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2359", "type": "HCPCS"}, {"code": "5322958", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OLANZAPINE/FLUOX6/25MGCP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308511", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1049.0, "discounted_cash": 786.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OLANZAPINE/FLUOX6/25MGCP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308511", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1049.0, "discounted_cash": 786.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OLIGOCLONAL BANDS", "code_information": [{"code": "83916", "type": "CPT"}, {"code": "7003925", "type": "CDM"}], "standard_charges": [{"gross_charge": 193.0, "discounted_cash": 144.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OLIGOCLONAL BANDS", "code_information": [{"code": "83916", "type": "CPT"}, {"code": "7253925", "type": "CDM"}], "standard_charges": [{"gross_charge": 695.0, "discounted_cash": 521.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OLMESARTAN 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308520", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 197.0, "discounted_cash": 147.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OLMESARTAN 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308520", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 197.0, "discounted_cash": 147.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OLMESARTAN 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308522", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 211.0, "discounted_cash": 158.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OLMESARTAN 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308522", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 211.0, "discounted_cash": 158.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OLMESARTAN 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308521", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OLMESARTAN 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308521", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "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": 444.0, "discounted_cash": 333.0, "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": 444.0, "discounted_cash": 333.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OMALIZUMAB PER 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2357", "type": "HCPCS"}, {"code": "5322951", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 288.0, "discounted_cash": 216.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OMALIZUMAB PER 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2357", "type": "HCPCS"}, {"code": "5322951", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 288.0, "discounted_cash": 216.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OMEGA3 ETH ESTERS 1GM CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308528", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OMEGA3 ETH ESTERS 1GM CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308528", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OMEGA3 FISH OIL 1000MGCP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5308530", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OMEGA3 FISH OIL 1000MGCP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5308530", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 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": 64.0, "discounted_cash": 48.0, "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": 64.0, "discounted_cash": 48.0, "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": 19.0, "discounted_cash": 14.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "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": 1049.0, "discounted_cash": 786.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ONDANSETRON 4MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308495", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1049.0, "discounted_cash": 786.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ONDANSETRON 4MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315890", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 161.0, "discounted_cash": 120.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ONDANSETRON 4MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315890", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 161.0, "discounted_cash": 120.75, "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": 1049.0, "discounted_cash": 786.75, "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": 1049.0, "discounted_cash": 786.75, "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": 593.0, "discounted_cash": 444.75, "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": 593.0, "discounted_cash": 444.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "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": 37583.0, "discounted_cash": 28187.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OPEN/PERC PL ST 1ST AR", "code_information": [{"code": "4917236", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 37583.0, "discounted_cash": 28187.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OPEN/PERC PL ST 1ST AR", "code_information": [{"code": "4957236", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 37583.0, "discounted_cash": 28187.25, "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": 39654.0, "discounted_cash": 29740.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OPEN/PERC PL ST 1ST VN", "code_information": [{"code": "4917238", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 39654.0, "discounted_cash": 29740.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OPEN/PERC PL ST 1ST VN", "code_information": [{"code": "4957238", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 39654.0, "discounted_cash": 29740.5, "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": 29859.0, "discounted_cash": 22394.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OPEN/PERC PL ST E/ADD AR", "code_information": [{"code": "4957237", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 29859.0, "discounted_cash": 22394.25, "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": 24234.0, "discounted_cash": 18175.5, "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": 24234.0, "discounted_cash": 18175.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OPEN/PERC PL ST E/ADD VN", "code_information": [{"code": "4957239", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 24234.0, "discounted_cash": 18175.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OPHTHALMIC IRRIG120ML OS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335376", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 105.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OPHTHALMIC IRRIG120ML OS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335376", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 105.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OPIATES", "code_information": [{"code": "80361", "type": "CPT"}, {"code": "7052544", "type": "CDM"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OPIATES/2", "code_information": [{"code": "80361", "type": "CPT"}, {"code": "7053926", "type": "CDM"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OPIATES/3", "code_information": [{"code": "80361", "type": "CPT"}, {"code": "7003928", "type": "CDM"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OPIATES/3", "code_information": [{"code": "80361", "type": "CPT"}, {"code": "7253926", "type": "CDM"}], "standard_charges": [{"gross_charge": 421.0, "discounted_cash": 315.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 7.4, "discounted_cash": 5.55, "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": 7.4, "discounted_cash": 5.55, "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": 3925.0, "discounted_cash": 2943.75, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 3925.0, "discounted_cash": 2943.75, "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": 8857.0, "discounted_cash": 6642.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OPTIFLOW HFOT INITIAL", "code_information": [{"code": "94799", "type": "CPT"}, {"code": "3110013", "type": "CDM"}, {"code": "460", "type": "RC"}], "standard_charges": [{"gross_charge": 944.0, "discounted_cash": 708.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OPTIFLOW HFOT INITIAL", "code_information": [{"code": "94799", "type": "CPT"}, {"code": "5500061", "type": "CDM"}, {"code": "460", "type": "RC"}], "standard_charges": [{"gross_charge": 944.0, "discounted_cash": 708.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OPTIFLOW HFOT MANAGEMENT DLY", "code_information": [{"code": "94799", "type": "CPT"}, {"code": "3110014", "type": "CDM"}, {"code": "460", "type": "RC"}], "standard_charges": [{"gross_charge": 944.0, "discounted_cash": 708.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OPTIFLOW HFOT MANAGEMENT DLY", "code_information": [{"code": "94799", "type": "CPT"}, {"code": "5500062", "type": "CDM"}, {"code": "460", "type": "RC"}], "standard_charges": [{"gross_charge": 944.0, "discounted_cash": 708.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ORAL CONTRACEP 1EA TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301600", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ORAL CONTRACEP 1EA TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301600", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ORAL CONTRACEP 1MNTH TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301601", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 592.0, "discounted_cash": 444.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ORAL CONTRACEP 1MNTH TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5301601", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 592.0, "discounted_cash": 444.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ORBITS 4VW MIN", "code_information": [{"code": "70200", "type": "CPT"}, {"code": "4900152", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1458.0, "discounted_cash": 1093.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ORBITS 4VW MIN", "code_information": [{"code": "70200", "type": "CPT"}, {"code": "5010152", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1458.0, "discounted_cash": 1093.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ORBITS 4VW MIN", "code_information": [{"code": "70200", "type": "CPT"}, {"code": "5120200", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1458.0, "discounted_cash": 1093.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ORGANIC ACID SNG QNT", "code_information": [{"code": "83921", "type": "CPT"}, {"code": "7252125", "type": "CDM"}], "standard_charges": [{"gross_charge": 238.0, "discounted_cash": 178.5, "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": 565.0, "discounted_cash": 423.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ORGANIC ACIDS QUAL", "code_information": [{"code": "83919", "type": "CPT"}, {"code": "7258391", "type": "CDM"}], "standard_charges": [{"gross_charge": 371.0, "discounted_cash": 278.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ORPHENADRINE 100MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308493", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 44.0, "discounted_cash": 33.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ORPHENADRINE 100MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308493", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 44.0, "discounted_cash": 33.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ORTH LE ADD SOCKT INS BK", "code_information": [{"code": "L5655", "type": "HCPCS"}, {"code": "8130097", "type": "CDM"}], "standard_charges": [{"gross_charge": 10460.0, "discounted_cash": 7845.0, "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": 464.0, "discounted_cash": 348.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OS CALCIS 2 VIEWS", "code_information": [{"code": "73650", "type": "CPT"}, {"code": "4903650", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 717.0, "discounted_cash": 537.75, "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": 717.0, "discounted_cash": 537.75, "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": 717.0, "discounted_cash": 537.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OS CALCIS 2 VIEWS", "code_information": [{"code": "73650", "type": "CPT"}, {"code": "5123650", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 717.0, "discounted_cash": 537.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "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": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OSELTAMIVIR 6/1 1ML PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315907", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OSELTAMIVIR 6/1 1ML PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315907", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OSELTAMIVIR 6/1 5ML PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315904", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 210.0, "discounted_cash": 157.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OSELTAMIVIR 6/1 5ML PWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315904", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 210.0, "discounted_cash": 157.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OSELTAMIVIR 75MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308504", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "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": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OSELTAMIVIR12/1 1MLPWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315891", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 44.0, "discounted_cash": 33.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OSELTAMIVIR12/1 1MLPWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315891", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 44.0, "discounted_cash": 33.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OSELTAMIVIR12/1 25MLPWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315893", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1130.0, "discounted_cash": 847.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OSELTAMIVIR12/1 25MLPWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315893", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1130.0, "discounted_cash": 847.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OSMOLALITY", "code_information": [{"code": "84999", "type": "CPT"}, {"code": "7004903", "type": "CDM"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OSMOLALITY BLOOD", "code_information": [{"code": "83930", "type": "CPT"}, {"code": "4103930", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 356.0, "discounted_cash": 267.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OSMOLALITY BLOOD", "code_information": [{"code": "83930", "type": "CPT"}, {"code": "4173930", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 281.0, "discounted_cash": 210.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OSMOLALITY BLOOD", "code_information": [{"code": "83930", "type": "CPT"}, {"code": "7253930", "type": "CDM"}], "standard_charges": [{"gross_charge": 101.0, "discounted_cash": 75.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OSMOLALITY FECAL", "code_information": [{"code": "84999", "type": "CPT"}, {"code": "7250168", "type": "CDM"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "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": 356.0, "discounted_cash": 267.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OSMOLALITY URINE", "code_information": [{"code": "83935", "type": "CPT"}, {"code": "4173935", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 281.0, "discounted_cash": 210.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OSMOLALITY URINE", "code_information": [{"code": "83935", "type": "CPT"}, {"code": "7253935", "type": "CDM"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OST ADHES+RING", "code_information": [{"code": "A4385", "type": "HCPCS"}, {"code": "8032975", "type": "CDM"}], "standard_charges": [{"gross_charge": 190.0, "discounted_cash": 142.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OST CLAMP BG", "code_information": [{"code": "A4363", "type": "HCPCS"}, {"code": "8033080", "type": "CDM"}], "standard_charges": [{"gross_charge": 370.0, "discounted_cash": 277.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OST PASTE STMA", "code_information": [{"code": "A4406", "type": "HCPCS"}, {"code": "8033145", "type": "CDM"}], "standard_charges": [{"gross_charge": 477.0, "discounted_cash": 357.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OT CAREGIVER TRNG 1ST 30 MIN", "code_information": [{"code": "97550", "type": "CPT"}, {"code": "5800052", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 295.0, "discounted_cash": 221.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT CAREGIVER TRNG ADD 15 MIN", "code_information": [{"code": "97551", "type": "CPT"}, {"code": "5800010", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 148.0, "discounted_cash": 111.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT CONT BATH EA 15 BSC", "code_information": [{"code": "97034", "type": "CPT"}, {"code": "5805278", "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 CST HND-LWR FOREARM", "code_information": [{"code": "5804894", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 514.0, "discounted_cash": 385.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OT EVAL HIGH COMP", "code_information": [{"code": "97167", "type": "CPT"}, {"code": "5805205", "type": "CDM"}, {"code": "434", "type": "RC"}], "standard_charges": [{"gross_charge": 981.0, "discounted_cash": 735.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT EVAL LOW COMP", "code_information": [{"code": "97165", "type": "CPT"}, {"code": "5805201", "type": "CDM"}, {"code": "434", "type": "RC"}], "standard_charges": [{"gross_charge": 424.0, "discounted_cash": 318.0, "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": 848.0, "discounted_cash": 636.0, "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": 687.0, "discounted_cash": 515.25, "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": 446.0, "discounted_cash": 334.5, "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": 384.0, "discounted_cash": 288.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT NSEL WD DEB WO AN BSC", "code_information": [{"code": "97602", "type": "CPT"}, {"code": "5807623", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 665.0, "discounted_cash": 498.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT NSL WD/S DEB WO AN CO", "code_information": [{"code": "97602", "type": "CPT"}, {"code": "5807625", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 665.0, "discounted_cash": 498.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT NSL WD/S DEB WO AN IN", "code_information": [{"code": "97602", "type": "CPT"}, {"code": "5807624", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 665.0, "discounted_cash": 498.75, "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": 220.0, "discounted_cash": 165.0, "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": 152.0, "discounted_cash": 114.0, "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": 165.0, "discounted_cash": 123.75, "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": 364.0, "discounted_cash": 273.0, "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": 268.0, "discounted_cash": 201.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT SENSRY INTRGRN EA15", "code_information": [{"code": "97533", "type": "CPT"}, {"code": "5807545", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 359.0, "discounted_cash": 269.25, "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": 274.0, "discounted_cash": 205.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OT SPLINT FINGER DYNAMIC", "code_information": [{"code": "5804742", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 448.0, "discounted_cash": 336.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OT SPLNT FNGR STATC", "code_information": [{"code": "5804916", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 360.0, "discounted_cash": 270.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OT SPLNT LNG ARM", "code_information": [{"code": "5804910", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 448.0, "discounted_cash": 336.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OT SPLNT SHRT ARM DYNAMC", "code_information": [{"code": "5804914", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 448.0, "discounted_cash": 336.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OT SPLNT SHRT ARM STATC", "code_information": [{"code": "5804912", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 292.0, "discounted_cash": 219.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OT THERAPTC ACT EA 15", "code_information": [{"code": "97530", "type": "CPT"}, {"code": "5805312", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 322.0, "discounted_cash": 241.5, "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": 435.0, "discounted_cash": 326.25, "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": 189.0, "discounted_cash": 141.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "OTA CONT BATH EA 15 BSC", "code_information": [{"code": "97034", "type": "CPT"}, {"code": "5800024", "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 IONTOPHOR EA 15 BSC", "code_information": [{"code": "97033", "type": "CPT"}, {"code": "5800023", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 687.0, "discounted_cash": 515.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GO|CO"}, {"description": "OTA MANUAL THERAPY EA 15M", "code_information": [{"code": "97140", "type": "CPT"}, {"code": "5800012", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 446.0, "discounted_cash": 334.5, "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": 384.0, "discounted_cash": 288.0, "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": 152.0, "discounted_cash": 114.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GO|CO"}, {"description": "OTA PARAFFIN BATH BSC", "code_information": [{"code": "97018", "type": "CPT"}, {"code": "5800017", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 165.0, "discounted_cash": 123.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GO|CO"}, {"description": "OTA SENSRY INTRGRN EA 15", "code_information": [{"code": "97533", "type": "CPT"}, {"code": "5800051", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 359.0, "discounted_cash": 269.25, "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": 274.0, "discounted_cash": 205.5, "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": 322.0, "discounted_cash": 241.5, "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": 435.0, "discounted_cash": 326.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GO|CO"}, {"description": "OTA US EA 15 BASIC", "code_information": [{"code": "97035", "type": "CPT"}, {"code": "5800025", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 189.0, "discounted_cash": 141.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GO|CO"}, {"description": "OUTSIDE FEE FFP/PEDIATRC", "code_information": [{"code": "P9017", "type": "HCPCS"}, {"code": "4500068", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 495.0, "discounted_cash": 371.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OVA & PARASITES SMEARS", "code_information": [{"code": "87177", "type": "CPT"}, {"code": "4177177", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 15.0, "discounted_cash": 11.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OVA & PARASITES SMEARS", "code_information": [{"code": "87177", "type": "CPT"}, {"code": "7007177", "type": "CDM"}], "standard_charges": [{"gross_charge": 45.0, "discounted_cash": 33.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OVA & PARASITES SMEARS/2", "code_information": [{"code": "87177", "type": "CPT"}, {"code": "7257177", "type": "CDM"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OXALATE", "code_information": [{"code": "83945", "type": "CPT"}, {"code": "7253945", "type": "CDM"}], "standard_charges": [{"gross_charge": 267.0, "discounted_cash": 200.25, "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": 10.0, "discounted_cash": 7.5, "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": 10.0, "discounted_cash": 7.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OXANDROLONE 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327840", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 161.0, "discounted_cash": 120.75, "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": 161.0, "discounted_cash": 120.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OXAPROZIN 600MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308540", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OXAPROZIN 600MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308540", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OXAZEPAM 10MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308555", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OXAZEPAM 10MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308555", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OXAZEPAM 15MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308559", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OXAZEPAM 15MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308559", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OXCARBAZEPINE", "code_information": [{"code": "80183", "type": "CPT"}, {"code": "7000317", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 304.0, "discounted_cash": 228.0, "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": 108.0, "discounted_cash": 81.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 180.0, "discounted_cash": 135.0, "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": 180.0, "discounted_cash": 135.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OXCARBAZEPINE 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315901", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 192.0, "discounted_cash": 144.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OXCARBAZEPINE 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5315901", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 192.0, "discounted_cash": 144.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OXCARBAZEPINE/2", "code_information": [{"code": "80183", "type": "CPT"}, {"code": "7250317", "type": "CDM"}], "standard_charges": [{"gross_charge": 264.0, "discounted_cash": 198.0, "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": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 377.0, "discounted_cash": 282.75, "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": 377.0, "discounted_cash": 282.75, "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": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYBUTYNIN 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308640", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYBUTYNIN 5MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308641", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 266.0, "discounted_cash": 199.5, "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": 266.0, "discounted_cash": 199.5, "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": 26.0, "discounted_cash": 19.5, "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": 26.0, "discounted_cash": 19.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYCOD/APAP 5/325 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327847", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYCOD/APAP 5/500 CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327846", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYCOD/APAP 5/500 CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327846", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "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": 58.0, "discounted_cash": 43.5, "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": 58.0, "discounted_cash": 43.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYCODONE 15MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327851", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYCODONE 15MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5327851", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "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": 232.0, "discounted_cash": 174.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 232.0, "discounted_cash": 174.0, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 23.0, "discounted_cash": 17.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 23.0, "discounted_cash": 17.25, "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": 639.0, "discounted_cash": 479.25, "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": 639.0, "discounted_cash": 479.25, "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": 102.0, "discounted_cash": 76.5, "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": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYMETAZOL NS.025%20MLIS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5331675", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYMETAZOL NS.025%20MLIS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5331675", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "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": 89.0, "discounted_cash": 66.75, "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": 89.0, "discounted_cash": 66.75, "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": 116.0, "discounted_cash": 87.0, "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": 116.0, "discounted_cash": 87.0, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYMETAZOLN NS.05%3ML SP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5331680", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYMETAZOLN NS.05%3ML SP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5331680", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYTOCIN PER 10U LR IV", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2590", "type": "HCPCS"}, {"code": "5323038", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "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": 76.0, "discounted_cash": 57.0, "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": 15.0, "discounted_cash": 11.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYTOCIN PER 10U NACL IV", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2590", "type": "HCPCS"}, {"code": "5323036", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 15.0, "discounted_cash": 11.25, "setting": "both", "billing_class": "facility"}]}, {"description": "OXYTOCIN UPTO 10U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2590", "type": "HCPCS"}, {"code": "5323045", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 308.0, "discounted_cash": 231.0, "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": 308.0, "discounted_cash": 231.0, "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": 9827.0, "discounted_cash": 7370.25, "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": 74.0, "discounted_cash": 55.5, "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": 74.0, "discounted_cash": 55.5, "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": 3.0, "discounted_cash": 2.25, "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": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PAD CERV COLLAR REPLC", "code_information": [{"code": "L9900", "type": "HCPCS"}, {"code": "8114372", "type": "CDM"}], "standard_charges": [{"gross_charge": 187.0, "discounted_cash": 140.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PALIPERIDN (INVEGA SUST) 1MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2426", "type": "HCPCS"}, {"code": "5323035", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 58.0, "discounted_cash": 43.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PALIPERIDN (INVEGA SUST) 1MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2426", "type": "HCPCS"}, {"code": "5323035", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 58.0, "discounted_cash": 43.5, "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": 9.0, "discounted_cash": 6.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 9.0, "discounted_cash": 6.75, "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": 451.0, "discounted_cash": 338.25, "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": 451.0, "discounted_cash": 338.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PALIPERIDONE 9MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308881", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 158.0, "discounted_cash": 118.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PALIPERIDONE 9MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308881", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 158.0, "discounted_cash": 118.5, "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": 9517.0, "discounted_cash": 7137.75, "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": 9517.0, "discounted_cash": 7137.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PALONOSETRON PER25MCGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2469", "type": "HCPCS"}, {"code": "5323064", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 289.0, "discounted_cash": 216.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PALONOSETRON PER25MCGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2469", "type": "HCPCS"}, {"code": "5323064", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 289.0, "discounted_cash": 216.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PAMIDRONATE PER 30MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2430", "type": "HCPCS"}, {"code": "5323060", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1776.0, "discounted_cash": 1332.0, "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": 1776.0, "discounted_cash": 1332.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PANCRELIP 10-34-55 XRCP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306613", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PANCRELIP 10-34-55 XRCP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306613", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PANCRELIP 5-17-27 XRCP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306601", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PANCRELIP 5-17-27 XRCP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306601", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PANCRELIP 56-20-44 XRCP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308865", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PANCRELIP 56-20-44 XRCP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308865", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PANCRTC POLYPEP (RIA)", "code_information": [{"code": "83519", "type": "CPT"}, {"code": "7003433", "type": "CDM"}], "standard_charges": [{"gross_charge": 749.0, "discounted_cash": 561.75, "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": 147.0, "discounted_cash": 110.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PANCURONIUM2MG/ML 2ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5323068", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 300.0, "discounted_cash": 225.0, "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": 627.0, "discounted_cash": 470.25, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 74.0, "discounted_cash": 55.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 74.0, "discounted_cash": 55.5, "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": 475.0, "discounted_cash": 356.25, "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": 475.0, "discounted_cash": 356.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PAPAIN UREA 30GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336970", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 142.0, "discounted_cash": 106.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PAPAIN UREA 33ML SP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336979", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1210.0, "discounted_cash": 907.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PAPAIN UREA 6GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336974", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 196.0, "discounted_cash": 147.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PAPAVERINE UPTO 60MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2440", "type": "HCPCS"}, {"code": "5323077", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "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": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PARAINFLUENZA DFA/4", "code_information": [{"code": "87279", "type": "CPT"}, {"code": "7007298", "type": "CDM"}], "standard_charges": [{"gross_charge": 123.0, "discounted_cash": 92.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PARANEOPLASTIC AB", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "7256269", "type": "CDM"}], "standard_charges": [{"gross_charge": 1530.0, "discounted_cash": 1147.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PARATHORMONE (PTH)", "code_information": [{"code": "83970", "type": "CPT"}, {"code": "4173972", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 414.0, "discounted_cash": 310.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PARATHORMONE (PTH)", "code_information": [{"code": "83970", "type": "CPT"}, {"code": "7003901", "type": "CDM"}], "standard_charges": [{"gross_charge": 286.0, "discounted_cash": 214.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PARATHORMONE (PTH)", "code_information": [{"code": "83970", "type": "CPT"}, {"code": "7253902", "type": "CDM"}], "standard_charges": [{"gross_charge": 526.0, "discounted_cash": 394.5, "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": 638.0, "discounted_cash": 478.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PARATHORMONE (PTH)/4", "code_information": [{"code": "83970", "type": "CPT"}, {"code": "7253970", "type": "CDM"}], "standard_charges": [{"gross_charge": 922.0, "discounted_cash": 691.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PARATHORMONE (PTH)/5", "code_information": [{"code": "83970", "type": "CPT"}, {"code": "7003970", "type": "CDM"}], "standard_charges": [{"gross_charge": 286.0, "discounted_cash": 214.5, "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": 1770.0, "discounted_cash": 1327.5, "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": 84.0, "discounted_cash": 63.0, "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": 84.0, "discounted_cash": 63.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 284.0, "discounted_cash": 213.0, "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": 284.0, "discounted_cash": 213.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PAROXETINE 12.5MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5308953", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 222.0, "discounted_cash": 166.5, "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": 222.0, "discounted_cash": 166.5, "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": 99.0, "discounted_cash": 74.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "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": 290.0, "discounted_cash": 217.5, "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": 290.0, "discounted_cash": 217.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PARTICLE AGGLUT AB EA/10", "code_information": [{"code": "86403", "type": "CPT"}, {"code": "7006406", "type": "CDM"}], "standard_charges": [{"gross_charge": 89.0, "discounted_cash": 66.75, "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": 464.0, "discounted_cash": 348.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PARTICLE AGGLUT AB EA/2", "code_information": [{"code": "86403", "type": "CPT"}, {"code": "4176403", "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/2", "code_information": [{"code": "86403", "type": "CPT"}, {"code": "7258643", "type": "CDM"}], "standard_charges": [{"gross_charge": 209.0, "discounted_cash": 156.75, "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": 633.0, "discounted_cash": 474.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PARTICLE AGGLUT AB EA/3", "code_information": [{"code": "86403", "type": "CPT"}, {"code": "4176404", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 498.0, "discounted_cash": 373.5, "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": 219.0, "discounted_cash": 164.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PARTICLE AGGLUT TITER EA", "code_information": [{"code": "86406", "type": "CPT"}, {"code": "4103999", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 174.0, "discounted_cash": 130.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PARVOVIRUS AB", "code_information": [{"code": "86747", "type": "CPT"}, {"code": "7256248", "type": "CDM"}], "standard_charges": [{"gross_charge": 276.0, "discounted_cash": 207.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PARVOVIRUS AB/3", "code_information": [{"code": "86747", "type": "CPT"}, {"code": "7006748", "type": "CDM"}], "standard_charges": [{"gross_charge": 130.0, "discounted_cash": 97.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PARVOVIRUS AB/3", "code_information": [{"code": "86747", "type": "CPT"}, {"code": "7256748", "type": "CDM"}], "standard_charges": [{"gross_charge": 276.0, "discounted_cash": 207.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PARVOVIRUS AB/4", "code_information": [{"code": "86747", "type": "CPT"}, {"code": "7006749", "type": "CDM"}], "standard_charges": [{"gross_charge": 130.0, "discounted_cash": 97.5, "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": 10800.0, "discounted_cash": 8100.0, "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": 3006.0, "discounted_cash": 2254.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PATELLA ATTUNE POLY DEPUY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012822", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3623.0, "discounted_cash": 2717.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PATELLA KNEE POLY MEDACTA CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013453", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4992.0, "discounted_cash": 3744.0, "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": 3780.0, "discounted_cash": 2835.0, "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": 2076.0, "discounted_cash": 1557.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PATELLA POLY EXACTECH CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012867", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 17259.0, "discounted_cash": 12944.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PATELLA POLY RP DEPUY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012824", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 3169.0, "discounted_cash": 2376.75, "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": 1805.0, "discounted_cash": 1353.75, "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": 317.0, "discounted_cash": 237.75, "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": 317.0, "discounted_cash": 237.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PDGFRA MUTATION ANALYSIS", "code_information": [{"code": "81314", "type": "CPT"}, {"code": "7270035", "type": "CDM"}], "standard_charges": [{"gross_charge": 2093.0, "discounted_cash": 1569.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PE 10% 1ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331821", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 157.0, "discounted_cash": 117.75, "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": 213.0, "discounted_cash": 159.75, "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": 143.0, "discounted_cash": 107.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PE 2.5% 15ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331829", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 143.0, "discounted_cash": 107.25, "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": 447.0, "discounted_cash": 335.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PE NAS .125% 15ML DR IS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5331779", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 44.0, "discounted_cash": 33.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PE NAS .125% 15ML DR IS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5331779", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 44.0, "discounted_cash": 33.0, "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": 23.0, "discounted_cash": 17.25, "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": 23.0, "discounted_cash": 17.25, "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": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PE NASAL .5% 15ML SP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5331808", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PE NASAL 1% 15ML DR IS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5331815", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PE NASAL 1% 15ML DR IS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5331815", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "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": 17.0, "discounted_cash": 12.75, "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": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PE/CPM/DM 5ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316031", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PE/CPM/DM 5ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316031", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "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": 807.0, "discounted_cash": 605.25, "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": 807.0, "discounted_cash": 605.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PELVIS 1 VIEW", "code_information": [{"code": "72170", "type": "CPT"}, {"code": "5112170", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 807.0, "discounted_cash": 605.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PELVIS 1 VIEW", "code_information": [{"code": "72170", "type": "CPT"}, {"code": "5122170", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 807.0, "discounted_cash": 605.25, "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": 807.0, "discounted_cash": 605.25, "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": 807.0, "discounted_cash": 605.25, "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": 807.0, "discounted_cash": 605.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PELVIS 2 VIEWS", "code_information": [{"code": "72170", "type": "CPT"}, {"code": "5122171", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 807.0, "discounted_cash": 605.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PELVIS MIN 3 VWS", "code_information": [{"code": "72190", "type": "CPT"}, {"code": "4902190", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1403.0, "discounted_cash": 1052.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PELVIS/HIP JT I&D ABSC", "code_information": [{"code": "5052200", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 17516.0, "discounted_cash": 13137.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 159.0, "discounted_cash": 119.25, "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": 159.0, "discounted_cash": 119.25, "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": 53.0, "discounted_cash": 39.75, "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": 53.0, "discounted_cash": 39.75, "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": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PEN G K UPTO 600KU IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2540", "type": "HCPCS"}, {"code": "5323151", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 58.0, "discounted_cash": 43.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PEN G K UPTO 600KU IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2540", "type": "HCPCS"}, {"code": "5323151", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 58.0, "discounted_cash": 43.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PEN G NA PED PER 1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5323152", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "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": 455.0, "discounted_cash": 341.25, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 455.0, "discounted_cash": 341.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PENICILLIN G K PED IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5323149", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.68, "discounted_cash": 0.51, "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": 359.0, "discounted_cash": 269.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "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": 108.0, "discounted_cash": 81.0, "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": 220.0, "discounted_cash": 165.0, "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": 220.0, "discounted_cash": 165.0, "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": 2735.0, "discounted_cash": 2051.25, "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": 1141.0, "discounted_cash": 855.75, "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": 45.0, "discounted_cash": 33.75, "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": 45.0, "discounted_cash": 33.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PENTOSN POLYSLF 100MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309065", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 269.0, "discounted_cash": 201.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PENTOSN POLYSLF 100MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309065", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 269.0, "discounted_cash": 201.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PENTOXIFYLLN 400MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309066", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 10.0, "discounted_cash": 7.5, "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": 10.0, "discounted_cash": 7.5, "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": 27402.0, "discounted_cash": 20551.5, "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": 27402.0, "discounted_cash": 20551.5, "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": 61187.0, "discounted_cash": 45890.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PER COR REVAS CHRONC SNG", "code_information": [{"code": "C9607", "type": "HCPCS"}, {"code": "4619607", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 61187.0, "discounted_cash": 45890.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PER COR REVAS D-E ADDL", "code_information": [{"code": "C9608", "type": "HCPCS"}, {"code": "4619608", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 24809.0, "discounted_cash": 18606.75, "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": 24809.0, "discounted_cash": 18606.75, "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": 72408.0, "discounted_cash": 54306.0, "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": 72408.0, "discounted_cash": 54306.0, "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": 4234.0, "discounted_cash": 3175.5, "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": 4234.0, "discounted_cash": 3175.5, "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": 9827.0, "discounted_cash": 7370.25, "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": 14373.0, "discounted_cash": 10779.75, "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": 10694.0, "discounted_cash": 8020.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC BIOPSY LYMPH NODE", "code_information": [{"code": "5010081", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1957.0, "discounted_cash": 1467.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC BIOPSY LYMPH NODE", "code_information": [{"code": "5057516", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2084.0, "discounted_cash": 1563.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC BIOPSY LYMPH NODE", "code_information": [{"code": "5068505", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1957.0, "discounted_cash": 1467.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC CATH PORTAL VEIN", "code_information": [{"code": "4910163", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5714.0, "discounted_cash": 4285.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC CHOLECYSTOSTOMY", "code_information": [{"code": "4917600", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7417.0, "discounted_cash": 5562.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC CHOLECYSTOSTOMY", "code_information": [{"code": "5057490", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7417.0, "discounted_cash": 5562.75, "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": 57166.0, "discounted_cash": 42874.5, "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": 57166.0, "discounted_cash": 42874.5, "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": 40226.0, "discounted_cash": 30169.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC COR ATH D-E STNT", "code_information": [{"code": "C9602", "type": "HCPCS"}, {"code": "4619602", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 40226.0, "discounted_cash": 30169.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC COR ATHER STNT ADD", "code_information": [{"code": "C9603", "type": "HCPCS"}, {"code": "4619603", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 23619.0, "discounted_cash": 17714.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC COR ATHER STNT ADD", "code_information": [{"code": "C9603", "type": "HCPCS"}, {"code": "4619603", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 23619.0, "discounted_cash": 17714.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC COR DRUG-ELUT STNT", "code_information": [{"code": "C9600", "type": "HCPCS"}, {"code": "4619600", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 58965.0, "discounted_cash": 44223.75, "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": 58965.0, "discounted_cash": 44223.75, "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": 49666.0, "discounted_cash": 37249.5, "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": 49666.0, "discounted_cash": 37249.5, "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": 11286.0, "discounted_cash": 8464.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC DEVC BRST 1ST MAMMO", "code_information": [{"code": "5019281", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1812.0, "discounted_cash": 1359.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC DEVC BRST 1ST MR", "code_information": [{"code": "5259287", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5191.0, "discounted_cash": 3893.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC DEVC BRST 1ST STRTC", "code_information": [{"code": "5019283", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3645.0, "discounted_cash": 2733.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC DEVC BRST 1ST STRTC", "code_information": [{"code": "5129283", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3645.0, "discounted_cash": 2733.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC DEVC BRST 1ST US", "code_information": [{"code": "5019285", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3735.0, "discounted_cash": 2801.25, "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": 2858.0, "discounted_cash": 2143.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC DEVC BRST 1ST US", "code_information": [{"code": "5129285", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3735.0, "discounted_cash": 2801.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC DEVC BRST ADD MAM", "code_information": [{"code": "5019282", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2152.0, "discounted_cash": 1614.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC DEVC BRST ADD MR", "code_information": [{"code": "5259288", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5191.0, "discounted_cash": 3893.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC DEVC BRST ADD STRTC", "code_information": [{"code": "5019284", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2341.0, "discounted_cash": 1755.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC DEVC BRST ADD US", "code_information": [{"code": "5019286", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3735.0, "discounted_cash": 2801.25, "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": 4404.0, "discounted_cash": 3303.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC DISC REMOVAL W/IMAG", "code_information": [{"code": "4912283", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 15675.0, "discounted_cash": 11756.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC DISC REMOVAL W/IMAG", "code_information": [{"code": "5052287", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 14409.0, "discounted_cash": 10806.75, "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": 1802.0, "discounted_cash": 1351.5, "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": 1522.0, "discounted_cash": 1141.5, "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": 1802.0, "discounted_cash": 1351.5, "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": 24718.0, "discounted_cash": 18538.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC DRUG-ELUT STNT ADDL", "code_information": [{"code": "C9601", "type": "HCPCS"}, {"code": "4619601", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 24718.0, "discounted_cash": 18538.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC IABP REMOVAL", "code_information": [{"code": "4613968", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6287.0, "discounted_cash": 4715.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC INSERT IABP DEV", "code_information": [{"code": "4613967", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 9716.0, "discounted_cash": 7287.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC MECH THROMBECTMY VN", "code_information": [{"code": "4617187", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 23800.0, "discounted_cash": 17850.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC MECH THROMBECTMY VN", "code_information": [{"code": "4914104", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 23800.0, "discounted_cash": 17850.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC MECH THROMBECTMY VN", "code_information": [{"code": "4957187", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 23800.0, "discounted_cash": 17850.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC MECH THROMBUS ART", "code_information": [{"code": "4951645", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 50249.0, "discounted_cash": 37686.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC NEPH/PYELO 0-2CM", "code_information": [{"code": "4915008", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3885.0, "discounted_cash": 2913.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC NEPH/PYELO > 2CM", "code_information": [{"code": "4915010", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2969.0, "discounted_cash": 2226.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC RF ABLATE BONE TUMR", "code_information": [{"code": "4912098", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 21070.0, "discounted_cash": 15802.5, "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": 19330.0, "discounted_cash": 14497.5, "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": 19195.0, "discounted_cash": 14396.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC RF ABLATE RENL TUMR", "code_information": [{"code": "5050592", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 14045.0, "discounted_cash": 10533.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC SACRL AUGMENT BILAT", "code_information": [{"code": "4912288", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 26560.0, "discounted_cash": 19920.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC SACRL AUGMENT UNIL", "code_information": [{"code": "4912286", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 20025.0, "discounted_cash": 15018.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC T-CATH MTRL VLV RPR", "code_information": [{"code": "4610343", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 58275.0, "discounted_cash": 43706.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC TRNSHEP PORT W/EVL", "code_information": [{"code": "75885", "type": "CPT"}, {"code": "4915886", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 8214.0, "discounted_cash": 6160.5, "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": 25389.0, "discounted_cash": 19041.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PERC VERT 1 BD ADD/IMG", "code_information": [{"code": "4914480", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 12136.0, "discounted_cash": 9102.0, "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": 12136.0, "discounted_cash": 9102.0, "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": 8564.0, "discounted_cash": 6423.0, "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": 2179.0, "discounted_cash": 1634.25, "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": 2179.0, "discounted_cash": 1634.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PERICARDIOCENTESIS W/IMG GUIDE", "code_information": [{"code": "4613016", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2886.0, "discounted_cash": 2164.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PERINDOPRIL 4MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309096", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PERINDOPRIL 4MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309096", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "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": 2426.0, "discounted_cash": 1819.5, "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": 367.0, "discounted_cash": 275.25, "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": 367.0, "discounted_cash": 275.25, "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": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PERMETHRIN 5% 60GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5336998", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PERPHENAZINE 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309106", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 23.0, "discounted_cash": 17.25, "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": 23.0, "discounted_cash": 17.25, "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": 44.0, "discounted_cash": 33.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 44.0, "discounted_cash": 33.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PERPHENAZINE UPTO 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3310", "type": "HCPCS"}, {"code": "5323225", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 305.0, "discounted_cash": 228.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PERPHENAZINE UPTO 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3310", "type": "HCPCS"}, {"code": "5323225", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 305.0, "discounted_cash": 228.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PERQ TRANSLUM CORONARY LITHOTR", "code_information": [{"code": "92972", "type": "CPT"}, {"code": "4610715", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 9981.0, "discounted_cash": 7485.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PET ANY SITE NOS NONCOVD", "code_information": [{"code": "G0235", "type": "HCPCS"}, {"code": "5238819", "type": "CDM"}, {"code": "404", "type": "RC"}], "standard_charges": [{"gross_charge": 13865.0, "discounted_cash": 10398.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PET/CT LIMITED", "code_information": [{"code": "78814", "type": "CPT"}, {"code": "5238814", "type": "CDM"}, {"code": "404", "type": "RC"}], "standard_charges": [{"gross_charge": 13556.0, "discounted_cash": 10167.0, "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": 14090.0, "discounted_cash": 10567.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PET/CT WHOLE BODY", "code_information": [{"code": "78816", "type": "CPT"}, {"code": "5238816", "type": "CDM"}, {"code": "404", "type": "RC"}], "standard_charges": [{"gross_charge": 14090.0, "discounted_cash": 10567.5, "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": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PETROLATUM 390GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337013", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PETROLATUM 390GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337013", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PETROLATUM AQUA 52GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334210", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "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": 32.0, "discounted_cash": 24.0, "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": 245.0, "discounted_cash": 183.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PH BODY FLUID NOS", "code_information": [{"code": "83986", "type": "CPT"}, {"code": "4173980", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 193.0, "discounted_cash": 144.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PH BODY FLUID NOS", "code_information": [{"code": "83986", "type": "CPT"}, {"code": "7253980", "type": "CDM"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "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": 147.0, "discounted_cash": 110.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PH BODY FLUID NOS/2", "code_information": [{"code": "83986", "type": "CPT"}, {"code": "7259358", "type": "CDM"}], "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENAZOPYRIDINE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309145", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENAZOPYRIDINE 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309149", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "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": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENCYCLIDINE(PCP) QUANT", "code_information": [{"code": "83992", "type": "CPT"}, {"code": "7003992", "type": "CDM"}], "standard_charges": [{"gross_charge": 201.0, "discounted_cash": 150.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENCYCLIDINE(PCP) QUANT", "code_information": [{"code": "83992", "type": "CPT"}, {"code": "7253992", "type": "CDM"}], "standard_charges": [{"gross_charge": 271.0, "discounted_cash": 203.25, "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": 111.0, "discounted_cash": 83.25, "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": 111.0, "discounted_cash": 83.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 158.0, "discounted_cash": 118.5, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 158.0, "discounted_cash": 118.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "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": 20.0, "discounted_cash": 15.0, "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": 247.0, "discounted_cash": 185.25, "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": 107.0, "discounted_cash": 80.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENOBARBITAL", "code_information": [{"code": "80184", "type": "CPT"}, {"code": "4174020", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 194.0, "discounted_cash": 145.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENOBARBITAL", "code_information": [{"code": "80184", "type": "CPT"}, {"code": "7250184", "type": "CDM"}], "standard_charges": [{"gross_charge": 97.0, "discounted_cash": 72.75, "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": 2.0, "discounted_cash": 1.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 33.0, "discounted_cash": 24.75, "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": 33.0, "discounted_cash": 24.75, "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": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "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": 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": "637", "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "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": 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": "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": "PHENOL 1.4% 180ML SP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5314597", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 10.0, "discounted_cash": 7.5, "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": 10.0, "discounted_cash": 7.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENOL 89%500ML TS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337030", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 467.0, "discounted_cash": 350.25, "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": 19.0, "discounted_cash": 14.25, "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": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENOXYBENZAMINE 10MGCP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309245", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 592.0, "discounted_cash": 444.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENOXYBENZAMINE 10MGCP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309245", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 592.0, "discounted_cash": 444.0, "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": 982.0, "discounted_cash": 736.5, "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": 982.0, "discounted_cash": 736.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENYLALANINE PKU BLOOD", "code_information": [{"code": "84030", "type": "CPT"}, {"code": "7004030", "type": "CDM"}], "standard_charges": [{"gross_charge": 432.0, "discounted_cash": 324.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENYLEPHRIN 20MG PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5323295", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 143.0, "discounted_cash": 107.25, "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": 23.0, "discounted_cash": 17.25, "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": 23.0, "discounted_cash": 17.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENYLEPHRINE HEMOR SU", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5338555", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "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": 3.0, "discounted_cash": 2.25, "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": 0.01, "discounted_cash": 0.01, "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": 0.01, "discounted_cash": 0.01, "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": 0.43, "discounted_cash": 0.32, "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": 0.43, "discounted_cash": 0.32, "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": 26.0, "discounted_cash": 19.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENYTOIN 100MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309438", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "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": 34.0, "discounted_cash": 25.5, "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": 20.0, "discounted_cash": 15.0, "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": 20.0, "discounted_cash": 15.0, "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": 20.0, "discounted_cash": 15.0, "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": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENYTOIN FREE", "code_information": [{"code": "80186", "type": "CPT"}, {"code": "4170186", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 646.0, "discounted_cash": 484.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENYTOIN FREE", "code_information": [{"code": "80186", "type": "CPT"}, {"code": "7004045", "type": "CDM"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENYTOIN FREE", "code_information": [{"code": "80186", "type": "CPT"}, {"code": "7254045", "type": "CDM"}], "standard_charges": [{"gross_charge": 822.0, "discounted_cash": 616.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENYTOIN PER 50MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1165", "type": "HCPCS"}, {"code": "5323320", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "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": 33.0, "discounted_cash": 24.75, "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": 271.0, "discounted_cash": 203.25, "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": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PHENYTOIN TOTAL", "code_information": [{"code": "80185", "type": "CPT"}, {"code": "4172655", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 214.0, "discounted_cash": 160.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PHLEBOTOMY THERAPEUTIC", "code_information": [{"code": "99195", "type": "CPT"}, {"code": "4549195", "type": "CDM"}, {"code": "940", "type": "RC"}], "standard_charges": [{"gross_charge": 360.0, "discounted_cash": 270.0, "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": 360.0, "discounted_cash": 270.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PHOSPHATASE ACID TOTAL", "code_information": [{"code": "84060", "type": "CPT"}, {"code": "4124060", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PHOSPHATASE ACID TOTAL", "code_information": [{"code": "84060", "type": "CPT"}, {"code": "7004060", "type": "CDM"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "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": 55.0, "discounted_cash": 41.25, "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": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PHOSPHATASE ALKALINE", "code_information": [{"code": "84075", "type": "CPT"}, {"code": "4174075", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PHOSPHATASE ALKALINE", "code_information": [{"code": "84075", "type": "CPT"}, {"code": "7254075", "type": "CDM"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PHOSPHATASE ISO ALK", "code_information": [{"code": "84080", "type": "CPT"}, {"code": "7004080", "type": "CDM"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PHOSPHATASE ISO ALK", "code_information": [{"code": "84080", "type": "CPT"}, {"code": "7254080", "type": "CDM"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PHOSPHOLIP NEUT PLATELET", "code_information": [{"code": "85597", "type": "CPT"}, {"code": "7005597", "type": "CDM"}], "standard_charges": [{"gross_charge": 307.0, "discounted_cash": 230.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PHOSPHOLIPIDS", "code_information": [{"code": "84311", "type": "CPT"}, {"code": "7254313", "type": "CDM"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PHOSPHOLP NEUT HEXAGONAL", "code_information": [{"code": "85598", "type": "CPT"}, {"code": "7255598", "type": "CDM"}], "standard_charges": [{"gross_charge": 204.0, "discounted_cash": 153.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PHOSPHORUS", "code_information": [{"code": "84100", "type": "CPT"}, {"code": "4104100", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 178.0, "discounted_cash": 133.5, "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": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PHOSPHORUS", "code_information": [{"code": "84100", "type": "CPT"}, {"code": "4174100", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 140.0, "discounted_cash": 105.0, "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": 171.0, "discounted_cash": 128.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PHOSPHORUS URINE", "code_information": [{"code": "84105", "type": "CPT"}, {"code": "4174102", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 134.0, "discounted_cash": 100.5, "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": 435.0, "discounted_cash": 326.25, "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": 76.0, "discounted_cash": 57.0, "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": 76.0, "discounted_cash": 57.0, "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": 223.0, "discounted_cash": 167.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PHYTONADIONE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3430", "type": "HCPCS"}, {"code": "5323366", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 223.0, "discounted_cash": 167.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PHYTONADN PED PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3430", "type": "HCPCS"}, {"code": "5323365", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 116.0, "discounted_cash": 87.0, "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": 116.0, "discounted_cash": 87.0, "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": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "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": 114.0, "discounted_cash": 85.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PILOCARPINE 2% 15ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331927", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 114.0, "discounted_cash": 85.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PILOCARPINE 4% 15ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331948", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 98.0, "discounted_cash": 73.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PILOCARPINE 4% 15ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5331948", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 98.0, "discounted_cash": 73.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "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": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PIMECROLIMUS 1% 30GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337046", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 138.0, "discounted_cash": 103.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PIMECROLIMUS 1% 30GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337046", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 138.0, "discounted_cash": 103.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PIN DISTRACTION", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133543", "type": "CDM"}], "standard_charges": [{"gross_charge": 897.0, "discounted_cash": 672.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PIN FIXATION PROVISIONAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133542", "type": "CDM"}], "standard_charges": [{"gross_charge": 1914.0, "discounted_cash": 1435.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PIN STEINMAN PL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133635", "type": "CDM"}], "standard_charges": [{"gross_charge": 974.0, "discounted_cash": 730.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PIN STEINMAN THR", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133640", "type": "CDM"}], "standard_charges": [{"gross_charge": 1535.0, "discounted_cash": 1151.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PIN TYPE I", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133638", "type": "CDM"}], "standard_charges": [{"gross_charge": 995.0, "discounted_cash": 746.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PIN TYPE II", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133636", "type": "CDM"}], "standard_charges": [{"gross_charge": 4067.0, "discounted_cash": 3050.25, "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": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PINDOLOL 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309484", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 148.0, "discounted_cash": 111.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PINWORM EXAM", "code_information": [{"code": "87172", "type": "CPT"}, {"code": "4177173", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 87.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 274.0, "discounted_cash": 205.5, "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": 274.0, "discounted_cash": 205.5, "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": 292.0, "discounted_cash": 219.0, "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": 292.0, "discounted_cash": 219.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PIPER/TAZ PER1.125GM IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2543", "type": "HCPCS"}, {"code": "5323412", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 262.0, "discounted_cash": 196.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PIPER/TAZ PER1.125GM IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2543", "type": "HCPCS"}, {"code": "5323412", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 262.0, "discounted_cash": 196.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PIPER/TAZ PER1.125GMPBIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2543", "type": "HCPCS"}, {"code": "5323413", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 45.0, "discounted_cash": 33.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PIPER/TAZ PER1.125GMPBIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2543", "type": "HCPCS"}, {"code": "5323413", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 45.0, "discounted_cash": 33.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "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": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PIROXICAM 20MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309534", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PIROXICAM 20MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309534", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PITCHER PL EXTRC 50ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5323410", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 208.0, "discounted_cash": 156.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PK AUTOGRF GRFLK CONVEN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4014303", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6139.0, "discounted_cash": 4604.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PKNG NASAL MEROGEL", "code_information": [{"code": "C1763", "type": "HCPCS"}, {"code": "8240277", "type": "CDM"}], "standard_charges": [{"gross_charge": 2522.0, "discounted_cash": 1891.5, "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": 2146.0, "discounted_cash": 1609.5, "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": 2146.0, "discounted_cash": 1609.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PL JEJUNOSTMYTBE WFLUORO", "code_information": [{"code": "4919442", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5494.0, "discounted_cash": 4120.5, "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": 36602.0, "discounted_cash": 27451.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PL ST CERV CAROTD WO/PRD", "code_information": [{"code": "4957216", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 36602.0, "discounted_cash": 27451.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PL STNT BIL EXIS ACCESS", "code_information": [{"code": "4917538", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 22832.0, "discounted_cash": 17124.0, "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": 3079.0, "discounted_cash": 2309.25, "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": 1333.0, "discounted_cash": 999.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLACENTAL A1 MICRO DIR", "code_information": [{"code": "84112", "type": "CPT"}, {"code": "4174112", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1048.0, "discounted_cash": 786.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLASMA LIQUID", "code_information": [{"code": "P9044", "type": "HCPCS"}, {"code": "4500108", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 304.0, "discounted_cash": 228.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLASMA PROT5%PER 50ML IJ", "code_information": [{"code": "P9043", "type": "HCPCS"}, {"code": "5323420", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1467.0, "discounted_cash": 1100.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLASMA PROT5%PER 50ML IJ", "code_information": [{"code": "P9043", "type": "HCPCS"}, {"code": "5323420", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1467.0, "discounted_cash": 1100.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLASMA PROT5%PER250ML IJ", "code_information": [{"code": "P9048", "type": "HCPCS"}, {"code": "5323423", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1058.0, "discounted_cash": 793.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLASMA PROT5%PER250ML IJ", "code_information": [{"code": "P9048", "type": "HCPCS"}, {"code": "5323423", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1058.0, "discounted_cash": 793.5, "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": 26.0, "discounted_cash": 19.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLATE AO SPECIAL TYP2", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133651", "type": "CDM"}], "standard_charges": [{"gross_charge": 1515.0, "discounted_cash": 1136.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLATE AO SPECIAL TYP3", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133652", "type": "CDM"}], "standard_charges": [{"gross_charge": 7773.0, "discounted_cash": 5829.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLATE AO SPECIAL TYP4", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133653", "type": "CDM"}], "standard_charges": [{"gross_charge": 5111.0, "discounted_cash": 3833.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLATE LCKG METACARPAL DORSAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133717", "type": "CDM"}], "standard_charges": [{"gross_charge": 5632.0, "discounted_cash": 4224.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLATE OTHER", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133843", "type": "CDM"}], "standard_charges": [{"gross_charge": 19465.0, "discounted_cash": 14598.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLATE/HIP COMP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133834", "type": "CDM"}], "standard_charges": [{"gross_charge": 5484.0, "discounted_cash": 4113.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLATELET AB", "code_information": [{"code": "86022", "type": "CPT"}, {"code": "4176022", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 98.0, "discounted_cash": 73.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLATELET AB", "code_information": [{"code": "86022", "type": "CPT"}, {"code": "7256014", "type": "CDM"}], "standard_charges": [{"gross_charge": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLATELET AB/2", "code_information": [{"code": "86022", "type": "CPT"}, {"code": "7006017", "type": "CDM"}], "standard_charges": [{"gross_charge": 623.0, "discounted_cash": 467.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLATELET AB/2", "code_information": [{"code": "86022", "type": "CPT"}, {"code": "7256017", "type": "CDM"}], "standard_charges": [{"gross_charge": 487.0, "discounted_cash": 365.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLATELET AB/7", "code_information": [{"code": "86022", "type": "CPT"}, {"code": "7256030", "type": "CDM"}], "standard_charges": [{"gross_charge": 692.0, "discounted_cash": 519.0, "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": 179.0, "discounted_cash": 134.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLATELET AUTO", "code_information": [{"code": "85049", "type": "CPT"}, {"code": "4175595", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 105.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLATELET IMMUNOGL ASSAY", "code_information": [{"code": "86023", "type": "CPT"}, {"code": "7006051", "type": "CDM"}], "standard_charges": [{"gross_charge": 205.0, "discounted_cash": 153.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH AORTA", "code_information": [{"code": "4617800", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1843.0, "discounted_cash": 1382.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH AORTA", "code_information": [{"code": "4917800", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2650.0, "discounted_cash": 1987.5, "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": 2723.0, "discounted_cash": 2042.25, "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": 2723.0, "discounted_cash": 2042.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH ART 1ST ORDR", "code_information": [{"code": "4957835", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2723.0, "discounted_cash": 2042.25, "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": 2498.0, "discounted_cash": 1873.5, "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": 2498.0, "discounted_cash": 1873.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH ART 2ND ORDR", "code_information": [{"code": "4956216", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2498.0, "discounted_cash": 1873.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH ART 3RD ORDR", "code_information": [{"code": "4617845", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3404.0, "discounted_cash": 2553.0, "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": 3404.0, "discounted_cash": 2553.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH ART 3RD ORDR", "code_information": [{"code": "4956217", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3404.0, "discounted_cash": 2553.0, "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": 3118.0, "discounted_cash": 2338.5, "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": 2868.0, "discounted_cash": 2151.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH ART ABD 2ND", "code_information": [{"code": "4617820", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2838.0, "discounted_cash": 2128.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH ART ABD 2ND", "code_information": [{"code": "4917820", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2838.0, "discounted_cash": 2128.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH ART ABD 3RD", "code_information": [{"code": "4617825", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3031.0, "discounted_cash": 2273.25, "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": 3031.0, "discounted_cash": 2273.25, "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": 5286.0, "discounted_cash": 3964.5, "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": 921.0, "discounted_cash": 690.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH ART ADD ORDR", "code_information": [{"code": "4956218", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 921.0, "discounted_cash": 690.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH EXTRM ARTERY", "code_information": [{"code": "4617860", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2617.0, "discounted_cash": 1962.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH EXTRM ARTERY", "code_information": [{"code": "4917865", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2846.0, "discounted_cash": 2134.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH LT/RT ARTERY", "code_information": [{"code": "4617865", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4000.0, "discounted_cash": 3000.0, "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": 4469.0, "discounted_cash": 3351.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH VEIN 1ST ORDR", "code_information": [{"code": "4917885", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2160.0, "discounted_cash": 1620.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH VEIN 1ST ORDR", "code_information": [{"code": "4956011", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2160.0, "discounted_cash": 1620.0, "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": 1747.0, "discounted_cash": 1310.25, "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": 1747.0, "discounted_cash": 1310.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH VEIN 2ND ORDR", "code_information": [{"code": "4956012", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1747.0, "discounted_cash": 1310.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH VENACAVA", "code_information": [{"code": "4617870", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1861.0, "discounted_cash": 1395.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CATH VENACAVA", "code_information": [{"code": "4917870", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1861.0, "discounted_cash": 1395.75, "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": 33641.0, "discounted_cash": 25230.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC CERV CAROTD W/PRD", "code_information": [{"code": "4957215", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 33641.0, "discounted_cash": 25230.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC NEPHROSTOMY CATH", "code_information": [{"code": "4917770", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 11947.0, "discounted_cash": 8960.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC NEPHROURETERAL CATH", "code_information": [{"code": "4914334", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 9483.0, "discounted_cash": 7112.25, "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": 1698.0, "discounted_cash": 1273.5, "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": 1698.0, "discounted_cash": 1273.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC SFT TISS DEV PERC 1ST+IMG", "code_information": [{"code": "5050035", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3096.0, "discounted_cash": 2322.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLC SFT TISS DEV PERC 1ST+IMG", "code_information": [{"code": "5060035", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3096.0, "discounted_cash": 2322.0, "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": 4035.0, "discounted_cash": 3026.25, "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": 12999.0, "discounted_cash": 9749.25, "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": 4652.0, "discounted_cash": 3489.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLEURAL DRAINAGE PERC", "code_information": [{"code": "4912557", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2972.0, "discounted_cash": 2229.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLEURAL DRAINAGE PERC", "code_information": [{"code": "5052557", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2972.0, "discounted_cash": 2229.0, "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": 191.0, "discounted_cash": 143.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT AGGREGATION EA AGENT", "code_information": [{"code": "85576", "type": "CPT"}, {"code": "4175576", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 150.0, "discounted_cash": 112.5, "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": 226.0, "discounted_cash": 169.5, "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": 208.0, "discounted_cash": 156.0, "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": 172.0, "discounted_cash": 129.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT AGGREGATION EA AGENT/5", "code_information": [{"code": "85576", "type": "CPT"}, {"code": "4105580", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT BROAD 2", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133682", "type": "CDM"}], "standard_charges": [{"gross_charge": 3599.0, "discounted_cash": 2699.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT BURR HOLE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133664", "type": "CDM"}], "standard_charges": [{"gross_charge": 3443.0, "discounted_cash": 2582.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT CABLE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137820", "type": "CDM"}], "standard_charges": [{"gross_charge": 5533.0, "discounted_cash": 4149.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT COMP LCP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133699", "type": "CDM"}], "standard_charges": [{"gross_charge": 4076.0, "discounted_cash": 3057.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT CRANI", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133702", "type": "CDM"}], "standard_charges": [{"gross_charge": 1329.0, "discounted_cash": 996.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT CRANI STRAIGHT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133706", "type": "CDM"}], "standard_charges": [{"gross_charge": 2098.0, "discounted_cash": 1573.5, "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": 2510.0, "discounted_cash": 1882.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT E COMP DCP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133725", "type": "CDM"}], "standard_charges": [{"gross_charge": 11033.0, "discounted_cash": 8274.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT E COMP NRW", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133735", "type": "CDM"}], "standard_charges": [{"gross_charge": 5546.0, "discounted_cash": 4159.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT E CONDYLR", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133750", "type": "CDM"}], "standard_charges": [{"gross_charge": 20439.0, "discounted_cash": 15329.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT E SEM TUBE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133785", "type": "CDM"}], "standard_charges": [{"gross_charge": 4372.0, "discounted_cash": 3279.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT FACIAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137825", "type": "CDM"}], "standard_charges": [{"gross_charge": 5661.0, "discounted_cash": 4245.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT FEM PROX ANGLED", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133828", "type": "CDM"}], "standard_charges": [{"gross_charge": 20409.0, "discounted_cash": 15306.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT LC CLAVICLE TIT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133896", "type": "CDM"}], "standard_charges": [{"gross_charge": 2966.0, "discounted_cash": 2224.5, "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": 10341.0, "discounted_cash": 7755.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT LC PROX TIBIAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4014311", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11495.0, "discounted_cash": 8621.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT LCP CLAVICLE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137821", "type": "CDM"}], "standard_charges": [{"gross_charge": 11518.0, "discounted_cash": 8638.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT LEUKO REDUC EA UNIT", "code_information": [{"code": "P9031", "type": "HCPCS"}, {"code": "4500035", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 1215.0, "discounted_cash": 911.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT LEUKORED IRRAD", "code_information": [{"code": "P9033", "type": "HCPCS"}, {"code": "4505580", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 1349.0, "discounted_cash": 1011.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT MAX FACL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8154030", "type": "CDM"}], "standard_charges": [{"gross_charge": 2616.0, "discounted_cash": 1962.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT MINI FRAG", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133840", "type": "CDM"}], "standard_charges": [{"gross_charge": 3577.0, "discounted_cash": 2682.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT NEURO", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133783", "type": "CDM"}], "standard_charges": [{"gross_charge": 3273.0, "discounted_cash": 2454.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT OLECRANON", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133841", "type": "CDM"}], "standard_charges": [{"gross_charge": 13877.0, "discounted_cash": 10407.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT ORBITAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137842", "type": "CDM"}], "standard_charges": [{"gross_charge": 1784.0, "discounted_cash": 1338.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT PHER IRRAD", "code_information": [{"code": "P9036", "type": "HCPCS"}, {"code": "4505587", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 1672.0, "discounted_cash": 1254.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT PHER L/R CMV NEG", "code_information": [{"code": "P9055", "type": "HCPCS"}, {"code": "4509055", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 2275.0, "discounted_cash": 1706.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT PHER LEUKO IRRAD", "code_information": [{"code": "P9037", "type": "HCPCS"}, {"code": "4509043", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 3462.0, "discounted_cash": 2596.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT PHER LEUKO IRRAD PED", "code_information": [{"code": "P9037", "type": "HCPCS"}, {"code": "4507309", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 3462.0, "discounted_cash": 2596.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT PHER LEUKO PED", "code_information": [{"code": "P9035", "type": "HCPCS"}, {"code": "4505309", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 3054.0, "discounted_cash": 2290.5, "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": 1675.0, "discounted_cash": 1256.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT PROX HUMERAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133898", "type": "CDM"}], "standard_charges": [{"gross_charge": 14580.0, "discounted_cash": 10935.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT RECONSTRCT II", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133846", "type": "CDM"}], "standard_charges": [{"gross_charge": 13877.0, "discounted_cash": 10407.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT RECONTSRCT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133845", "type": "CDM"}], "standard_charges": [{"gross_charge": 6112.0, "discounted_cash": 4584.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT SPINAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133865", "type": "CDM"}], "standard_charges": [{"gross_charge": 14170.0, "discounted_cash": 10627.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT SUPRACOND", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133870", "type": "CDM"}], "standard_charges": [{"gross_charge": 13088.0, "discounted_cash": 9816.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT SYNTHES", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133887", "type": "CDM"}], "standard_charges": [{"gross_charge": 7305.0, "discounted_cash": 5478.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT VOLAR DISTAL RADIUS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133899", "type": "CDM"}], "standard_charges": [{"gross_charge": 11461.0, "discounted_cash": 8595.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT VOLAR LCP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8130133", "type": "CDM"}], "standard_charges": [{"gross_charge": 12944.0, "discounted_cash": 9708.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT VOLAR RADIUS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133888", "type": "CDM"}], "standard_charges": [{"gross_charge": 11127.0, "discounted_cash": 8345.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT WRIST LCKNG", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133891", "type": "CDM"}], "standard_charges": [{"gross_charge": 14466.0, "discounted_cash": 10849.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT X STERNAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133892", "type": "CDM"}], "standard_charges": [{"gross_charge": 5788.0, "discounted_cash": 4341.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT Y DBL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8133889", "type": "CDM"}], "standard_charges": [{"gross_charge": 3332.0, "discounted_cash": 2499.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLT/TUBE E COM", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8134000", "type": "CDM"}], "standard_charges": [{"gross_charge": 2039.0, "discounted_cash": 1529.25, "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": 336.0, "discounted_cash": 252.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PLUG VASC OCCLUSION", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8176107", "type": "CDM"}], "standard_charges": [{"gross_charge": 6945.0, "discounted_cash": 5208.75, "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": 10756.0, "discounted_cash": 8067.0, "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": 57968.0, "discounted_cash": 43476.0, "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": 37494.0, "discounted_cash": 28120.5, "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": 32034.0, "discounted_cash": 24025.5, "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": 54045.0, "discounted_cash": 40533.75, "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": 28901.0, "discounted_cash": 21675.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PM ACCOLADE SR L300", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4004088", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 26620.0, "discounted_cash": 19965.0, "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": 32896.0, "discounted_cash": 24672.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PM ADVISA DR MRI A2DR01", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4004098", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 56827.0, "discounted_cash": 42620.25, "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": 43626.0, "discounted_cash": 32719.5, "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": 54048.0, "discounted_cash": 40536.0, "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": 52725.0, "discounted_cash": 39543.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PM AMVIA EDGE DR-T 460163", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000439", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 28572.0, "discounted_cash": 21429.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PM AMVIA EDGE HF-T QP 460162", "code_information": [{"code": "C2621", "type": "HCPCS"}, {"code": "4000469", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 54682.0, "discounted_cash": 41011.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PM AMVIA EDGE SR-T 460164", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4000488", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 28975.0, "discounted_cash": 21731.25, "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": 50891.0, "discounted_cash": 38168.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PM ASSURITY DR-RF PM2240", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000429", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 44788.0, "discounted_cash": 33591.0, "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": 34634.0, "discounted_cash": 25975.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PM ASSURITY MRI PM2272", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000433", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 36483.0, "discounted_cash": 27362.25, "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": 37447.0, "discounted_cash": 28085.25, "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": 35256.0, "discounted_cash": 26442.0, "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": 25424.0, "discounted_cash": 19068.0, "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": 67959.0, "discounted_cash": 50969.25, "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": 36192.0, "discounted_cash": 27144.0, "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": 36192.0, "discounted_cash": 27144.0, "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": 32982.0, "discounted_cash": 24736.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PM DC ENPULSE E2VDD01", "code_information": [{"code": "C2619", "type": "HCPCS"}, {"code": "4000471", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 50997.0, "discounted_cash": 38247.75, "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": 42067.0, "discounted_cash": 31550.25, "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": 69165.0, "discounted_cash": 51873.75, "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": 34689.0, "discounted_cash": 26016.75, "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": 43471.0, "discounted_cash": 32603.25, "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": 54854.0, "discounted_cash": 41140.5, "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": 48019.0, "discounted_cash": 36014.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PM DC RR CYLOS DR", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000513", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 56751.0, "discounted_cash": 42563.25, "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": 53589.0, "discounted_cash": 40191.75, "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": 57046.0, "discounted_cash": 42784.5, "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": 67419.0, "discounted_cash": 50564.25, "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": 48019.0, "discounted_cash": 36014.25, "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": 58343.0, "discounted_cash": 43757.25, "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": 58343.0, "discounted_cash": 43757.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PM DC RR KAPPA KDR901", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000555", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 55319.0, "discounted_cash": 41489.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PM DC RR PHIL DR RR", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000586", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 56751.0, "discounted_cash": 42563.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PM DC RR PHILOS II DR T", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000588", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 48019.0, "discounted_cash": 36014.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PM DC RR SENSIA SEDR01", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000498", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 69165.0, "discounted_cash": 51873.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PM DC RR SYMPHONY", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000600", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 41380.0, "discounted_cash": 31035.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PM DC RR VERITY ADX XL", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000623", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 58524.0, "discounted_cash": 43893.0, "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": 57193.0, "discounted_cash": 42894.75, "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": 51713.0, "discounted_cash": 38784.75, "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": 48338.0, "discounted_cash": 36253.5, "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": 48338.0, "discounted_cash": 36253.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PM EDORA 8 HF-T 407138", "code_information": [{"code": "C2621", "type": "HCPCS"}, {"code": "4004146", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 54028.0, "discounted_cash": 40521.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PM EDORA HF-T QP 407137", "code_information": [{"code": "C2621", "type": "HCPCS"}, {"code": "4004145", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 50729.0, "discounted_cash": 38046.75, "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": 30598.0, "discounted_cash": 22948.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PM EDORA PROMRI 407157", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4004137", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 27379.0, "discounted_cash": 20534.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PM ELUNA PROMRI 394969", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4004139", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 34642.0, "discounted_cash": 25981.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PM ELUNA PROMRI 394971", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4004140", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 32151.0, "discounted_cash": 24113.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PM ENTOVIS PROMRI 404722", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4004133", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 36523.0, "discounted_cash": 27392.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PM ENTOVIS PROMRI 404723", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4004134", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 33879.0, "discounted_cash": 25409.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PM ESSENTIO DR IS1 L101", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000463", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 23149.0, "discounted_cash": 17361.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PM ESSENTIO EL DR L121", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000462", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 31183.0, "discounted_cash": 23387.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PM ESSENTIO MRI DR L111", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000459", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 49664.0, "discounted_cash": 37248.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PM ESSENTIO MRI EL L131", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000468", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 45377.0, "discounted_cash": 34032.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PM ESSENTIO MRI VR L110", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4000460", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 35427.0, "discounted_cash": 26570.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PM ETRINSA DR-T 394931", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4004143", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 31503.0, "discounted_cash": 23627.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PM ETRINSA HF-T 394919", "code_information": [{"code": "C2621", "type": "HCPCS"}, {"code": "4004141", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 52284.0, "discounted_cash": 39213.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PM ETRINSA SR-T 394936", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4004142", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 26864.0, "discounted_cash": 20148.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PM EVIA DR-T CLS/HM GSM", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4004126", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 34057.0, "discounted_cash": 25542.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PM EVIA HF-T CLS 395421", "code_information": [{"code": "C2621", "type": "HCPCS"}, {"code": "4004129", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 56465.0, "discounted_cash": 42348.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PM EVIA HFT LNDLN 377208", "code_information": [{"code": "C2621", "type": "HCPCS"}, {"code": "4004128", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 54854.0, "discounted_cash": 41140.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PM EVIA SR-T CLS/HM MOB", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4004127", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 31369.0, "discounted_cash": 23526.75, "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": 32896.0, "discounted_cash": 24672.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PM INGENIO DR K174", "code_information": [{"code": "C1785", "type": "HCPCS"}, {"code": "4000697", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 32034.0, "discounted_cash": 24025.5, "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": 28081.0, "discounted_cash": 21060.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PM INTUA CRT-P V273", "code_information": [{"code": "C2621", "type": "HCPCS"}, {"code": "4000703", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 62668.0, "discounted_cash": 47001.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PM INVIVE CRT-P IS1 V173", "code_information": [{"code": "C2621", "type": "HCPCS"}, {"code": "4000702", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 55009.0, "discounted_cash": 41256.75, "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": 60905.0, "discounted_cash": 45678.75, "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": 60905.0, "discounted_cash": 45678.75, "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": 58471.0, "discounted_cash": 43853.25, "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": 43559.0, "discounted_cash": 32669.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PM SC ACCENT SR PM1110", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4000910", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 30770.0, "discounted_cash": 23077.5, "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": 30770.0, "discounted_cash": 23077.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PM SC EVIA SR-T 359533", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4000920", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 37586.0, "discounted_cash": 28189.5, "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 SR01ID", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4001047", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 49267.0, "discounted_cash": 36950.25, "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": 48019.0, "discounted_cash": 36014.25, "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": 49267.0, "discounted_cash": 36950.25, "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": 48019.0, "discounted_cash": 36014.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PM SC RR IDENTITY UNI/BI", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4001091", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 47877.0, "discounted_cash": 35907.75, "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": 49699.0, "discounted_cash": 37274.25, "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": 54020.0, "discounted_cash": 40515.0, "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": 48019.0, "discounted_cash": 36014.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PM SC RR MICRONY II SR", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4001130", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 27572.0, "discounted_cash": 20679.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PM SC RR PHILOS II SR", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4001146", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 36976.0, "discounted_cash": 27732.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PM SC RR PROTOS VR", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4001147", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 43216.0, "discounted_cash": 32412.0, "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": 38848.0, "discounted_cash": 29136.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PM SC RR SIGMA SSR303", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4001173", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 36494.0, "discounted_cash": 27370.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PM SC RR VERITY ADX XL", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4001198", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 19728.0, "discounted_cash": 14796.0, "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": 29300.0, "discounted_cash": 21975.0, "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": 39501.0, "discounted_cash": 29625.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PM SC SYMPHONY", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4001220", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 29558.0, "discounted_cash": 22168.5, "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": 62597.0, "discounted_cash": 46947.75, "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": 63927.0, "discounted_cash": 47945.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PM VALITUDE X4 CRTP U125", "code_information": [{"code": "C2621", "type": "HCPCS"}, {"code": "4001249", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 57540.0, "discounted_cash": 43155.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PM VALITUDE X4 CRTP U128", "code_information": [{"code": "C2621", "type": "HCPCS"}, {"code": "4001250", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 55009.0, "discounted_cash": 41256.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PML/RARALPHA COM BRKPNTS", "code_information": [{"code": "81315", "type": "CPT"}, {"code": "7270036", "type": "CDM"}], "standard_charges": [{"gross_charge": 1318.0, "discounted_cash": 988.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PN CNTRL LVL 1 EA ADDL 15MIN", "code_information": [{"code": "6930023", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 388.0, "discounted_cash": 291.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PN CNTRL LVL 1 INIT 15", "code_information": [{"code": "6930020", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 556.0, "discounted_cash": 417.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PN CNTRL LVL 2 EA ADDL15MIN", "code_information": [{"code": "6930026", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 791.0, "discounted_cash": 593.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PN CNTRL LVL 2 INIT 15", "code_information": [{"code": "6930028", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 827.0, "discounted_cash": 620.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PN CNTRL LVL 3 EA ADDL 15MIN", "code_information": [{"code": "6930041", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 774.0, "discounted_cash": 580.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PN CNTRL LVL 3 INIT 15", "code_information": [{"code": "6930033", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1139.0, "discounted_cash": 854.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PN CNTRL LVL 4 EA ADDL 15MIN", "code_information": [{"code": "6930038", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1473.0, "discounted_cash": 1104.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PN CNTRL LVL 4 INIT 15", "code_information": [{"code": "6930035", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1717.0, "discounted_cash": 1287.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PNEUMOCOC 13 VAL VACC IJ", "code_information": [{"code": "90670", "type": "CPT"}, {"code": "5323447", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1124.0, "discounted_cash": 843.0, "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": 356.0, "discounted_cash": 267.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PNEUMOCOCCAL 20-VALENT VACCINE", "code_information": [{"code": "90677", "type": "CPT"}, {"code": "5323451", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1125.0, "discounted_cash": 843.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PNEUMOCOCCAL VACC ADMIN", "code_information": [{"code": "G0009", "type": "HCPCS"}, {"code": "3110009", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 276.0, "discounted_cash": 207.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PNEUMOCOCCAL VACC ADMIN", "code_information": [{"code": "G0009", "type": "HCPCS"}, {"code": "6100009", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 276.0, "discounted_cash": 207.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PNEUMOCOCCAL VACC ADMIN", "code_information": [{"code": "G0009", "type": "HCPCS"}, {"code": "6160009", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 269.0, "discounted_cash": 201.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PNEUMOCOCCAL VACC ADMIN", "code_information": [{"code": "G0009", "type": "HCPCS"}, {"code": "6290009", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 276.0, "discounted_cash": 207.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PNEUMOCYST CARIN DFA", "code_information": [{"code": "87281", "type": "CPT"}, {"code": "4177281", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 296.0, "discounted_cash": 222.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PNEUMOCYST CARIN DFA", "code_information": [{"code": "87281", "type": "CPT"}, {"code": "7007281", "type": "CDM"}], "standard_charges": [{"gross_charge": 431.0, "discounted_cash": 323.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PNEUMOCYST CARIN DFA", "code_information": [{"code": "87281", "type": "CPT"}, {"code": "7257281", "type": "CDM"}], "standard_charges": [{"gross_charge": 377.0, "discounted_cash": 282.75, "setting": "both", "billing_class": "facility"}]}, {"description": "POLIOVIRUS VAC IM/SQ IJ", "code_information": [{"code": "90713", "type": "CPT"}, {"code": "5323465", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 116.0, "discounted_cash": 87.0, "setting": "both", "billing_class": "facility"}]}, {"description": "POLIOVIRUS VAC IM/SQ IJ", "code_information": [{"code": "90713", "type": "CPT"}, {"code": "5323465", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 116.0, "discounted_cash": 87.0, "setting": "both", "billing_class": "facility"}]}, {"description": "POLY/NEO/HCTS 10ML OT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332095", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 591.0, "discounted_cash": 443.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 591.0, "discounted_cash": 443.25, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "POLYCARBOPHIL 625MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5301901", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "POLYETHYLE GLYCOL 17GMPW", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316072", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "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": 784.0, "discounted_cash": 588.0, "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": 784.0, "discounted_cash": 588.0, "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": 351.0, "discounted_cash": 263.25, "setting": "both", "billing_class": "facility"}]}, {"description": "POLYMYXIN/HCTS 10ML OT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332047", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 865.0, "discounted_cash": 648.75, "setting": "both", "billing_class": "facility"}]}, {"description": "POLYMYXIN/HCTS 10ML OT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332047", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 865.0, "discounted_cash": 648.75, "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": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "POOLING PLT/OTH BLD PROD", "code_information": [{"code": "86965", "type": "CPT"}, {"code": "4170067", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 157.0, "discounted_cash": 117.75, "setting": "both", "billing_class": "facility"}]}, {"description": "POOLING PLT/OTH BLD PROD/2", "code_information": [{"code": "86965", "type": "CPT"}, {"code": "4202031", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 201.0, "discounted_cash": 150.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PORACTANT 120MG/1.5ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332140", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1914.0, "discounted_cash": 1435.5, "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": 3095.0, "discounted_cash": 2321.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PORPHOBILINOGEN URINE QL", "code_information": [{"code": "84106", "type": "CPT"}, {"code": "7004109", "type": "CDM"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PORPHOBILINOGEN URINE QN", "code_information": [{"code": "84110", "type": "CPT"}, {"code": "7004110", "type": "CDM"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PORPHOBILINOGEN URINE QN", "code_information": [{"code": "84110", "type": "CPT"}, {"code": "7254110", "type": "CDM"}], "standard_charges": [{"gross_charge": 290.0, "discounted_cash": 217.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PORPHYRINS", "code_information": [{"code": "84311", "type": "CPT"}, {"code": "7254311", "type": "CDM"}], "standard_charges": [{"gross_charge": 222.0, "discounted_cash": 166.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PORPHYRINS URINE QN/FRACT", "code_information": [{"code": "84120", "type": "CPT"}, {"code": "7004120", "type": "CDM"}], "standard_charges": [{"gross_charge": 173.0, "discounted_cash": 129.75, "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": 427.0, "discounted_cash": 320.25, "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": 327.0, "discounted_cash": 245.25, "setting": "both", "billing_class": "facility"}]}, {"description": "POST GLENOID SHLD ARTHROSRF CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013303", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 13966.0, "discounted_cash": 10474.5, "setting": "both", "billing_class": "facility"}]}, {"description": "POST TAPER", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8134003", "type": "CDM"}], "standard_charges": [{"gross_charge": 5711.0, "discounted_cash": 4283.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 168.0, "discounted_cash": 126.0, "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": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "POTASSIUM", "code_information": [{"code": "84132", "type": "CPT"}, {"code": "4174132", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 132.0, "discounted_cash": 99.0, "setting": "both", "billing_class": "facility"}]}, {"description": "POTASSIUM CIT 5MEQ XRTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309641", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "POTASSIUM CIT 5MEQ XRTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309641", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 3.0, "discounted_cash": 2.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "POTASSIUM FECAL", "code_information": [{"code": "84999", "type": "CPT"}, {"code": "7250170", "type": "CDM"}], "standard_charges": [{"gross_charge": 128.0, "discounted_cash": 96.0, "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": 332.0, "discounted_cash": 249.0, "setting": "both", "billing_class": "facility"}]}, {"description": "POTASSIUM URINE", "code_information": [{"code": "84133", "type": "CPT"}, {"code": "4174133", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 261.0, "discounted_cash": 195.75, "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": 253.0, "discounted_cash": 189.75, "setting": "both", "billing_class": "facility"}]}, {"description": "POTASSIUM URINE/2", "code_information": [{"code": "84133", "type": "CPT"}, {"code": "4174134", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 199.0, "discounted_cash": 149.25, "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": 3.0, "discounted_cash": 2.25, "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": 3.0, "discounted_cash": 2.25, "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": 172.0, "discounted_cash": 129.0, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "POVIDONE-IODINE10%30GMOI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337107", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "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": 58.0, "discounted_cash": 43.5, "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": 58.0, "discounted_cash": 43.5, "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": 23.0, "discounted_cash": 17.25, "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": 23.0, "discounted_cash": 17.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PRALIDOXIME UPTO1GM IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2730", "type": "HCPCS"}, {"code": "5323574", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1226.0, "discounted_cash": 919.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PRALIDOXIME UPTO1GM IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2730", "type": "HCPCS"}, {"code": "5323574", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1226.0, "discounted_cash": 919.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PRAMIPEXOLE .25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309692", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "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": 295.0, "discounted_cash": 221.25, "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": 295.0, "discounted_cash": 221.25, "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": 237.0, "discounted_cash": 177.75, "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": 237.0, "discounted_cash": 177.75, "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": 187.0, "discounted_cash": 140.25, "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": 187.0, "discounted_cash": 140.25, "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": 384.0, "discounted_cash": 288.0, "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": 384.0, "discounted_cash": 288.0, "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": 20.0, "discounted_cash": 15.0, "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": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRASUGREL 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309703", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "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": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PRAVASTATIN 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309691", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 305.0, "discounted_cash": 228.75, "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": 305.0, "discounted_cash": 228.75, "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": 10.0, "discounted_cash": 7.5, "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": 10.0, "discounted_cash": 7.5, "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": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRAZOSIN 1MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309723", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "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": 34.0, "discounted_cash": 25.5, "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": 34.0, "discounted_cash": 25.5, "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": 32.0, "discounted_cash": 24.0, "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": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRB CRYO", "code_information": [{"code": "C2618", "type": "HCPCS"}, {"code": "8176127", "type": "CDM"}], "standard_charges": [{"gross_charge": 20484.0, "discounted_cash": 15363.0, "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": 359.0, "discounted_cash": 269.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PRE-ALBUMIN", "code_information": [{"code": "84134", "type": "CPT"}, {"code": "4174176", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 282.0, "discounted_cash": 211.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PRE-ALBUMIN", "code_information": [{"code": "84134", "type": "CPT"}, {"code": "7004166", "type": "CDM"}], "standard_charges": [{"gross_charge": 171.0, "discounted_cash": 128.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PRE-ALBUMIN", "code_information": [{"code": "84134", "type": "CPT"}, {"code": "7254166", "type": "CDM"}], "standard_charges": [{"gross_charge": 69.0, "discounted_cash": 51.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 593.0, "discounted_cash": 444.75, "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": 593.0, "discounted_cash": 444.75, "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": 642.0, "discounted_cash": 481.5, "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": 642.0, "discounted_cash": 481.5, "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": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PREDNISOLONE 1% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332193", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PREDNISOLONE 15/5 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316123", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 45.0, "discounted_cash": 33.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 45.0, "discounted_cash": 33.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PREDNISOLONE 15MG ODTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7510", "type": "HCPCS"}, {"code": "5309755", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PREDNISOLONE 15MG ODTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7510", "type": "HCPCS"}, {"code": "5309755", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "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": 174.0, "discounted_cash": 130.5, "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": 174.0, "discounted_cash": 130.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PREDNISOLONE PER 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7510", "type": "HCPCS"}, {"code": "5309754", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PREDNISOLONE PER 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7510", "type": "HCPCS"}, {"code": "5309754", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "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": 16.0, "discounted_cash": 12.0, "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": 16.0, "discounted_cash": 12.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.38, "discounted_cash": 0.29, "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": 0.38, "discounted_cash": 0.29, "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": 141.0, "discounted_cash": 105.75, "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": 141.0, "discounted_cash": 105.75, "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": 32.0, "discounted_cash": 24.0, "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": 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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 152.0, "discounted_cash": 114.0, "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": 152.0, "discounted_cash": 114.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRETX RBC AB W/CHEM EA", "code_information": [{"code": "86970", "type": "CPT"}, {"code": "4176970", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PRETX RBC AB W/CHEM EA", "code_information": [{"code": "86970", "type": "CPT"}, {"code": "7196010", "type": "CDM"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PRETX RBC AB W/ENZYM EA", "code_information": [{"code": "86971", "type": "CPT"}, {"code": "4176971", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 432.0, "discounted_cash": 324.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRETX RBC AB W/ENZYM EA", "code_information": [{"code": "86971", "type": "CPT"}, {"code": "7196009", "type": "CDM"}], "standard_charges": [{"gross_charge": 549.0, "discounted_cash": 411.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PRETX RBC EA ABSRP", "code_information": [{"code": "86978", "type": "CPT"}, {"code": "4176978", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 116.0, "discounted_cash": 87.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRETX RBC EA ABSRP", "code_information": [{"code": "86978", "type": "CPT"}, {"code": "7196012", "type": "CDM"}], "standard_charges": [{"gross_charge": 147.0, "discounted_cash": 110.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PRETX RBC S W/INHIB EA", "code_information": [{"code": "86977", "type": "CPT"}, {"code": "4176977", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 274.0, "discounted_cash": 205.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PRETX RBC S W/INHIB EA", "code_information": [{"code": "86977", "type": "CPT"}, {"code": "7198697", "type": "CDM"}], "standard_charges": [{"gross_charge": 349.0, "discounted_cash": 261.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PRETX RBC W/DILUTION", "code_information": [{"code": "86976", "type": "CPT"}, {"code": "7196011", "type": "CDM"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIMAQUINE 26.3MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309809", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIMAQUINE 26.3MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309809", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIMIDONE", "code_information": [{"code": "80188", "type": "CPT"}, {"code": "4174141", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIMIDONE", "code_information": [{"code": "80188", "type": "CPT"}, {"code": "7004141", "type": "CDM"}], "standard_charges": [{"gross_charge": 325.0, "discounted_cash": 243.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIMIDONE", "code_information": [{"code": "80188", "type": "CPT"}, {"code": "7250188", "type": "CDM"}], "standard_charges": [{"gross_charge": 106.0, "discounted_cash": 79.5, "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": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIMIDONE 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309824", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "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": 32.0, "discounted_cash": 24.0, "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": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE OBSTETRICS", "code_information": [{"code": "1990043", "type": "CDM"}, {"code": "112", "type": "RC"}], "standard_charges": [{"gross_charge": 4231.0, "discounted_cash": 3173.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE OBSTETRICS", "code_information": [{"code": "2500043", "type": "CDM"}, {"code": "112", "type": "RC"}], "standard_charges": [{"gross_charge": 4231.0, "discounted_cash": 3173.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE PSYCHIATRIC", "code_information": [{"code": "1990052", "type": "CDM"}, {"code": "114", "type": "RC"}], "standard_charges": [{"gross_charge": 6279.0, "discounted_cash": 4709.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE PSYCHIATRIC", "code_information": [{"code": "2450052", "type": "CDM"}, {"code": "114", "type": "RC"}], "standard_charges": [{"gross_charge": 6279.0, "discounted_cash": 4709.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE ROOM", "code_information": [{"code": "1990001", "type": "CDM"}, {"code": "111", "type": "RC"}], "standard_charges": [{"gross_charge": 4231.0, "discounted_cash": 3173.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE ROOM", "code_information": [{"code": "2000001", "type": "CDM"}, {"code": "111", "type": "RC"}], "standard_charges": [{"gross_charge": 4231.0, "discounted_cash": 3173.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE ROOM", "code_information": [{"code": "2010001", "type": "CDM"}, {"code": "111", "type": "RC"}], "standard_charges": [{"gross_charge": 4231.0, "discounted_cash": 3173.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE ROOM", "code_information": [{"code": "2060001", "type": "CDM"}, {"code": "111", "type": "RC"}], "standard_charges": [{"gross_charge": 4231.0, "discounted_cash": 3173.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE ROOM", "code_information": [{"code": "2100001", "type": "CDM"}, {"code": "111", "type": "RC"}], "standard_charges": [{"gross_charge": 4231.0, "discounted_cash": 3173.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE ROOM", "code_information": [{"code": "2120001", "type": "CDM"}, {"code": "111", "type": "RC"}], "standard_charges": [{"gross_charge": 4231.0, "discounted_cash": 3173.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE ROOM", "code_information": [{"code": "2150001", "type": "CDM"}, {"code": "111", "type": "RC"}], "standard_charges": [{"gross_charge": 4231.0, "discounted_cash": 3173.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE ROOM", "code_information": [{"code": "2310001", "type": "CDM"}, {"code": "111", "type": "RC"}], "standard_charges": [{"gross_charge": 4231.0, "discounted_cash": 3173.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE ROOM", "code_information": [{"code": "2320001", "type": "CDM"}, {"code": "111", "type": "RC"}], "standard_charges": [{"gross_charge": 4231.0, "discounted_cash": 3173.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE ROOM", "code_information": [{"code": "2340001", "type": "CDM"}, {"code": "111", "type": "RC"}], "standard_charges": [{"gross_charge": 4231.0, "discounted_cash": 3173.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE ROOM", "code_information": [{"code": "2350001", "type": "CDM"}, {"code": "111", "type": "RC"}], "standard_charges": [{"gross_charge": 4231.0, "discounted_cash": 3173.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE ROOM", "code_information": [{"code": "2370001", "type": "CDM"}, {"code": "111", "type": "RC"}], "standard_charges": [{"gross_charge": 4231.0, "discounted_cash": 3173.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE ROOM", "code_information": [{"code": "2400001", "type": "CDM"}, {"code": "111", "type": "RC"}], "standard_charges": [{"gross_charge": 4231.0, "discounted_cash": 3173.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PRIVATE ROOM", "code_information": [{"code": "2500001", "type": "CDM"}, {"code": "111", "type": "RC"}], "standard_charges": [{"gross_charge": 4231.0, "discounted_cash": 3173.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PRO-INSULIN", "code_information": [{"code": "84206", "type": "CPT"}, {"code": "7003526", "type": "CDM"}], "standard_charges": [{"gross_charge": 938.0, "discounted_cash": 703.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PRO-INSULIN", "code_information": [{"code": "84206", "type": "CPT"}, {"code": "7253526", "type": "CDM"}], "standard_charges": [{"gross_charge": 416.0, "discounted_cash": 312.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROBE BIOROBOT HNDPC AQUABEAM", "code_information": [{"code": "C2596", "type": "HCPCS"}, {"code": "8176161", "type": "CDM"}], "standard_charges": [{"gross_charge": 36333.0, "discounted_cash": 27249.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROBE CRYOABLATION", "code_information": [{"code": "C2618", "type": "HCPCS"}, {"code": "8240355", "type": "CDM"}], "standard_charges": [{"gross_charge": 8564.0, "discounted_cash": 6423.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROBE CRYOABLATION 2", "code_information": [{"code": "C2618", "type": "HCPCS"}, {"code": "8240353", "type": "CDM"}], "standard_charges": [{"gross_charge": 16758.0, "discounted_cash": 12568.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROBE PERC LUMB DISC", "code_information": [{"code": "C2614", "type": "HCPCS"}, {"code": "8242614", "type": "CDM"}], "standard_charges": [{"gross_charge": 26912.0, "discounted_cash": 20184.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROBE RADIOFREQUENCY INTRACEPT", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8176160", "type": "CDM"}], "standard_charges": [{"gross_charge": 38461.0, "discounted_cash": 28845.75, "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": 31.0, "discounted_cash": 23.25, "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": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROBIOTIC TRIPLE NEONATAL 1PK", "code_information": [{"code": "8030901", "type": "CDM"}], "standard_charges": [{"gross_charge": 267.0, "discounted_cash": 200.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROCAINAMIDE", "code_information": [{"code": "80190", "type": "CPT"}, {"code": "7004142", "type": "CDM"}], "standard_charges": [{"gross_charge": 133.0, "discounted_cash": 99.75, "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": 32.0, "discounted_cash": 24.0, "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": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROCAINAMIDE UPTO 1GM IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2690", "type": "HCPCS"}, {"code": "5323678", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 138.0, "discounted_cash": 103.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROCAINAMIDE UPTO 1GM IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2690", "type": "HCPCS"}, {"code": "5323678", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 138.0, "discounted_cash": 103.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROCALCITONIN", "code_information": [{"code": "84145", "type": "CPT"}, {"code": "4108374", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 597.0, "discounted_cash": 447.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROCALCITONIN", "code_information": [{"code": "84145", "type": "CPT"}, {"code": "4178374", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 469.0, "discounted_cash": 351.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROCALCITONIN", "code_information": [{"code": "84145", "type": "CPT"}, {"code": "7258374", "type": "CDM"}], "standard_charges": [{"gross_charge": 602.0, "discounted_cash": 451.5, "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": 1210.0, "discounted_cash": 907.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1210.0, "discounted_cash": 907.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROCESSOR SOUND BAHA5", "code_information": [{"code": "L8690", "type": "HCPCS"}, {"code": "8123511", "type": "CDM"}], "standard_charges": [{"gross_charge": 51827.0, "discounted_cash": 38870.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROCHLORPERAZINE 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0780", "type": "HCPCS"}, {"code": "5323720", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 178.0, "discounted_cash": 133.5, "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": 178.0, "discounted_cash": 133.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "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": 118.0, "discounted_cash": 88.5, "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": 118.0, "discounted_cash": 88.5, "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": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROCHLORPERAZINE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309979", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROCHLORPERZN10MGXR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309991", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 58.0, "discounted_cash": 43.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROCHLORPERZN10MGXR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5309991", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 58.0, "discounted_cash": 43.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROG SQ ICD", "code_information": [{"code": "93260", "type": "CPT"}, {"code": "4610328", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 348.0, "discounted_cash": 261.0, "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": 458.0, "discounted_cash": 343.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROGESTERONE", "code_information": [{"code": "84144", "type": "CPT"}, {"code": "4174144", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 291.0, "discounted_cash": 218.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROGESTERONE", "code_information": [{"code": "84144", "type": "CPT"}, {"code": "7004144", "type": "CDM"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROGESTERONE", "code_information": [{"code": "84144", "type": "CPT"}, {"code": "7254144", "type": "CDM"}], "standard_charges": [{"gross_charge": 370.0, "discounted_cash": 277.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROGESTERONE 100MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310030", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 10.0, "discounted_cash": 7.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROGESTERONE 100MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310030", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 10.0, "discounted_cash": 7.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROGRAMMER PATIENT INSPIRE", "code_information": [{"code": "C1787", "type": "HCPCS"}, {"code": "8176158", "type": "CDM"}], "standard_charges": [{"gross_charge": 4449.0, "discounted_cash": 3336.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROGRAMMER PT NEUROSTIM", "code_information": [{"code": "C1787", "type": "HCPCS"}, {"code": "8240357", "type": "CDM"}], "standard_charges": [{"gross_charge": 382.0, "discounted_cash": 286.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROGRAMMER PT NSTIM 2", "code_information": [{"code": "C1787", "type": "HCPCS"}, {"code": "8242820", "type": "CDM"}], "standard_charges": [{"gross_charge": 20987.0, "discounted_cash": 15740.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROLACT 26 RTF 100ML", "code_information": [{"code": "8030891", "type": "CDM"}], "standard_charges": [{"gross_charge": 1272.0, "discounted_cash": 954.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROLACT HM 4OZ", "code_information": [{"code": "8030894", "type": "CDM"}], "standard_charges": [{"gross_charge": 700.0, "discounted_cash": 525.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROLACT RTF 24 100ML", "code_information": [{"code": "8030893", "type": "CDM"}], "standard_charges": [{"gross_charge": 1224.0, "discounted_cash": 918.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROLACT RTF 28 100ML", "code_information": [{"code": "8030892", "type": "CDM"}], "standard_charges": [{"gross_charge": 1637.0, "discounted_cash": 1227.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROLACT+10 HMF 50ML", "code_information": [{"code": "8030899", "type": "CDM"}], "standard_charges": [{"gross_charge": 2245.0, "discounted_cash": 1683.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROLACT+4 HMF 10ML", "code_information": [{"code": "8030895", "type": "CDM"}], "standard_charges": [{"gross_charge": 924.0, "discounted_cash": 693.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROLACT+4 HMF 20ML", "code_information": [{"code": "8030896", "type": "CDM"}], "standard_charges": [{"gross_charge": 1334.0, "discounted_cash": 1000.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROLACT+6 HMF 30ML", "code_information": [{"code": "8030897", "type": "CDM"}], "standard_charges": [{"gross_charge": 1347.0, "discounted_cash": 1010.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROLACT+8 HMF 40ML", "code_information": [{"code": "8030898", "type": "CDM"}], "standard_charges": [{"gross_charge": 1651.0, "discounted_cash": 1238.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROLACTA CR 10ML", "code_information": [{"code": "8030890", "type": "CDM"}], "standard_charges": [{"gross_charge": 692.0, "discounted_cash": 519.0, "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": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROLACTIN", "code_information": [{"code": "84146", "type": "CPT"}, {"code": "4174146", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 274.0, "discounted_cash": 205.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROLACTIN", "code_information": [{"code": "84146", "type": "CPT"}, {"code": "7004146", "type": "CDM"}], "standard_charges": [{"gross_charge": 138.0, "discounted_cash": 103.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROLACTIN", "code_information": [{"code": "84146", "type": "CPT"}, {"code": "7254146", "type": "CDM"}], "standard_charges": [{"gross_charge": 349.0, "discounted_cash": 261.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROMETHAZ 6.25MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316155", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROMETHAZ 6.25MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316155", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROMETHAZIN/COD 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316147", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROMETHAZIN/COD 5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316147", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROMETHAZINE 12.5MG SU", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338634", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "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": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROMETHAZINE 25MG SU", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338638", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "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": 49.0, "discounted_cash": 36.75, "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": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROMETHAZINE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310068", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROMETHAZINE 50MG SU", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5338642", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 275.0, "discounted_cash": 206.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 275.0, "discounted_cash": 206.25, "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": 95.0, "discounted_cash": 71.25, "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": 95.0, "discounted_cash": 71.25, "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": 19.0, "discounted_cash": 14.25, "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": 19.0, "discounted_cash": 14.25, "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 XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310093", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 339.0, "discounted_cash": 254.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPAFENONE 225MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310093", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 339.0, "discounted_cash": 254.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPAFENONE 325MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310094", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 156.0, "discounted_cash": 117.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPAFENONE 325MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310094", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 156.0, "discounted_cash": 117.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPAFENONE 425MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310095", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 251.0, "discounted_cash": 188.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPAFENONE 425MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310095", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 251.0, "discounted_cash": 188.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPANTHELINE 15MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310138", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPANTHELINE 15MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310138", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "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": 31.0, "discounted_cash": 23.25, "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": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPOXYPHENE QNT", "code_information": [{"code": "80367", "type": "CPT"}, {"code": "7058249", "type": "CDM"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 146.0, "discounted_cash": 109.5, "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": 146.0, "discounted_cash": 109.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 97.0, "discounted_cash": 72.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPRANOLOL 60MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310208", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 97.0, "discounted_cash": 72.75, "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": 116.0, "discounted_cash": 87.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 116.0, "discounted_cash": 87.0, "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": 211.0, "discounted_cash": 158.25, "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": 211.0, "discounted_cash": 158.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROPYLTHIOURACIL 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310216", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS AUGMENTATION", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134155", "type": "CDM"}], "standard_charges": [{"gross_charge": 39647.0, "discounted_cash": 29735.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS BRST MENTR SALINE", "code_information": [{"code": "C1789", "type": "HCPCS"}, {"code": "8242871", "type": "CDM"}], "standard_charges": [{"gross_charge": 10554.0, "discounted_cash": 7915.5, "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": 10746.0, "discounted_cash": 8059.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS BRST MNTRSPEC SALIN", "code_information": [{"code": "C1789", "type": "HCPCS"}, {"code": "8242874", "type": "CDM"}], "standard_charges": [{"gross_charge": 10150.0, "discounted_cash": 7612.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS BRST SAL STYLE 2000", "code_information": [{"code": "C1789", "type": "HCPCS"}, {"code": "8242869", "type": "CDM"}], "standard_charges": [{"gross_charge": 8407.0, "discounted_cash": 6305.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS BRST SMOOTHSURF GEL", "code_information": [{"code": "C1789", "type": "HCPCS"}, {"code": "8242876", "type": "CDM"}], "standard_charges": [{"gross_charge": 15663.0, "discounted_cash": 11747.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS BRST TE MENTOR", "code_information": [{"code": "C1789", "type": "HCPCS"}, {"code": "8248280", "type": "CDM"}], "standard_charges": [{"gross_charge": 8889.0, "discounted_cash": 6666.75, "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": 15391.0, "discounted_cash": 11543.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS EAR", "code_information": [{"code": "L8613", "type": "HCPCS"}, {"code": "8134267", "type": "CDM"}], "standard_charges": [{"gross_charge": 8313.0, "discounted_cash": 6234.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS EAR 2", "code_information": [{"code": "L8613", "type": "HCPCS"}, {"code": "8134273", "type": "CDM"}], "standard_charges": [{"gross_charge": 5628.0, "discounted_cash": 4221.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS EAR FLUOROPL PISTON", "code_information": [{"code": "L8613", "type": "HCPCS"}, {"code": "8123512", "type": "CDM"}], "standard_charges": [{"gross_charge": 2551.0, "discounted_cash": 1913.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS ELBOW", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134269", "type": "CDM"}], "standard_charges": [{"gross_charge": 42175.0, "discounted_cash": 31631.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS FEMORAL HEAD", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134204", "type": "CDM"}], "standard_charges": [{"gross_charge": 1090.0, "discounted_cash": 817.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS GLENOSPH UNIV REVRS", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134282", "type": "CDM"}], "standard_charges": [{"gross_charge": 22152.0, "discounted_cash": 16614.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS HIP ACET INSERT", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134299", "type": "CDM"}], "standard_charges": [{"gross_charge": 2725.0, "discounted_cash": 2043.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS HIP BEARIN", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134305", "type": "CDM"}], "standard_charges": [{"gross_charge": 10954.0, "discounted_cash": 8215.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS HIP LINER", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134338", "type": "CDM"}], "standard_charges": [{"gross_charge": 2725.0, "discounted_cash": 2043.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS HUMERAL COMPONENT", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134353", "type": "CDM"}], "standard_charges": [{"gross_charge": 11064.0, "discounted_cash": 8298.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS HUMERAL HD", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134352", "type": "CDM"}], "standard_charges": [{"gross_charge": 23749.0, "discounted_cash": 17811.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS HUMERAL STEM", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134354", "type": "CDM"}], "standard_charges": [{"gross_charge": 7899.0, "discounted_cash": 5924.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS KNE/PATELA", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134385", "type": "CDM"}], "standard_charges": [{"gross_charge": 2180.0, "discounted_cash": 1635.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS KNEE", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134425", "type": "CDM"}], "standard_charges": [{"gross_charge": 30662.0, "discounted_cash": 22996.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS METACARPOPHALANGEAL", "code_information": [{"code": "L8630", "type": "HCPCS"}, {"code": "8134433", "type": "CDM"}], "standard_charges": [{"gross_charge": 11739.0, "discounted_cash": 8804.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS PENILE AMS 700", "code_information": [{"code": "C1813", "type": "HCPCS"}, {"code": "8240360", "type": "CDM"}], "standard_charges": [{"gross_charge": 70961.0, "discounted_cash": 53220.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS PENILE AMS MALLE650", "code_information": [{"code": "C2622", "type": "HCPCS"}, {"code": "8242879", "type": "CDM"}], "standard_charges": [{"gross_charge": 52793.0, "discounted_cash": 39594.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS PENILE INFL PRELIFE", "code_information": [{"code": "C1813", "type": "HCPCS"}, {"code": "8242886", "type": "CDM"}], "standard_charges": [{"gross_charge": 0.01, "discounted_cash": 0.01, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS PENILE INHIBIZONE/PRECONN", "code_information": [{"code": "C1813", "type": "HCPCS"}, {"code": "8240363", "type": "CDM"}], "standard_charges": [{"gross_charge": 55793.0, "discounted_cash": 41844.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS PENILE PUM", "code_information": [{"code": "C1813", "type": "HCPCS"}, {"code": "8154155", "type": "CDM"}], "standard_charges": [{"gross_charge": 98581.0, "discounted_cash": 73935.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS POST MAST CAMISOLE", "code_information": [{"code": "L8015", "type": "HCPCS"}, {"code": "8130235", "type": "CDM"}], "standard_charges": [{"gross_charge": 387.0, "discounted_cash": 290.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS RADIAL HEAD", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134435", "type": "CDM"}], "standard_charges": [{"gross_charge": 16133.0, "discounted_cash": 12099.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS RADIAL STEM", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8130236", "type": "CDM"}], "standard_charges": [{"gross_charge": 16968.0, "discounted_cash": 12726.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS SHOULDER", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134450", "type": "CDM"}], "standard_charges": [{"gross_charge": 23980.0, "discounted_cash": 17985.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS TESTICULAR", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8154190", "type": "CDM"}], "standard_charges": [{"gross_charge": 16928.0, "discounted_cash": 12696.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS TIB STEM", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134480", "type": "CDM"}], "standard_charges": [{"gross_charge": 6540.0, "discounted_cash": 4905.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS TIBIAL TRAY", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8133305", "type": "CDM"}], "standard_charges": [{"gross_charge": 74813.0, "discounted_cash": 56109.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS TOE HAMMER", "code_information": [{"code": "L8641", "type": "HCPCS"}, {"code": "8134495", "type": "CDM"}], "standard_charges": [{"gross_charge": 5550.0, "discounted_cash": 4162.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS TOE TYPE II", "code_information": [{"code": "L8641", "type": "HCPCS"}, {"code": "8134502", "type": "CDM"}], "standard_charges": [{"gross_charge": 12537.0, "discounted_cash": 9402.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS ULNAR ASSEMBLY", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8134509", "type": "CDM"}], "standard_charges": [{"gross_charge": 51008.0, "discounted_cash": 38256.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROS ULNAR STEM", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8130237", "type": "CDM"}], "standard_charges": [{"gross_charge": 39490.0, "discounted_cash": 29617.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROSTATE NEEDLE BX", "code_information": [{"code": "G0416", "type": "HCPCS"}, {"code": "4170014", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 1455.0, "discounted_cash": 1091.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROSTATE NEEDLE BX", "code_information": [{"code": "G0416", "type": "HCPCS"}, {"code": "4300416", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 1850.0, "discounted_cash": 1387.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROSTHESIS VOICE", "code_information": [{"code": "L8509", "type": "HCPCS"}, {"code": "8154201", "type": "CDM"}], "standard_charges": [{"gross_charge": 2872.0, "discounted_cash": 2154.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROSTHESIS VOICE PV SMRT", "code_information": [{"code": "L8509", "type": "HCPCS"}, {"code": "8154202", "type": "CDM"}], "standard_charges": [{"gross_charge": 3290.0, "discounted_cash": 2467.5, "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": 62.0, "discounted_cash": 46.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTAMINE PER 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2720", "type": "HCPCS"}, {"code": "5323870", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 62.0, "discounted_cash": 46.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN C ACTIVITY", "code_information": [{"code": "85303", "type": "CPT"}, {"code": "4175305", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 224.0, "discounted_cash": 168.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN C ACTIVITY", "code_information": [{"code": "85303", "type": "CPT"}, {"code": "7005303", "type": "CDM"}], "standard_charges": [{"gross_charge": 1094.0, "discounted_cash": 820.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN C ACTIVITY", "code_information": [{"code": "85303", "type": "CPT"}, {"code": "7255303", "type": "CDM"}], "standard_charges": [{"gross_charge": 284.0, "discounted_cash": 213.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN C ACTIVITY/2", "code_information": [{"code": "85303", "type": "CPT"}, {"code": "7255304", "type": "CDM"}], "standard_charges": [{"gross_charge": 168.0, "discounted_cash": 126.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN C ANTIGEN", "code_information": [{"code": "85302", "type": "CPT"}, {"code": "7005302", "type": "CDM"}], "standard_charges": [{"gross_charge": 308.0, "discounted_cash": 231.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN C ANTIGEN", "code_information": [{"code": "85302", "type": "CPT"}, {"code": "7255302", "type": "CDM"}], "standard_charges": [{"gross_charge": 213.0, "discounted_cash": 159.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN C RESIST", "code_information": [{"code": "85307", "type": "CPT"}, {"code": "7005307", "type": "CDM"}], "standard_charges": [{"gross_charge": 772.0, "discounted_cash": 579.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN C RESIST", "code_information": [{"code": "85307", "type": "CPT"}, {"code": "7255307", "type": "CDM"}], "standard_charges": [{"gross_charge": 642.0, "discounted_cash": 481.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN ELCTRO OTHER FLUIDS", "code_information": [{"code": "84166", "type": "CPT"}, {"code": "4174166", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 228.0, "discounted_cash": 171.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN ELCTRO OTHER FLUIDS", "code_information": [{"code": "84166", "type": "CPT"}, {"code": "7254167", "type": "CDM"}], "standard_charges": [{"gross_charge": 290.0, "discounted_cash": 217.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN ELCTRO OTHER FLUIDS/2", "code_information": [{"code": "84166", "type": "CPT"}, {"code": "7004170", "type": "CDM"}], "standard_charges": [{"gross_charge": 505.0, "discounted_cash": 378.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN ELCTRO OTHER FLUIDS/3", "code_information": [{"code": "84166", "type": "CPT"}, {"code": "7254169", "type": "CDM"}], "standard_charges": [{"gross_charge": 334.0, "discounted_cash": 250.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN ELCTRO OTHER FLUIDS/5", "code_information": [{"code": "84166", "type": "CPT"}, {"code": "7004191", "type": "CDM"}], "standard_charges": [{"gross_charge": 171.0, "discounted_cash": 128.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN ELCTRO SERUM", "code_information": [{"code": "84165", "type": "CPT"}, {"code": "4174165", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN ELCTRO SERUM", "code_information": [{"code": "84165", "type": "CPT"}, {"code": "7004165", "type": "CDM"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN ELCTRO SERUM", "code_information": [{"code": "84165", "type": "CPT"}, {"code": "7254165", "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": "7005306", "type": "CDM"}], "standard_charges": [{"gross_charge": 1147.0, "discounted_cash": 860.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN S FREE/2", "code_information": [{"code": "85306", "type": "CPT"}, {"code": "7255306", "type": "CDM"}], "standard_charges": [{"gross_charge": 311.0, "discounted_cash": 233.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN S FREE/3", "code_information": [{"code": "85306", "type": "CPT"}, {"code": "7255308", "type": "CDM"}], "standard_charges": [{"gross_charge": 183.0, "discounted_cash": 137.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN S FREE/4", "code_information": [{"code": "85306", "type": "CPT"}, {"code": "7256898", "type": "CDM"}], "standard_charges": [{"gross_charge": 197.0, "discounted_cash": 147.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN S TOTAL", "code_information": [{"code": "85305", "type": "CPT"}, {"code": "7005305", "type": "CDM"}], "standard_charges": [{"gross_charge": 1251.0, "discounted_cash": 938.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN S TOTAL", "code_information": [{"code": "85305", "type": "CPT"}, {"code": "7255305", "type": "CDM"}], "standard_charges": [{"gross_charge": 152.0, "discounted_cash": 114.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN TOTAL", "code_information": [{"code": "84155", "type": "CPT"}, {"code": "4104155", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "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": 26.0, "discounted_cash": 19.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN TOTAL", "code_information": [{"code": "84155", "type": "CPT"}, {"code": "4174155", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 56.0, "discounted_cash": 42.0, "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": 191.0, "discounted_cash": 143.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN TOTAL OTHER SOURCE", "code_information": [{"code": "84157", "type": "CPT"}, {"code": "4174154", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 150.0, "discounted_cash": 112.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN TOTAL OTHER SOURCE", "code_information": [{"code": "84157", "type": "CPT"}, {"code": "7254154", "type": "CDM"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "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": 328.0, "discounted_cash": 246.0, "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": 486.0, "discounted_cash": 364.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN URINE", "code_information": [{"code": "84156", "type": "CPT"}, {"code": "4174156", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 382.0, "discounted_cash": 286.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN URINE", "code_information": [{"code": "84156", "type": "CPT"}, {"code": "7254156", "type": "CDM"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN URINE/2", "code_information": [{"code": "84156", "type": "CPT"}, {"code": "4174180", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 56.0, "discounted_cash": 42.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN URINE/2", "code_information": [{"code": "84156", "type": "CPT"}, {"code": "7254157", "type": "CDM"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "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": 446.0, "discounted_cash": 334.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN URINE/4", "code_information": [{"code": "84156", "type": "CPT"}, {"code": "7254180", "type": "CDM"}], "standard_charges": [{"gross_charge": 44.0, "discounted_cash": 33.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN WESTERN BLOT", "code_information": [{"code": "84181", "type": "CPT"}, {"code": "7004181", "type": "CDM"}], "standard_charges": [{"gross_charge": 688.0, "discounted_cash": 516.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEIN WESTERN BLOT/3", "code_information": [{"code": "84181", "type": "CPT"}, {"code": "7004189", "type": "CDM"}], "standard_charges": [{"gross_charge": 488.0, "discounted_cash": 366.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTEINASE ANTIBODY", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "7253510", "type": "CDM"}], "standard_charges": [{"gross_charge": 59.0, "discounted_cash": 44.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTHROM COMPLX BALFAXAR 1U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7165", "type": "HCPCS"}, {"code": "5323877", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 8.0, "discounted_cash": 6.0, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 8.0, "discounted_cash": 6.0, "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": 12.0, "discounted_cash": 9.0, "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": 12.0, "discounted_cash": 9.0, "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": 237.0, "discounted_cash": 177.75, "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": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTHROMBIN TIME", "code_information": [{"code": "85610", "type": "CPT"}, {"code": "4175610", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 186.0, "discounted_cash": 139.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTHROMBIN TIME", "code_information": [{"code": "85610", "type": "CPT"}, {"code": "4185610", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 45.0, "discounted_cash": 33.75, "setting": "both", "billing_class": "facility"}], "modifiers": "QW"}, {"description": "PROTHROMBIN TIME", "code_information": [{"code": "85610", "type": "CPT"}, {"code": "7005610", "type": "CDM"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTHROMBIN TIME", "code_information": [{"code": "85610", "type": "CPT"}, {"code": "7255610", "type": "CDM"}], "standard_charges": [{"gross_charge": 89.0, "discounted_cash": 66.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTOPORPHYRIN RBC QN", "code_information": [{"code": "84202", "type": "CPT"}, {"code": "7004128", "type": "CDM"}], "standard_charges": [{"gross_charge": 166.0, "discounted_cash": 124.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTOPORPHYRIN RBC QN", "code_information": [{"code": "84202", "type": "CPT"}, {"code": "7254128", "type": "CDM"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTOZOA AB NES/6", "code_information": [{"code": "86753", "type": "CPT"}, {"code": "7256713", "type": "CDM"}], "standard_charges": [{"gross_charge": 363.0, "discounted_cash": 272.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTOZOA AB NES/7", "code_information": [{"code": "86753", "type": "CPT"}, {"code": "7256718", "type": "CDM"}], "standard_charges": [{"gross_charge": 160.0, "discounted_cash": 120.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTRIPTYLINE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310236", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 148.0, "discounted_cash": 111.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PROTRIPTYLINE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310236", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 148.0, "discounted_cash": 111.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PSA FREE", "code_information": [{"code": "84154", "type": "CPT"}, {"code": "4178415", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 124.0, "discounted_cash": 93.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PSA FREE", "code_information": [{"code": "84154", "type": "CPT"}, {"code": "7004200", "type": "CDM"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PSA FREE", "code_information": [{"code": "84154", "type": "CPT"}, {"code": "7254200", "type": "CDM"}], "standard_charges": [{"gross_charge": 158.0, "discounted_cash": 118.5, "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": 128.0, "discounted_cash": 96.0, "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": 128.0, "discounted_cash": 96.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PSA TOTAL", "code_information": [{"code": "84153", "type": "CPT"}, {"code": "4176316", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 100.0, "discounted_cash": 75.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PSA TOTAL", "code_information": [{"code": "84153", "type": "CPT"}, {"code": "7256316", "type": "CDM"}], "standard_charges": [{"gross_charge": 158.0, "discounted_cash": 118.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PSE 15MG/5ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316194", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.43, "discounted_cash": 0.32, "setting": "both", "billing_class": "facility"}]}, {"description": "PSE 15MG/5ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316194", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 0.43, "discounted_cash": 0.32, "setting": "both", "billing_class": "facility"}]}, {"description": "PSE 30MG/5ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316184", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PSE 30MG/5ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316184", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "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": 31.0, "discounted_cash": 23.25, "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": 31.0, "discounted_cash": 23.25, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PSEUDOEPHED 30MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5310266", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PSY THRPY 30 MIN PT", "code_information": [{"code": "90832", "type": "CPT"}, {"code": "6180832", "type": "CDM"}, {"code": "914", "type": "RC"}], "standard_charges": [{"gross_charge": 432.0, "discounted_cash": 324.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PSY THRPY 30 MIN PT", "code_information": [{"code": "90832", "type": "CPT"}, {"code": "6400832", "type": "CDM"}, {"code": "914", "type": "RC"}], "standard_charges": [{"gross_charge": 432.0, "discounted_cash": 324.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PSY THRPY 45MIN PT", "code_information": [{"code": "90834", "type": "CPT"}, {"code": "6180834", "type": "CDM"}, {"code": "914", "type": "RC"}], "standard_charges": [{"gross_charge": 1027.0, "discounted_cash": 770.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PSY THRPY 45MIN PT", "code_information": [{"code": "90834", "type": "CPT"}, {"code": "6400834", "type": "CDM"}, {"code": "914", "type": "RC"}], "standard_charges": [{"gross_charge": 1027.0, "discounted_cash": 770.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PSYCH DIAG EVAL", "code_information": [{"code": "90791", "type": "CPT"}, {"code": "6400791", "type": "CDM"}, {"code": "900", "type": "RC"}], "standard_charges": [{"gross_charge": 1113.0, "discounted_cash": 834.75, "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": 14.0, "discounted_cash": 10.5, "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": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PT CAREGIVER TRNG 1ST 30 MIN", "code_information": [{"code": "97550", "type": "CPT"}, {"code": "5700707", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 295.0, "discounted_cash": 221.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT CAREGIVER TRNG ADD 15 MIN", "code_information": [{"code": "97551", "type": "CPT"}, {"code": "5700017", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 148.0, "discounted_cash": 111.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT COMM/WK REINT TRN EA15M", "code_information": [{"code": "97537", "type": "CPT"}, {"code": "5705320", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 242.0, "discounted_cash": 181.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT CONTRAST BATH 15 BSC", "code_information": [{"code": "97034", "type": "CPT"}, {"code": "5705278", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 315.0, "discounted_cash": 236.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT E-STIM BASIC", "code_information": [{"code": "G0283", "type": "HCPCS"}, {"code": "5700283", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 138.0, "discounted_cash": 103.5, "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": 1094.0, "discounted_cash": 820.5, "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": 403.0, "discounted_cash": 302.25, "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": 635.0, "discounted_cash": 476.25, "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": 1094.0, "discounted_cash": 820.5, "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": 403.0, "discounted_cash": 302.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT EVAL WND CARE MOD", "code_information": [{"code": "97162", "type": "CPT"}, {"code": "5707207", "type": "CDM"}, {"code": "424", "type": "RC"}], "standard_charges": [{"gross_charge": 635.0, "discounted_cash": 476.25, "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": 256.0, "discounted_cash": 192.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT GROUP THERAPY PROCED BASIC", "code_information": [{"code": "97150", "type": "CPT"}, {"code": "5705368", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 455.0, "discounted_cash": 341.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT IONTOPHORESIS 15 BSC", "code_information": [{"code": "97033", "type": "CPT"}, {"code": "5705272", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 629.0, "discounted_cash": 471.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT MANUAL THERAPY EA 15M", "code_information": [{"code": "97140", "type": "CPT"}, {"code": "5705178", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 533.0, "discounted_cash": 399.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT MECH TRACTION BSC", "code_information": [{"code": "97012", "type": "CPT"}, {"code": "5705600", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 267.0, "discounted_cash": 200.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT NEG PRESS <=50CM", "code_information": [{"code": "97605", "type": "CPT"}, {"code": "5707614", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 966.0, "discounted_cash": 724.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT NEG PRESS >50CM", "code_information": [{"code": "97606", "type": "CPT"}, {"code": "5707613", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 966.0, "discounted_cash": 724.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT NEUROMUSC RE-ED EA15", "code_information": [{"code": "97112", "type": "CPT"}, {"code": "5705300", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 384.0, "discounted_cash": 288.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT NSL WD/S DEB WO AN BS", "code_information": [{"code": "97602", "type": "CPT"}, {"code": "5707605", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 665.0, "discounted_cash": 498.75, "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": 665.0, "discounted_cash": 498.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT NSL WD/S DEB WO AN IN", "code_information": [{"code": "97602", "type": "CPT"}, {"code": "5707606", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 665.0, "discounted_cash": 498.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT ORTHO MGMT INIT EA 15MIN", "code_information": [{"code": "97760", "type": "CPT"}, {"code": "5707760", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 247.0, "discounted_cash": 185.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT ORTHO PROS MGMT EA15", "code_information": [{"code": "97763", "type": "CPT"}, {"code": "5707766", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 152.0, "discounted_cash": 114.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT PARAFFIN BATH BSC", "code_information": [{"code": "97018", "type": "CPT"}, {"code": "5705248", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 220.0, "discounted_cash": 165.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT PHYS PERF TST 15MIN", "code_information": [{"code": "97750", "type": "CPT"}, {"code": "5705224", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 492.0, "discounted_cash": 369.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT PROSTH TRN INIT EA 15MIN", "code_information": [{"code": "97761", "type": "CPT"}, {"code": "5707762", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 325.0, "discounted_cash": 243.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT RE-EVAL", "code_information": [{"code": "97164", "type": "CPT"}, {"code": "5705209", "type": "CDM"}, {"code": "424", "type": "RC"}], "standard_charges": [{"gross_charge": 364.0, "discounted_cash": 273.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT RE-EVAL WOUND CARE", "code_information": [{"code": "97164", "type": "CPT"}, {"code": "5705371", "type": "CDM"}, {"code": "424", "type": "RC"}], "standard_charges": [{"gross_charge": 364.0, "discounted_cash": 273.0, "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": 411.0, "discounted_cash": 308.25, "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": 392.0, "discounted_cash": 294.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT SLF CR/HM MGMT EA 15", "code_information": [{"code": "97535", "type": "CPT"}, {"code": "5705316", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 274.0, "discounted_cash": 205.5, "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": 62.0, "discounted_cash": 46.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PT SUBST PLSMA FRCT EA", "code_information": [{"code": "85611", "type": "CPT"}, {"code": "4175611", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PT THER EX EA 15", "code_information": [{"code": "97110", "type": "CPT"}, {"code": "5705296", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 435.0, "discounted_cash": 326.25, "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": 322.0, "discounted_cash": 241.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT THERAPEUTC MASSG EA15", "code_information": [{"code": "97124", "type": "CPT"}, {"code": "5705308", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 230.0, "discounted_cash": 172.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT US EA 15 BSC", "code_information": [{"code": "97035", "type": "CPT"}, {"code": "5705284", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 189.0, "discounted_cash": 141.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT WHLCHR TRN EA 15", "code_information": [{"code": "97542", "type": "CPT"}, {"code": "5705664", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 267.0, "discounted_cash": 200.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT WK HRD/COND ADDL HR", "code_information": [{"code": "97546", "type": "CPT"}, {"code": "5705362", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 653.0, "discounted_cash": 489.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PT WK HRD/COND INIT 2 HR", "code_information": [{"code": "97545", "type": "CPT"}, {"code": "5705360", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 1306.0, "discounted_cash": 979.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "PTA COMM/WK REINT TRN EA15M", "code_information": [{"code": "97537", "type": "CPT"}, {"code": "5700070", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 242.0, "discounted_cash": 181.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA CONTRAST BATH 15 BSC", "code_information": [{"code": "97034", "type": "CPT"}, {"code": "5700039", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 315.0, "discounted_cash": 236.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA E-STIM BASIC", "code_information": [{"code": "G0283", "type": "HCPCS"}, {"code": "5700023", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 138.0, "discounted_cash": 103.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA GAIT/STR TRN EA 15", "code_information": [{"code": "97116", "type": "CPT"}, {"code": "5700053", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 256.0, "discounted_cash": 192.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA GROUP THRPY PROC BASIC", "code_information": [{"code": "97150", "type": "CPT"}, {"code": "5700062", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 455.0, "discounted_cash": 341.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA INTRACRANIAL", "code_information": [{"code": "4951630", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 30081.0, "discounted_cash": 22560.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PTA INTRACRANIAL W/STENT", "code_information": [{"code": "4951635", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 30081.0, "discounted_cash": 22560.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PTA IONTOPHORESIS 15 BSC", "code_information": [{"code": "97033", "type": "CPT"}, {"code": "5700038", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 629.0, "discounted_cash": 471.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA MANUAL THRPY EA 15MIN", "code_information": [{"code": "97140", "type": "CPT"}, {"code": "5700057", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 533.0, "discounted_cash": 399.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA MECH TRACTION BSC", "code_information": [{"code": "97012", "type": "CPT"}, {"code": "5700025", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 267.0, "discounted_cash": 200.25, "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": 384.0, "discounted_cash": 288.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA ORTHO PROS MGMT EA15MIN", "code_information": [{"code": "97763", "type": "CPT"}, {"code": "5700080", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 152.0, "discounted_cash": 114.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA PARAFFIN BATH BSC", "code_information": [{"code": "97018", "type": "CPT"}, {"code": "5700028", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 220.0, "discounted_cash": 165.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA SLF CR/HM MGMT EA 15MIN", "code_information": [{"code": "97535", "type": "CPT"}, {"code": "5700068", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 274.0, "discounted_cash": 205.5, "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": 435.0, "discounted_cash": 326.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA THERAPEUTC ACT EA 15MIN", "code_information": [{"code": "97530", "type": "CPT"}, {"code": "5700063", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 322.0, "discounted_cash": 241.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA THERAPUTC MASSG EA15MIN", "code_information": [{"code": "97124", "type": "CPT"}, {"code": "5700055", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 230.0, "discounted_cash": 172.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA US EA 15 BASIC", "code_information": [{"code": "97035", "type": "CPT"}, {"code": "5700040", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 189.0, "discounted_cash": 141.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTA WHLCHR TRN EA 15MIN", "code_information": [{"code": "97542", "type": "CPT"}, {"code": "5700072", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 267.0, "discounted_cash": 200.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GP|CQ"}, {"description": "PTCH HERNIA OVAL 2", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "8144164", "type": "CDM"}], "standard_charges": [{"gross_charge": 21453.0, "discounted_cash": 16089.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PTH ANTIBODY", "code_information": [{"code": "83519", "type": "CPT"}, {"code": "7003978", "type": "CDM"}], "standard_charges": [{"gross_charge": 749.0, "discounted_cash": 561.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PTH ANTIBODY/2", "code_information": [{"code": "83519", "type": "CPT"}, {"code": "7259381", "type": "CDM"}], "standard_charges": [{"gross_charge": 282.0, "discounted_cash": 211.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PTT", "code_information": [{"code": "85730", "type": "CPT"}, {"code": "4105700", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 300.0, "discounted_cash": 225.0, "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": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PTT", "code_information": [{"code": "85730", "type": "CPT"}, {"code": "4175700", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 236.0, "discounted_cash": 177.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PTT", "code_information": [{"code": "85730", "type": "CPT"}, {"code": "7005730", "type": "CDM"}], "standard_charges": [{"gross_charge": 235.0, "discounted_cash": 176.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PTT", "code_information": [{"code": "85730", "type": "CPT"}, {"code": "7255730", "type": "CDM"}], "standard_charges": [{"gross_charge": 307.0, "discounted_cash": 230.25, "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": 97.0, "discounted_cash": 72.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PTT SUB EA FRACTION", "code_information": [{"code": "85732", "type": "CPT"}, {"code": "4175732", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PTT SUB EA FRACTION", "code_information": [{"code": "85732", "type": "CPT"}, {"code": "7005710", "type": "CDM"}], "standard_charges": [{"gross_charge": 328.0, "discounted_cash": 246.0, "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": 180.0, "discounted_cash": 135.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PTT SUB EA FRACTION/4", "code_information": [{"code": "85732", "type": "CPT"}, {"code": "7255733", "type": "CDM"}], "standard_charges": [{"gross_charge": 180.0, "discounted_cash": 135.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PTT SUB EA FRACTION/6", "code_information": [{"code": "85732", "type": "CPT"}, {"code": "7258573", "type": "CDM"}], "standard_charges": [{"gross_charge": 230.0, "discounted_cash": 172.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PULMONARY STRESS TST", "code_information": [{"code": "94618", "type": "CPT"}, {"code": "6034618", "type": "CDM"}, {"code": "460", "type": "RC"}], "standard_charges": [{"gross_charge": 1027.0, "discounted_cash": 770.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PULSE OX SINGLE", "code_information": [{"code": "94760", "type": "CPT"}, {"code": "5502205", "type": "CDM"}, {"code": "460", "type": "RC"}], "standard_charges": [{"gross_charge": 172.0, "discounted_cash": 129.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PUNCH BX SKIN SINGLE LESION", "code_information": [{"code": "6901104", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 737.0, "discounted_cash": 552.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PUNCH BX SKIN SINGLE LESION", "code_information": [{"code": "6901104", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 737.0, "discounted_cash": 552.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PUNCT SHUNT TB/RESERV", "code_information": [{"code": "4901070", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2092.0, "discounted_cash": 1569.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PUNCT SHUNT TB/RESERV", "code_information": [{"code": "5201070", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2092.0, "discounted_cash": 1569.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PURAPLY AM 2CMX4CM PER SQ CM", "code_information": [{"code": "Q4196", "type": "HCPCS"}, {"code": "4024634", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 614.0, "discounted_cash": 460.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PURAPLY AM 2CMX4CM PER SQ CM", "code_information": [{"code": "Q4196", "type": "HCPCS"}, {"code": "4024634", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 614.0, "discounted_cash": 460.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PURAPLY AM 5X5 PER SQ CM", "code_information": [{"code": "Q4196", "type": "HCPCS"}, {"code": "4024267", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 448.0, "discounted_cash": 336.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PURAPLY AM 5X5 PER SQ CM", "code_information": [{"code": "Q4196", "type": "HCPCS"}, {"code": "4024267", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 448.0, "discounted_cash": 336.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PUTTY DBM GRAFTON", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8134886", "type": "CDM"}], "standard_charges": [{"gross_charge": 2449.0, "discounted_cash": 1836.75, "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": 83.0, "discounted_cash": 62.25, "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": 83.0, "discounted_cash": 62.25, "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": 31.0, "discounted_cash": 23.25, "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": 31.0, "discounted_cash": 23.25, "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": 1049.0, "discounted_cash": 786.75, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PYRIDOXINE 50MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5310328", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "PYRIDOXINE PER 100MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3415", "type": "HCPCS"}, {"code": "5323929", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 268.0, "discounted_cash": 201.0, "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": 268.0, "discounted_cash": 201.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PYRIDOXL PHOSPH VIT B6", "code_information": [{"code": "84207", "type": "CPT"}, {"code": "7004207", "type": "CDM"}], "standard_charges": [{"gross_charge": 216.0, "discounted_cash": 162.0, "setting": "both", "billing_class": "facility"}]}, {"description": "PYRIDOXL PHOSPH VIT B6", "code_information": [{"code": "84207", "type": "CPT"}, {"code": "7254207", "type": "CDM"}], "standard_charges": [{"gross_charge": 824.0, "discounted_cash": 618.0, "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": 70.0, "discounted_cash": 52.5, "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": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "PYRUVATE", "code_information": [{"code": "84210", "type": "CPT"}, {"code": "7004210", "type": "CDM"}], "standard_charges": [{"gross_charge": 171.0, "discounted_cash": 128.25, "setting": "both", "billing_class": "facility"}]}, {"description": "PYRUVATE", "code_information": [{"code": "84210", "type": "CPT"}, {"code": "7254210", "type": "CDM"}], "standard_charges": [{"gross_charge": 189.0, "discounted_cash": 141.75, "setting": "both", "billing_class": "facility"}]}, {"description": "Q FEVER AB", "code_information": [{"code": "86638", "type": "CPT"}, {"code": "7256541", "type": "CDM"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "Q FEVER AB/3", "code_information": [{"code": "86638", "type": "CPT"}, {"code": "7006174", "type": "CDM"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "QUANT OF DRUG NES", "code_information": [{"code": "80299", "type": "CPT"}, {"code": "7250299", "type": "CDM"}], "standard_charges": [{"gross_charge": 464.0, "discounted_cash": 348.0, "setting": "both", "billing_class": "facility"}]}, {"description": "QUANT OF DRUG NES", "code_information": [{"code": "80299", "type": "CPT"}, {"code": "7250315", "type": "CDM"}], "standard_charges": [{"gross_charge": 398.0, "discounted_cash": 298.5, "setting": "both", "billing_class": "facility"}]}, {"description": "QUANT OF DRUG NES/2", "code_information": [{"code": "80299", "type": "CPT"}, {"code": "7000094", "type": "CDM"}, {"code": "300", "type": "RC"}], "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": 680.0, "discounted_cash": 510.0, "setting": "both", "billing_class": "facility"}]}, {"description": "QUANT OF DRUG NES/3", "code_information": [{"code": "80299", "type": "CPT"}, {"code": "7251345", "type": "CDM"}], "standard_charges": [{"gross_charge": 199.0, "discounted_cash": 149.25, "setting": "both", "billing_class": "facility"}]}, {"description": "QUANT OF DRUG NES/4", "code_information": [{"code": "80299", "type": "CPT"}, {"code": "7006369", "type": "CDM"}], "standard_charges": [{"gross_charge": 1283.0, "discounted_cash": 962.25, "setting": "both", "billing_class": "facility"}]}, {"description": "QUETIAPINE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310371", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 252.0, "discounted_cash": 189.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 252.0, "discounted_cash": 189.0, "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": 292.0, "discounted_cash": 219.0, "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": 292.0, "discounted_cash": 219.0, "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": 55.0, "discounted_cash": 41.25, "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": 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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "QUETIAPINE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310370", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 574.0, "discounted_cash": 430.5, "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": 574.0, "discounted_cash": 430.5, "setting": "both", "billing_class": "facility"}]}, {"description": "QUETIAPINE 300MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310377", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 62.0, "discounted_cash": 46.5, "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": 62.0, "discounted_cash": 46.5, "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": 39.0, "discounted_cash": 29.25, "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": 39.0, "discounted_cash": 29.25, "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": 35.0, "discounted_cash": 26.25, "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": 35.0, "discounted_cash": 26.25, "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": 729.0, "discounted_cash": 546.75, "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": 101.0, "discounted_cash": 75.75, "setting": "both", "billing_class": "facility"}]}, {"description": "QUINIDINE", "code_information": [{"code": "80194", "type": "CPT"}, {"code": "4174230", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 573.0, "discounted_cash": 429.75, "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": 12.0, "discounted_cash": 9.0, "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": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "QUINIDINE 300MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310451", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "QUINIDINE 300MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310451", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "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": 44.0, "discounted_cash": 33.0, "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": 44.0, "discounted_cash": 33.0, "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": 28.0, "discounted_cash": 21.0, "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": 28.0, "discounted_cash": 21.0, "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": 19.0, "discounted_cash": 14.25, "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": 19.0, "discounted_cash": 14.25, "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": 58.0, "discounted_cash": 43.5, "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": 58.0, "discounted_cash": 43.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2310.0, "discounted_cash": 1732.5, "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": 2310.0, "discounted_cash": 1732.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RABIES IG HT PER150U IJ", "code_information": [{"code": "90376", "type": "CPT"}, {"code": "5323979", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3948.0, "discounted_cash": 2961.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RABIES IG HT PER150U IJ", "code_information": [{"code": "90376", "type": "CPT"}, {"code": "5323979", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 3948.0, "discounted_cash": 2961.0, "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": 1637.0, "discounted_cash": 1227.75, "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": 1637.0, "discounted_cash": 1227.75, "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": 2851.0, "discounted_cash": 2138.25, "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": 2851.0, "discounted_cash": 2138.25, "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": 909.0, "discounted_cash": 681.75, "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": 692.0, "discounted_cash": 519.0, "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": 560.0, "discounted_cash": 420.0, "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": 1499.0, "discounted_cash": 1124.25, "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": 1000.0, "discounted_cash": 750.0, "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": 2157.0, "discounted_cash": 1617.75, "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": 2661.0, "discounted_cash": 1995.75, "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": 3728.0, "discounted_cash": 2796.0, "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": 1481.0, "discounted_cash": 1110.75, "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": 262.0, "discounted_cash": 196.5, "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": 262.0, "discounted_cash": 196.5, "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": 93.0, "discounted_cash": 69.75, "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": 93.0, "discounted_cash": 69.75, "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": 234.0, "discounted_cash": 175.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RAMELTEON 8MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310488", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 234.0, "discounted_cash": 175.5, "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": 234.0, "discounted_cash": 175.5, "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": 234.0, "discounted_cash": 175.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RAMIPRIL 2.5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310490", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 171.0, "discounted_cash": 128.25, "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": 171.0, "discounted_cash": 128.25, "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": 147.0, "discounted_cash": 110.25, "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": 147.0, "discounted_cash": 110.25, "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": 19.0, "discounted_cash": 14.25, "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": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RANITIDINE 150MG/10ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316245", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RANITIDINE 150MG/10ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316245", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RANITIDINE NEO DOSE LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316243", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 44.0, "discounted_cash": 33.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RANITIDINE NEO DOSE LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316243", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 44.0, "discounted_cash": 33.0, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 1172.0, "discounted_cash": 879.0, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1172.0, "discounted_cash": 879.0, "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": "4176095", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RBC AG EXCPT ABO/RHO EA", "code_information": [{"code": "86905", "type": "CPT"}, {"code": "7198690", "type": "CDM"}], "standard_charges": [{"gross_charge": 1420.0, "discounted_cash": 1065.0, "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": 187.0, "discounted_cash": 140.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RBC ANTIBDY ELUTION EACH", "code_information": [{"code": "86860", "type": "CPT"}, {"code": "4176019", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 399.0, "discounted_cash": 299.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RBC ANTIBDY ELUTION EACH", "code_information": [{"code": "86860", "type": "CPT"}, {"code": "7196019", "type": "CDM"}], "standard_charges": [{"gross_charge": 349.0, "discounted_cash": 261.75, "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": 363.0, "discounted_cash": 272.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RBC ANTIBODIES SCREEN", "code_information": [{"code": "86850", "type": "CPT"}, {"code": "4176016", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 285.0, "discounted_cash": 213.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RBC ANTIBODIES SCREEN", "code_information": [{"code": "86850", "type": "CPT"}, {"code": "7196016", "type": "CDM"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RBC AUTO", "code_information": [{"code": "85041", "type": "CPT"}, {"code": "4175011", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 30.0, "discounted_cash": 22.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RBC AUTO", "code_information": [{"code": "85041", "type": "CPT"}, {"code": "7005010", "type": "CDM"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RBC AUTO", "code_information": [{"code": "85041", "type": "CPT"}, {"code": "7255041", "type": "CDM"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RBC AUTOLOGOUS", "code_information": [{"code": "P9021", "type": "HCPCS"}, {"code": "4509608", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 1103.0, "discounted_cash": 827.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RBC FDW LR IRR", "code_information": [{"code": "P9057", "type": "HCPCS"}, {"code": "4509057", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 2151.0, "discounted_cash": 1613.25, "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": 1559.0, "discounted_cash": 1169.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RBC LEUKO RED CMV NEG EA", "code_information": [{"code": "P9051", "type": "HCPCS"}, {"code": "4509051", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 823.0, "discounted_cash": 617.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RBC LEUKORED IRRAD", "code_information": [{"code": "P9040", "type": "HCPCS"}, {"code": "4506023", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 801.0, "discounted_cash": 600.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RBC LEUKORED IRRAD PED", "code_information": [{"code": "P9040", "type": "HCPCS"}, {"code": "4509042", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 1418.0, "discounted_cash": 1063.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RBC LEUKOREDUCED PED", "code_information": [{"code": "P9016", "type": "HCPCS"}, {"code": "4509025", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 1093.0, "discounted_cash": 819.75, "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": 6612.0, "discounted_cash": 4959.0, "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": 3502.0, "discounted_cash": 2626.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RBC WASHED IRRADIATED", "code_information": [{"code": "P9040", "type": "HCPCS"}, {"code": "4506027", "type": "CDM"}, {"code": "399", "type": "RC"}], "standard_charges": [{"gross_charge": 1418.0, "discounted_cash": 1063.5, "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": 13095.0, "discounted_cash": 9821.25, "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": 4571.0, "discounted_cash": 3428.25, "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": 10185.0, "discounted_cash": 7638.75, "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": 5818.0, "discounted_cash": 4363.5, "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": 7877.0, "discounted_cash": 5907.75, "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": 17335.0, "discounted_cash": 13001.25, "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": 4571.0, "discounted_cash": 3428.25, "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": 10185.0, "discounted_cash": 7638.75, "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": 5818.0, "discounted_cash": 4363.5, "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": 13095.0, "discounted_cash": 9821.25, "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": 7879.0, "discounted_cash": 5909.25, "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": 17335.0, "discounted_cash": 13001.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RBTCS DAVN OH EA 15", "code_information": [{"code": "3303559", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4543.0, "discounted_cash": 3407.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RBTCS DAVN OH INT 30", "code_information": [{"code": "3303558", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 10077.0, "discounted_cash": 7557.75, "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": 4571.0, "discounted_cash": 3428.25, "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": 10185.0, "discounted_cash": 7638.75, "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": 5818.0, "discounted_cash": 4363.5, "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": 7879.0, "discounted_cash": 5909.25, "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": 17335.0, "discounted_cash": 13001.25, "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": 13095.0, "discounted_cash": 9821.25, "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": 4571.0, "discounted_cash": 3428.25, "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": 10185.0, "discounted_cash": 7638.75, "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": 5818.0, "discounted_cash": 4363.5, "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": 13095.0, "discounted_cash": 9821.25, "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": 7879.0, "discounted_cash": 5909.25, "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": 17335.0, "discounted_cash": 13001.25, "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": 38092.0, "discounted_cash": 28569.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RD SPINAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8135030", "type": "CDM"}], "standard_charges": [{"gross_charge": 1908.0, "discounted_cash": 1431.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RECAL PRS URINRY SPHNCTR", "code_information": [{"code": "C1815", "type": "HCPCS"}, {"code": "8041815", "type": "CDM"}], "standard_charges": [{"gross_charge": 0.01, "discounted_cash": 0.01, "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": 271.0, "discounted_cash": 203.25, "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": 409.0, "discounted_cash": 306.75, "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": 1753.0, "discounted_cash": 1314.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RECOVERY INIT 30 MIN", "code_information": [{"code": "3223570", "type": "CDM"}, {"code": "710", "type": "RC"}], "standard_charges": [{"gross_charge": 4014.0, "discounted_cash": 3010.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REFILL IMP PMP/RSV SYST", "code_information": [{"code": "96522", "type": "CPT"}, {"code": "4546530", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 1215.0, "discounted_cash": 911.25, "setting": "both", "billing_class": "facility"}]}, {"description": "REFILL IMP PMP/RSV SYST", "code_information": [{"code": "96522", "type": "CPT"}, {"code": "4546530", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1215.0, "discounted_cash": 911.25, "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": 755.0, "discounted_cash": 566.25, "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": 755.0, "discounted_cash": 566.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RELOCATE SKIN PKT AICD", "code_information": [{"code": "4613223", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 22765.0, "discounted_cash": 17073.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REM AICD LDS TRANSVEN", "code_information": [{"code": "4613243", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 26249.0, "discounted_cash": 19686.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REM AICD PULS GEN", "code_information": [{"code": "4613241", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 15886.0, "discounted_cash": 11914.5, "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": 17263.0, "discounted_cash": 12947.25, "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": 17263.0, "discounted_cash": 12947.25, "setting": "both", "billing_class": "facility"}]}, {"description": "REM FOREIGN BODY ARM", "code_information": [{"code": "4914201", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 12172.0, "discounted_cash": 9129.0, "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": 16714.0, "discounted_cash": 12535.5, "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": 8948.0, "discounted_cash": 6711.0, "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": 8834.0, "discounted_cash": 6625.5, "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": 6215.0, "discounted_cash": 4661.25, "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": 16714.0, "discounted_cash": 12535.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REM TUNNLD INTRAPER CATH", "code_information": [{"code": "4919422", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 11890.0, "discounted_cash": 8917.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REM TUNNLD PLEURL CATH", "code_information": [{"code": "4910025", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 761.0, "discounted_cash": 570.75, "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": 107039.0, "discounted_cash": 80279.25, "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": 39.47, "discounted_cash": 29.6, "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": 39.47, "discounted_cash": 29.6, "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": 421.0, "discounted_cash": 315.75, "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": 213.0, "discounted_cash": 159.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REMOVE BILI DRAIN CATH", "code_information": [{"code": "4917537", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4158.0, "discounted_cash": 3118.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REMOVE CONTRACEPTIVE CAPSULE", "code_information": [{"code": "4911976", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2550.0, "discounted_cash": 1912.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REMOVE FB SUBQ SIMPLE", "code_information": [{"code": "4910120", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2299.0, "discounted_cash": 1724.25, "setting": "both", "billing_class": "facility"}]}, {"description": "REMOVE NON BIO IMPLANT DEVICE", "code_information": [{"code": "4911982", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2550.0, "discounted_cash": 1912.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REMOVE PERC LEFT HEART VAD", "code_information": [{"code": "4613992", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 18944.0, "discounted_cash": 14208.0, "setting": "both", "billing_class": "facility"}]}, {"description": "REMOVE URETER STENT PERC", "code_information": [{"code": "4917528", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7229.0, "discounted_cash": 5421.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REMV TUNL CVC WO PMP/PRT", "code_information": [{"code": "4616589", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4636.0, "discounted_cash": 3477.0, "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": 4636.0, "discounted_cash": 3477.0, "setting": "both", "billing_class": "facility"}]}, {"description": "REMVE RENL TUBE W/FLUORO", "code_information": [{"code": "4914238", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4325.0, "discounted_cash": 3243.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RENAL FUNCTION PANEL", "code_information": [{"code": "80069", "type": "CPT"}, {"code": "4100069", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 322.0, "discounted_cash": 241.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RENAL FUNCTION PANEL", "code_information": [{"code": "80069", "type": "CPT"}, {"code": "4170069", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 253.0, "discounted_cash": 189.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RENIN", "code_information": [{"code": "84244", "type": "CPT"}, {"code": "4174244", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 307.0, "discounted_cash": 230.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RENIN", "code_information": [{"code": "84244", "type": "CPT"}, {"code": "7004244", "type": "CDM"}], "standard_charges": [{"gross_charge": 208.0, "discounted_cash": 156.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RENIN", "code_information": [{"code": "84244", "type": "CPT"}, {"code": "7258424", "type": "CDM"}], "standard_charges": [{"gross_charge": 391.0, "discounted_cash": 293.25, "setting": "both", "billing_class": "facility"}]}, {"description": "REPAGLINIDE 0.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310552", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "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": 83.0, "discounted_cash": 62.25, "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": 93.0, "discounted_cash": 69.75, "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": 93.0, "discounted_cash": 69.75, "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": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REPAGLINIDE 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310554", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REPAIR CVAD W SQ PUMP", "code_information": [{"code": "4916577", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 11034.0, "discounted_cash": 8275.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REPL GASTRO TUBE W/FLUOR", "code_information": [{"code": "4909450", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2320.0, "discounted_cash": 1740.0, "setting": "both", "billing_class": "facility"}]}, {"description": "REPL GASTRO TUBE W/FLUOR", "code_information": [{"code": "4919450", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1381.0, "discounted_cash": 1035.75, "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": 3875.0, "discounted_cash": 2906.25, "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": 4320.0, "discounted_cash": 3240.0, "setting": "both", "billing_class": "facility"}]}, {"description": "REPLACE TUNNELED CV CATH", "code_information": [{"code": "4616581", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5671.0, "discounted_cash": 4253.25, "setting": "both", "billing_class": "facility"}]}, {"description": "REPLACE TUNNELED CV CATH", "code_information": [{"code": "4916581", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3673.0, "discounted_cash": 2754.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REPLCE NON-TUNNL CV CATH", "code_information": [{"code": "4916580", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2036.0, "discounted_cash": 1527.0, "setting": "both", "billing_class": "facility"}]}, {"description": "REPOS GI TUBE THRU DUODN", "code_information": [{"code": "4907903", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 935.0, "discounted_cash": 701.25, "setting": "both", "billing_class": "facility"}]}, {"description": "REPOS GI TUBE THRU DUODN", "code_information": [{"code": "4913761", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 935.0, "discounted_cash": 701.25, "setting": "both", "billing_class": "facility"}]}, {"description": "REPOS SQ DEFIB ELEC/GEN", "code_information": [{"code": "4610325", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 25735.0, "discounted_cash": 19301.25, "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": 1618.0, "discounted_cash": 1213.5, "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": 8076.0, "discounted_cash": 6057.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RESERV CLOVERLEAF TITAN", "code_information": [{"code": "C1813", "type": "HCPCS"}, {"code": "8155033", "type": "CDM"}], "standard_charges": [{"gross_charge": 19719.0, "discounted_cash": 14789.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RESERV PENL PROSTH FLAT", "code_information": [{"code": "C1813", "type": "HCPCS"}, {"code": "8155034", "type": "CDM"}], "standard_charges": [{"gross_charge": 19734.0, "discounted_cash": 14800.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RESLIZUMAB PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2786", "type": "HCPCS"}, {"code": "5323994", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RESLIZUMAB PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2786", "type": "HCPCS"}, {"code": "5323994", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RESP FUNCT OTH IND 15MIN", "code_information": [{"code": "G0238", "type": "HCPCS"}, {"code": "6030238", "type": "CDM"}, {"code": "419", "type": "RC"}], "standard_charges": [{"gross_charge": 311.0, "discounted_cash": 233.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RESP FUNCTION GRP SESSN", "code_information": [{"code": "G0239", "type": "HCPCS"}, {"code": "6030239", "type": "CDM"}, {"code": "419", "type": "RC"}], "standard_charges": [{"gross_charge": 286.0, "discounted_cash": 214.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RESP MUSC STRENGTH IND15", "code_information": [{"code": "G0237", "type": "HCPCS"}, {"code": "6030237", "type": "CDM"}, {"code": "419", "type": "RC"}], "standard_charges": [{"gross_charge": 311.0, "discounted_cash": 233.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RESP VIR 12-25 TARGETS", "code_information": [{"code": "87633", "type": "CPT"}, {"code": "7257634", "type": "CDM"}], "standard_charges": [{"gross_charge": 2119.0, "discounted_cash": 1589.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RESP VIRUS 12-25 AMP PROBE", "code_information": [{"code": "87633", "type": "CPT"}, {"code": "4107633", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 3486.0, "discounted_cash": 2614.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RESP VIRUS 12-25 AMP PROBE", "code_information": [{"code": "87633", "type": "CPT"}, {"code": "4177637", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 2742.0, "discounted_cash": 2056.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RESP VIRUS 12-25 AMP PROBE", "code_information": [{"code": "87633", "type": "CPT"}, {"code": "7257633", "type": "CDM"}], "standard_charges": [{"gross_charge": 649.0, "discounted_cash": 486.75, "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": 725.0, "discounted_cash": 543.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RESPI SYNC VIRUS DIR OPT", "code_information": [{"code": "87807", "type": "CPT"}, {"code": "4170025", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 119.0, "discounted_cash": 89.25, "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": 152.0, "discounted_cash": 114.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RETEPLASE 1U SG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5323988", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2025.0, "discounted_cash": 1518.75, "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": 10032.0, "discounted_cash": 7524.0, "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": 10032.0, "discounted_cash": 7524.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RETICULIN AB", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "7008670", "type": "CDM"}], "standard_charges": [{"gross_charge": 670.0, "discounted_cash": 502.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RETICULIN AB/2", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "7258670", "type": "CDM"}], "standard_charges": [{"gross_charge": 292.0, "discounted_cash": 219.0, "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": 177.0, "discounted_cash": 132.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RETICULOCYTE COUNT AUTO", "code_information": [{"code": "85045", "type": "CPT"}, {"code": "4175045", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 139.0, "discounted_cash": 104.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RETICULOCYTE COUNT AUTO", "code_information": [{"code": "85045", "type": "CPT"}, {"code": "7255045", "type": "CDM"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RETICULOCYTE COUNT MAN", "code_information": [{"code": "85044", "type": "CPT"}, {"code": "4105044", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RETICULOCYTE COUNT MAN", "code_information": [{"code": "85044", "type": "CPT"}, {"code": "4125044", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RETICULOCYTE COUNT MAN", "code_information": [{"code": "85044", "type": "CPT"}, {"code": "4175044", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REVAS PERC TRANS OCC ADD", "code_information": [{"code": "92944", "type": "CPT"}, {"code": "4612944", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 25882.0, "discounted_cash": 19411.5, "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": 41292.0, "discounted_cash": 30969.0, "setting": "both", "billing_class": "facility"}]}, {"description": "REVAS PERC TRANS SGL VES", "code_information": [{"code": "92937", "type": "CPT"}, {"code": "4612937", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 66463.0, "discounted_cash": 49847.25, "setting": "both", "billing_class": "facility"}]}, {"description": "REVAS PERC TRANS TOT OCC", "code_information": [{"code": "92943", "type": "CPT"}, {"code": "4612943", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 47487.0, "discounted_cash": 35615.25, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC FEMPOP STNT ATHER", "code_information": [{"code": "4610235", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 45599.0, "discounted_cash": 34199.25, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC FEMPOP W/ATHER", "code_information": [{"code": "4610233", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 28129.0, "discounted_cash": 21096.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC FEMPOP W/STENT", "code_information": [{"code": "4610231", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 29756.0, "discounted_cash": 22317.0, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC FEMPOP W/TLA", "code_information": [{"code": "4610229", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 19963.0, "discounted_cash": 14972.25, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC FEMPOP W/TLA", "code_information": [{"code": "4918176", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 19963.0, "discounted_cash": 14972.25, "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": 26867.0, "discounted_cash": 20150.25, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC ILIAC ADD ON", "code_information": [{"code": "4610223", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 14819.0, "discounted_cash": 11114.25, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC ILIAC INITIAL", "code_information": [{"code": "4610221", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 19944.0, "discounted_cash": 14958.0, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC ILIAC W/STENT", "code_information": [{"code": "4610225", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 32360.0, "discounted_cash": 24270.0, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC INTRAVASC LITHO+ATHER", "code_information": [{"code": "4619766", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 31065.0, "discounted_cash": 23298.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC INTRAVASC LITHO+PLASTY", "code_information": [{"code": "4619772", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 31820.0, "discounted_cash": 23865.0, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC INTRAVASC LITHO+STENT", "code_information": [{"code": "4619765", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 32837.0, "discounted_cash": 24627.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC INTRAVASC LITHOTRIP", "code_information": [{"code": "4619764", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 19963.0, "discounted_cash": 14972.25, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC INTVASC LITH+STNT+ATHER", "code_information": [{"code": "4619767", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 45599.0, "discounted_cash": 34199.25, "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": 18256.0, "discounted_cash": 13692.0, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC TIBPER STNT ATHER", "code_information": [{"code": "4610249", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 56748.0, "discounted_cash": 42561.0, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC TIBPER W/ATHER", "code_information": [{"code": "4610241", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 31065.0, "discounted_cash": 23298.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC TIBPER W/STENT", "code_information": [{"code": "4610245", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 32837.0, "discounted_cash": 24627.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC TIBPER W/TLA", "code_information": [{"code": "4610237", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 24249.0, "discounted_cash": 18186.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REVASC TIBPER W/TLA", "code_information": [{"code": "4918184", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 24249.0, "discounted_cash": 18186.75, "setting": "both", "billing_class": "facility"}]}, {"description": "REVEFENACIN 175MCG/3ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7699", "type": "HCPCS"}, {"code": "5332410", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 166.0, "discounted_cash": 124.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REVEFENACIN 175MCG/3ML IS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7699", "type": "HCPCS"}, {"code": "5332410", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 166.0, "discounted_cash": 124.5, "setting": "both", "billing_class": "facility"}]}, {"description": "REVERSE T3", "code_information": [{"code": "84482", "type": "CPT"}, {"code": "7004905", "type": "CDM"}], "standard_charges": [{"gross_charge": 276.0, "discounted_cash": 207.0, "setting": "both", "billing_class": "facility"}]}, {"description": "REVERSE T3", "code_information": [{"code": "84482", "type": "CPT"}, {"code": "7254905", "type": "CDM"}], "standard_charges": [{"gross_charge": 295.0, "discounted_cash": 221.25, "setting": "both", "billing_class": "facility"}]}, {"description": "REVSN INTRHEP PORTO SHNT", "code_information": [{"code": "4917183", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6685.0, "discounted_cash": 5013.75, "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": 11203.0, "discounted_cash": 8402.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RHEUMATOID FACTOR QUAL", "code_information": [{"code": "86430", "type": "CPT"}, {"code": "4106431", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 178.0, "discounted_cash": 133.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RHEUMATOID FACTOR QUAL", "code_information": [{"code": "86430", "type": "CPT"}, {"code": "4126431", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 44.0, "discounted_cash": 33.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RHEUMATOID FACTOR QUAL", "code_information": [{"code": "86430", "type": "CPT"}, {"code": "4176431", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 140.0, "discounted_cash": 105.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RHEUMATOID FACTOR QUAL", "code_information": [{"code": "86430", "type": "CPT"}, {"code": "7006431", "type": "CDM"}], "standard_charges": [{"gross_charge": 58.0, "discounted_cash": 43.5, "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": 174.0, "discounted_cash": 130.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RHEUMATOID FACTOR QUANT", "code_information": [{"code": "86431", "type": "CPT"}, {"code": "4176432", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 137.0, "discounted_cash": 102.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RHEUMATOID FACTOR QUANT", "code_information": [{"code": "86431", "type": "CPT"}, {"code": "7256432", "type": "CDM"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "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": 9075.0, "discounted_cash": 6806.25, "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": 9075.0, "discounted_cash": 6806.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RHO(D) IG PER 300MCG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2790", "type": "HCPCS"}, {"code": "5324010", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3129.0, "discounted_cash": 2346.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RHO(D) IG PER 300MCG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2790", "type": "HCPCS"}, {"code": "5324010", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 3129.0, "discounted_cash": 2346.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "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": 161.0, "discounted_cash": 120.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RIA NONANTIBODY/2", "code_information": [{"code": "83519", "type": "CPT"}, {"code": "7003609", "type": "CDM"}], "standard_charges": [{"gross_charge": 749.0, "discounted_cash": 561.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RIBOFLAVIN(VITAMIN B2)", "code_information": [{"code": "84252", "type": "CPT"}, {"code": "7254252", "type": "CDM"}], "standard_charges": [{"gross_charge": 213.0, "discounted_cash": 159.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RIBOSOMAL P AB", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "7253959", "type": "CDM"}], "standard_charges": [{"gross_charge": 427.0, "discounted_cash": 320.25, "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": 2385.0, "discounted_cash": 1788.75, "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": 2385.0, "discounted_cash": 1788.75, "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": 2385.0, "discounted_cash": 1788.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RIBS BI 4V MIN W/PA CXR", "code_information": [{"code": "71111", "type": "CPT"}, {"code": "5121111", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2385.0, "discounted_cash": 1788.75, "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": 1417.0, "discounted_cash": 1062.75, "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": 1417.0, "discounted_cash": 1062.75, "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": 1417.0, "discounted_cash": 1062.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RIBS BILAT 3VW MIN", "code_information": [{"code": "71110", "type": "CPT"}, {"code": "5127111", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1417.0, "discounted_cash": 1062.75, "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": 1574.0, "discounted_cash": 1180.5, "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": 1574.0, "discounted_cash": 1180.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RIBS UNI 3V MIN W/PA CXR", "code_information": [{"code": "71101", "type": "CPT"}, {"code": "5111101", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1574.0, "discounted_cash": 1180.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RIBS UNI 3V MIN W/PA CXR", "code_information": [{"code": "71101", "type": "CPT"}, {"code": "5121101", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1574.0, "discounted_cash": 1180.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RIBS UNILAT 2VW", "code_information": [{"code": "71100", "type": "CPT"}, {"code": "4901100", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1007.0, "discounted_cash": 755.25, "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": 1007.0, "discounted_cash": 755.25, "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": 1007.0, "discounted_cash": 755.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RIBS UNILAT 2VW", "code_information": [{"code": "71100", "type": "CPT"}, {"code": "5121100", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1007.0, "discounted_cash": 755.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RICKETTSIA AB", "code_information": [{"code": "86757", "type": "CPT"}, {"code": "4126747", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 133.0, "discounted_cash": 99.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RICKETTSIA AB", "code_information": [{"code": "86757", "type": "CPT"}, {"code": "7256742", "type": "CDM"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RICKETTSIA AB/2", "code_information": [{"code": "86757", "type": "CPT"}, {"code": "7256437", "type": "CDM"}], "standard_charges": [{"gross_charge": 349.0, "discounted_cash": 261.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RICKETTSIA AB/3", "code_information": [{"code": "86757", "type": "CPT"}, {"code": "7256439", "type": "CDM"}], "standard_charges": [{"gross_charge": 349.0, "discounted_cash": 261.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RICKETTSIA AB/4", "code_information": [{"code": "86757", "type": "CPT"}, {"code": "7006437", "type": "CDM"}], "standard_charges": [{"gross_charge": 156.0, "discounted_cash": 117.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RICKETTSIA AB/5", "code_information": [{"code": "86757", "type": "CPT"}, {"code": "7006439", "type": "CDM"}], "standard_charges": [{"gross_charge": 156.0, "discounted_cash": 117.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RICKETTSIA AB/7", "code_information": [{"code": "86757", "type": "CPT"}, {"code": "7256443", "type": "CDM"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 69.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RIFABUTIN 150MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310620", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 106.0, "discounted_cash": 79.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RIFABUTIN 150MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310620", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 106.0, "discounted_cash": 79.5, "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": 94.0, "discounted_cash": 70.5, "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": 94.0, "discounted_cash": 70.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RIFAMPIN 300MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310637", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 133.0, "discounted_cash": 99.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 133.0, "discounted_cash": 99.75, "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": 0.62, "discounted_cash": 0.47, "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": 0.62, "discounted_cash": 0.47, "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": 40.0, "discounted_cash": 30.0, "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": 40.0, "discounted_cash": 30.0, "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": 178.0, "discounted_cash": 133.5, "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": 178.0, "discounted_cash": 133.5, "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": 31.54, "discounted_cash": 23.66, "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": 157.0, "discounted_cash": 117.75, "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": 157.0, "discounted_cash": 117.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RIMANTADINE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310631", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RIMANTADINE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310631", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RINGERS 1000ML IRR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5414125", "type": "CDM"}, {"code": "270", "type": "RC"}], "standard_charges": [{"gross_charge": 284.0, "discounted_cash": 213.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RISEDRONATE 30MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310656", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 609.0, "discounted_cash": 456.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RISEDRONATE 30MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310656", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 609.0, "discounted_cash": 456.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RISEDRONATE 35MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310648", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 824.0, "discounted_cash": 618.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RISEDRONATE 35MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310648", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 824.0, "discounted_cash": 618.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RISEDRONATE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310649", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 300.0, "discounted_cash": 225.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RISEDRONATE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310649", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 300.0, "discounted_cash": 225.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RISPERIDONE 0.25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5300648", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 226.0, "discounted_cash": 169.5, "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": 226.0, "discounted_cash": 169.5, "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": 428.0, "discounted_cash": 321.0, "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": 428.0, "discounted_cash": 321.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RISPERIDONE 1M/M 30ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316255", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2412.0, "discounted_cash": 1809.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RISPERIDONE 1M/M 30ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316255", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2412.0, "discounted_cash": 1809.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RISPERIDONE 1MG DT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310634", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 282.0, "discounted_cash": 211.5, "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": 282.0, "discounted_cash": 211.5, "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": 2.0, "discounted_cash": 1.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 311.0, "discounted_cash": 233.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 311.0, "discounted_cash": 233.25, "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": 338.0, "discounted_cash": 253.5, "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": 338.0, "discounted_cash": 253.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RITONAVIR 100 MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310670", "type": "CDM"}, {"code": "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 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": 86.0, "discounted_cash": 64.5, "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": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RITONAVIR 80MG/ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316250", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RITONAVIR 80MG/ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316250", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 396.0, "discounted_cash": 297.0, "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": 396.0, "discounted_cash": 297.0, "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": 238.0, "discounted_cash": 178.5, "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": 238.0, "discounted_cash": 178.5, "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": 144.0, "discounted_cash": 108.0, "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": 144.0, "discounted_cash": 108.0, "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": 61.0, "discounted_cash": 45.75, "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": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RIVAROXABAN 15MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310632", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 44.0, "discounted_cash": 33.0, "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": 44.0, "discounted_cash": 33.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 25.0, "discounted_cash": 18.75, "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": 25.0, "discounted_cash": 18.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RIVAROXABAN 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310638", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RIVAROXABAN 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310638", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 247.0, "discounted_cash": 185.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RIVASTIGMINE 1.5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310665", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 247.0, "discounted_cash": 185.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RIVASTIGMINE 3MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310666", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 208.0, "discounted_cash": 156.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RIVASTIGMINE 3MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310666", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 208.0, "discounted_cash": 156.0, "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": 283.0, "discounted_cash": 212.25, "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": 283.0, "discounted_cash": 212.25, "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": 71.0, "discounted_cash": 53.25, "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": 71.0, "discounted_cash": 53.25, "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": 71.0, "discounted_cash": 53.25, "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": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RIZATRIPTAN 10MG DT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310661", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 89.0, "discounted_cash": 66.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RIZATRIPTAN 10MG DT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310661", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 89.0, "discounted_cash": 66.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RIZATRIPTAN 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310658", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 560.0, "discounted_cash": 420.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RIZATRIPTAN 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310658", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 560.0, "discounted_cash": 420.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RMV SQ DEFIB ELEC", "code_information": [{"code": "4610324", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 20889.0, "discounted_cash": 15666.75, "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": 4636.0, "discounted_cash": 3477.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RMVL SUBQ CAR RHYTHM MNTR", "code_information": [{"code": "4613273", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6987.0, "discounted_cash": 5240.25, "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": 197.0, "discounted_cash": 147.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ROCURONIUM10MG/1ML SG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5324026", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "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": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ROFLUMILAST 500MCG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310641", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ROFLUMILAST 500MCG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310641", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "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": 166.0, "discounted_cash": 124.5, "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": 166.0, "discounted_cash": 124.5, "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": 108.0, "discounted_cash": 81.0, "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": 108.0, "discounted_cash": 81.0, "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": 142.0, "discounted_cash": 106.5, "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": 142.0, "discounted_cash": 106.5, "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": 10.0, "discounted_cash": 7.5, "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": 10.0, "discounted_cash": 7.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ROPIV 0.2% PMP 550ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5324034", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1389.0, "discounted_cash": 1041.75, "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": 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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ROPIVACAINE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2795", "type": "HCPCS"}, {"code": "5324052", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ROPIVACAINE PER1MG PMXIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2795", "type": "HCPCS"}, {"code": "5324053", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "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": 370.0, "discounted_cash": 277.5, "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": 370.0, "discounted_cash": 277.5, "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": 467.0, "discounted_cash": 350.25, "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": 467.0, "discounted_cash": 350.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ROSUVASTATIN 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310693", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "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": 12.0, "discounted_cash": 9.0, "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": 10.0, "discounted_cash": 7.5, "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": 10.0, "discounted_cash": 7.5, "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": 92.0, "discounted_cash": 69.0, "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": 92.0, "discounted_cash": 69.0, "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": 10.0, "discounted_cash": 7.5, "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": 10.0, "discounted_cash": 7.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ROTAVIRUS IA", "code_information": [{"code": "87425", "type": "CPT"}, {"code": "4177425", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 119.0, "discounted_cash": 89.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ROTAVIRUS IA", "code_information": [{"code": "87425", "type": "CPT"}, {"code": "7026318", "type": "CDM"}], "standard_charges": [{"gross_charge": 446.0, "discounted_cash": 334.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ROTAVIRUS IA", "code_information": [{"code": "87425", "type": "CPT"}, {"code": "7256318", "type": "CDM"}], "standard_charges": [{"gross_charge": 152.0, "discounted_cash": 114.0, "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": 5775.0, "discounted_cash": 4331.25, "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": 4050.0, "discounted_cash": 3037.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RSV AG DFA", "code_information": [{"code": "87280", "type": "CPT"}, {"code": "7257280", "type": "CDM"}], "standard_charges": [{"gross_charge": 114.0, "discounted_cash": 85.5, "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": 427.0, "discounted_cash": 320.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RSV IA", "code_information": [{"code": "87420", "type": "CPT"}, {"code": "4176414", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 336.0, "discounted_cash": 252.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RT VENT ASSIST DEVCE IMPELA RP", "code_information": [{"code": "4613995", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 21792.0, "discounted_cash": 16344.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RUBELLA AB/2", "code_information": [{"code": "86762", "type": "CPT"}, {"code": "4106317", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 166.0, "discounted_cash": 124.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RUBELLA AB/2", "code_information": [{"code": "86762", "type": "CPT"}, {"code": "4126317", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RUBELLA AB/2", "code_information": [{"code": "86762", "type": "CPT"}, {"code": "4176317", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 131.0, "discounted_cash": 98.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RUBELLA AB/2", "code_information": [{"code": "86762", "type": "CPT"}, {"code": "7256324", "type": "CDM"}], "standard_charges": [{"gross_charge": 320.0, "discounted_cash": 240.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RUBELLA AB/3", "code_information": [{"code": "86762", "type": "CPT"}, {"code": "4176762", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 240.0, "discounted_cash": 180.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RUBELLA AB/3", "code_information": [{"code": "86762", "type": "CPT"}, {"code": "7256762", "type": "CDM"}], "standard_charges": [{"gross_charge": 305.0, "discounted_cash": 228.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RUBELLA AB/4", "code_information": [{"code": "86762", "type": "CPT"}, {"code": "7006324", "type": "CDM"}], "standard_charges": [{"gross_charge": 187.0, "discounted_cash": 140.25, "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": 330.0, "discounted_cash": 247.5, "setting": "both", "billing_class": "facility"}]}, {"description": "RUBEOLA AB", "code_information": [{"code": "86765", "type": "CPT"}, {"code": "4126765", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 89.0, "discounted_cash": 66.75, "setting": "both", "billing_class": "facility"}]}, {"description": "RUBEOLA AB", "code_information": [{"code": "86765", "type": "CPT"}, {"code": "4176765", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 260.0, "discounted_cash": 195.0, "setting": "both", "billing_class": "facility"}]}, {"description": "RUBEOLA AB", "code_information": [{"code": "86765", "type": "CPT"}, {"code": "7256715", "type": "CDM"}], "standard_charges": [{"gross_charge": 179.0, "discounted_cash": 134.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RUSSL VIPR VEN TIME DIL", "code_information": [{"code": "85613", "type": "CPT"}, {"code": "4175613", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 125.0, "discounted_cash": 93.75, "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": 159.0, "discounted_cash": 119.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RUSSL VIPR VEN TIME DIL/2", "code_information": [{"code": "85613", "type": "CPT"}, {"code": "7255615", "type": "CDM"}], "standard_charges": [{"gross_charge": 183.0, "discounted_cash": 137.25, "setting": "both", "billing_class": "facility"}]}, {"description": "RUSSL VIPR VEN TIME DIL/3", "code_information": [{"code": "85613", "type": "CPT"}, {"code": "7255618", "type": "CDM"}], "standard_charges": [{"gross_charge": 97.0, "discounted_cash": 72.75, "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": 97.0, "discounted_cash": 72.75, "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": 1024.0, "discounted_cash": 768.0, "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": 1024.0, "discounted_cash": 768.0, "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": 1024.0, "discounted_cash": 768.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SACROILIAC JOINTS 3 VWS", "code_information": [{"code": "72202", "type": "CPT"}, {"code": "5122202", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1024.0, "discounted_cash": 768.0, "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": 1204.0, "discounted_cash": 903.0, "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": 1204.0, "discounted_cash": 903.0, "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": 1204.0, "discounted_cash": 903.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SACRUM COCCYX 2 VWS", "code_information": [{"code": "72220", "type": "CPT"}, {"code": "5122220", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1204.0, "discounted_cash": 903.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SACUBIT/VALSAR 24-26MGTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310707", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "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": 44.0, "discounted_cash": 33.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SACUBIT/VALSAR 49-51MGTB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310708", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 44.0, "discounted_cash": 33.0, "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": 34.0, "discounted_cash": 25.5, "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": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SALMONELLA AB", "code_information": [{"code": "86768", "type": "CPT"}, {"code": "7006716", "type": "CDM"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SALMONELLA AB/4", "code_information": [{"code": "86768", "type": "CPT"}, {"code": "7006772", "type": "CDM"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SALMONELLA AB/7", "code_information": [{"code": "86768", "type": "CPT"}, {"code": "7006780", "type": "CDM"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SALMONELLA AB/8", "code_information": [{"code": "86768", "type": "CPT"}, {"code": "7006782", "type": "CDM"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SALMONELLA AB/9", "code_information": [{"code": "86768", "type": "CPT"}, {"code": "7006783", "type": "CDM"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 10.0, "discounted_cash": 7.5, "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": 10.0, "discounted_cash": 7.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SARSCOV2 COVID19 AMP PRB", "code_information": [{"code": "87635", "type": "CPT"}, {"code": "4100352", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 283.0, "discounted_cash": 212.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SARSCOV2/A&B/RSV AMP PRB", "code_information": [{"code": "87637", "type": "CPT"}, {"code": "4100374", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 906.0, "discounted_cash": 679.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SARSCOV2/A&B/RSV AMP PRB", "code_information": [{"code": "87637", "type": "CPT"}, {"code": "4170050", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 712.0, "discounted_cash": 534.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SARSCOV2/FLU A&B AMP PRB", "code_information": [{"code": "87636", "type": "CPT"}, {"code": "4100373", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 906.0, "discounted_cash": 679.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SARSCOV2/FLU A&B AMP PRB", "code_information": [{"code": "87636", "type": "CPT"}, {"code": "4170049", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 712.0, "discounted_cash": 534.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SAXAGLIPTIN 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310705", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SAXAGLIPTIN 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310705", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "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": 1830.0, "discounted_cash": 1372.5, "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": 1232.0, "discounted_cash": 924.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCAN HEMODIALYSIS ACCESS", "code_information": [{"code": "93990", "type": "CPT"}, {"code": "4637014", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 1118.0, "discounted_cash": 838.5, "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": 1118.0, "discounted_cash": 838.5, "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": 983.0, "discounted_cash": 737.25, "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": 983.0, "discounted_cash": 737.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCAPULA COMPLETE", "code_information": [{"code": "73010", "type": "CPT"}, {"code": "5123010", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 983.0, "discounted_cash": 737.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCLEROTHERAPY FLUID COLL", "code_information": [{"code": "4919186", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5289.0, "discounted_cash": 3966.75, "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": 143.0, "discounted_cash": 107.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 416.0, "discounted_cash": 312.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 416.0, "discounted_cash": 312.0, "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": 284.0, "discounted_cash": 213.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCREEN TOMO BILAT", "code_information": [{"code": "77063", "type": "CPT"}, {"code": "5127065", "type": "CDM"}, {"code": "403", "type": "RC"}], "standard_charges": [{"gross_charge": 284.0, "discounted_cash": 213.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCREW CANN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136031", "type": "CDM"}], "standard_charges": [{"gross_charge": 5572.0, "discounted_cash": 4179.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCREW CORTX", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136069", "type": "CDM"}], "standard_charges": [{"gross_charge": 936.0, "discounted_cash": 702.0, "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": 662.0, "discounted_cash": 496.5, "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": 784.0, "discounted_cash": 588.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCREW MALLEOLAR", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136108", "type": "CDM"}], "standard_charges": [{"gross_charge": 1473.0, "discounted_cash": 1104.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SCREW SPECIALITY TYPEI", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136266", "type": "CDM"}], "standard_charges": [{"gross_charge": 2238.0, "discounted_cash": 1678.5, "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": 711.0, "discounted_cash": 533.25, "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": 711.0, "discounted_cash": 533.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRN MAMMO+CAD BILAT", "code_information": [{"code": "77067", "type": "CPT"}, {"code": "5120202", "type": "CDM"}, {"code": "403", "type": "RC"}], "standard_charges": [{"gross_charge": 711.0, "discounted_cash": 533.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW BIOABSRB ARTHREX", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8246080", "type": "CDM"}], "standard_charges": [{"gross_charge": 14535.0, "discounted_cash": 10901.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW BIOINTERFER ARTHREX", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8248410", "type": "CDM"}], "standard_charges": [{"gross_charge": 3599.0, "discounted_cash": 2699.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW BIOINTERFER ARTHRX", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8246082", "type": "CDM"}], "standard_charges": [{"gross_charge": 3599.0, "discounted_cash": 2699.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW BN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136005", "type": "CDM"}], "standard_charges": [{"gross_charge": 4111.0, "discounted_cash": 3083.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW BN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136006", "type": "CDM"}], "standard_charges": [{"gross_charge": 7630.0, "discounted_cash": 5722.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW BN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136007", "type": "CDM"}], "standard_charges": [{"gross_charge": 3521.0, "discounted_cash": 2640.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW CANC LCK", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136022", "type": "CDM"}], "standard_charges": [{"gross_charge": 2576.0, "discounted_cash": 1932.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW CANCL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136020", "type": "CDM"}], "standard_charges": [{"gross_charge": 1975.0, "discounted_cash": 1481.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW CANCL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136021", "type": "CDM"}], "standard_charges": [{"gross_charge": 1373.0, "discounted_cash": 1029.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW CANCL V", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136025", "type": "CDM"}], "standard_charges": [{"gross_charge": 1146.0, "discounted_cash": 859.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW CANN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136030", "type": "CDM"}], "standard_charges": [{"gross_charge": 3599.0, "discounted_cash": 2699.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW COMPRESS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136050", "type": "CDM"}], "standard_charges": [{"gross_charge": 2771.0, "discounted_cash": 2078.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW COMPRS/LAG", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136065", "type": "CDM"}], "standard_charges": [{"gross_charge": 6036.0, "discounted_cash": 4527.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW CORTICAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136071", "type": "CDM"}], "standard_charges": [{"gross_charge": 2020.0, "discounted_cash": 1515.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW CORTICAL II", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8135011", "type": "CDM"}], "standard_charges": [{"gross_charge": 2576.0, "discounted_cash": 1932.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW CORTX", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136067", "type": "CDM"}], "standard_charges": [{"gross_charge": 3599.0, "discounted_cash": 2699.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW CORTX", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136068", "type": "CDM"}], "standard_charges": [{"gross_charge": 1301.0, "discounted_cash": 975.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW DISTRACTION", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136076", "type": "CDM"}], "standard_charges": [{"gross_charge": 3599.0, "discounted_cash": 2699.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW E CANCL4.0", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136080", "type": "CDM"}], "standard_charges": [{"gross_charge": 1322.0, "discounted_cash": 991.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW E CANCL6.5", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136085", "type": "CDM"}], "standard_charges": [{"gross_charge": 3398.0, "discounted_cash": 2548.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW E SCHANZ", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136115", "type": "CDM"}], "standard_charges": [{"gross_charge": 2199.0, "discounted_cash": 1649.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW FIXATION", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136140", "type": "CDM"}], "standard_charges": [{"gross_charge": 2119.0, "discounted_cash": 1589.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW HEADLESS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8132806", "type": "CDM"}], "standard_charges": [{"gross_charge": 4434.0, "discounted_cash": 3325.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW HI-TORQUE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136155", "type": "CDM"}], "standard_charges": [{"gross_charge": 536.0, "discounted_cash": 402.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW HIP COMP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136175", "type": "CDM"}], "standard_charges": [{"gross_charge": 2190.0, "discounted_cash": 1642.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW HIP LAG", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136180", "type": "CDM"}], "standard_charges": [{"gross_charge": 3895.0, "discounted_cash": 2921.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW INTERFEREN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8034015", "type": "CDM"}], "standard_charges": [{"gross_charge": 2680.0, "discounted_cash": 2010.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW LCK SLF TAP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136199", "type": "CDM"}], "standard_charges": [{"gross_charge": 2351.0, "discounted_cash": 1763.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW LCK TIT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136194", "type": "CDM"}], "standard_charges": [{"gross_charge": 2576.0, "discounted_cash": 1932.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW LCKNG NONLCKNG MEDACTA CL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4013473", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 523.0, "discounted_cash": 392.25, "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": 542.0, "discounted_cash": 406.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW LOCK NON-LOCK DEPUY CL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4013130", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1130.0, "discounted_cash": 847.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW LOCKING", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136196", "type": "CDM"}], "standard_charges": [{"gross_charge": 2346.0, "discounted_cash": 1759.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW LOCKING CANN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136197", "type": "CDM"}], "standard_charges": [{"gross_charge": 3706.0, "discounted_cash": 2779.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW MANDIBULAR", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8130274", "type": "CDM"}], "standard_charges": [{"gross_charge": 2449.0, "discounted_cash": 1836.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW MAX FACIAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136106", "type": "CDM"}], "standard_charges": [{"gross_charge": 1784.0, "discounted_cash": 1338.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW METAPHYSEAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136203", "type": "CDM"}], "standard_charges": [{"gross_charge": 379.0, "discounted_cash": 284.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW MINI", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136204", "type": "CDM"}], "standard_charges": [{"gross_charge": 5481.0, "discounted_cash": 4110.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW MODULAR CENTRAL FIXATION", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8130273", "type": "CDM"}], "standard_charges": [{"gross_charge": 8992.0, "discounted_cash": 6744.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW MULTIAXIAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136206", "type": "CDM"}], "standard_charges": [{"gross_charge": 1324.0, "discounted_cash": 993.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW NEURO SLF-TAP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136208", "type": "CDM"}], "standard_charges": [{"gross_charge": 1612.0, "discounted_cash": 1209.0, "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": 7164.0, "discounted_cash": 5373.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW SACRAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136225", "type": "CDM"}], "standard_charges": [{"gross_charge": 7358.0, "discounted_cash": 5518.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW SET SPINAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136245", "type": "CDM"}], "standard_charges": [{"gross_charge": 614.0, "discounted_cash": 460.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW SHANK MOD RELINE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8130277", "type": "CDM"}], "standard_charges": [{"gross_charge": 5450.0, "discounted_cash": 4087.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW SPIN BREAK OFF", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136269", "type": "CDM"}], "standard_charges": [{"gross_charge": 708.0, "discounted_cash": 531.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW SPINAL LOCKING RELINE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8130278", "type": "CDM"}], "standard_charges": [{"gross_charge": 654.0, "discounted_cash": 490.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW THR HIP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136275", "type": "CDM"}], "standard_charges": [{"gross_charge": 1210.0, "discounted_cash": 907.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW TIBIAL FIXATION", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136279", "type": "CDM"}], "standard_charges": [{"gross_charge": 5388.0, "discounted_cash": 4041.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW TIT SLF DRILL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136281", "type": "CDM"}], "standard_charges": [{"gross_charge": 1635.0, "discounted_cash": 1226.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW TITAN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136280", "type": "CDM"}], "standard_charges": [{"gross_charge": 3398.0, "discounted_cash": 2548.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SCRW TWIST-OFF", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136291", "type": "CDM"}], "standard_charges": [{"gross_charge": 3931.0, "discounted_cash": 2948.25, "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": 409.0, "discounted_cash": 306.75, "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": 409.0, "discounted_cash": 306.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SED RATE AUTO", "code_information": [{"code": "85652", "type": "CPT"}, {"code": "4105653", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 251.0, "discounted_cash": 188.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SED RATE AUTO", "code_information": [{"code": "85652", "type": "CPT"}, {"code": "4125653", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SED RATE AUTO", "code_information": [{"code": "85652", "type": "CPT"}, {"code": "4175653", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 197.0, "discounted_cash": 147.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SEL DEB 1ST 20CM OR LESS", "code_information": [{"code": "97597", "type": "CPT"}, {"code": "5807597", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 411.0, "discounted_cash": 308.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "SEL DEB 1ST 20CM OR LESS", "code_information": [{"code": "97597", "type": "CPT"}, {"code": "6107597", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 411.0, "discounted_cash": 308.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SEL DEB 1ST 20CM OR LESS", "code_information": [{"code": "97597", "type": "CPT"}, {"code": "6907597", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 411.0, "discounted_cash": 308.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SEL DEB EAADD UPTO 20CM", "code_information": [{"code": "97598", "type": "CPT"}, {"code": "6907598", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 392.0, "discounted_cash": 294.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SEL DEB EAADD UPTP 20CM", "code_information": [{"code": "97598", "type": "CPT"}, {"code": "5807598", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 392.0, "discounted_cash": 294.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GO"}, {"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": 94.0, "discounted_cash": 70.5, "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": 94.0, "discounted_cash": 70.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SELENIUM", "code_information": [{"code": "84255", "type": "CPT"}, {"code": "7004255", "type": "CDM"}], "standard_charges": [{"gross_charge": 498.0, "discounted_cash": 373.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SELENIUM", "code_information": [{"code": "84255", "type": "CPT"}, {"code": "7254255", "type": "CDM"}], "standard_charges": [{"gross_charge": 497.0, "discounted_cash": 372.75, "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": 363.0, "discounted_cash": 272.25, "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": 363.0, "discounted_cash": 272.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SELENUM SU SHMP1%210MLLT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337245", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SELENUM SU SHMP1%210MLLT", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337245", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SEMEN ANALY PST COITAL", "code_information": [{"code": "89300", "type": "CPT"}, {"code": "4109301", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 226.0, "discounted_cash": 169.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SEMEN ANALY PST COITAL", "code_information": [{"code": "89300", "type": "CPT"}, {"code": "4179301", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 178.0, "discounted_cash": 133.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SEMEN ANALYSIS PST VAS", "code_information": [{"code": "89321", "type": "CPT"}, {"code": "4109300", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 192.0, "discounted_cash": 144.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SEMEN ANALYSIS PST VAS", "code_information": [{"code": "89321", "type": "CPT"}, {"code": "4179300", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 151.0, "discounted_cash": 113.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SEMEN MOTILITY & COUNT", "code_information": [{"code": "89310", "type": "CPT"}, {"code": "4109310", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 391.0, "discounted_cash": 293.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SEMI-PRIVATE PSYCHIATRIC", "code_information": [{"code": "1990039", "type": "CDM"}, {"code": "124", "type": "RC"}], "standard_charges": [{"gross_charge": 5909.0, "discounted_cash": 4431.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SEMI-PRIVATE PSYCHIATRIC", "code_information": [{"code": "2120039", "type": "CDM"}, {"code": "124", "type": "RC"}], "standard_charges": [{"gross_charge": 5909.0, "discounted_cash": 4431.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SEMI-PRIVATE PSYCHIATRIC", "code_information": [{"code": "2450039", "type": "CDM"}, {"code": "124", "type": "RC"}], "standard_charges": [{"gross_charge": 5909.0, "discounted_cash": 4431.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SENNA 218/5 10ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316288", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SENNA 218/5 10ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316288", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SENNA 8.8MG/5ML 10ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316291", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SENNA 8.8MG/5ML 10ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316291", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "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": 108.0, "discounted_cash": 81.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SENSITIVITY ANTBDY AGAR", "code_information": [{"code": "87181", "type": "CPT"}, {"code": "4177181", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "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": 226.0, "discounted_cash": 169.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SENSITV 12 DISKS OR LESS", "code_information": [{"code": "87184", "type": "CPT"}, {"code": "4177184", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 178.0, "discounted_cash": 133.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SEPARATOR INDIGO", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8177024", "type": "CDM"}], "standard_charges": [{"gross_charge": 6148.0, "discounted_cash": 4611.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SEROTONIN", "code_information": [{"code": "84260", "type": "CPT"}, {"code": "7004260", "type": "CDM"}], "standard_charges": [{"gross_charge": 558.0, "discounted_cash": 418.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SEROTONIN", "code_information": [{"code": "84260", "type": "CPT"}, {"code": "7254260", "type": "CDM"}], "standard_charges": [{"gross_charge": 425.0, "discounted_cash": 318.75, "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": 269.0, "discounted_cash": 201.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 269.0, "discounted_cash": 201.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 347.0, "discounted_cash": 260.25, "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": 347.0, "discounted_cash": 260.25, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 53.0, "discounted_cash": 39.75, "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": 53.0, "discounted_cash": 39.75, "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": 13.0, "discounted_cash": 9.75, "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": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SEVELAMER 403MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310762", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 106.0, "discounted_cash": 79.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SEVELAMER 403MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310762", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 106.0, "discounted_cash": 79.5, "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": 113.0, "discounted_cash": 84.75, "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": 113.0, "discounted_cash": 84.75, "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": 21.0, "discounted_cash": 15.75, "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": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SEX HORMONE BIND GLOBULN", "code_information": [{"code": "84270", "type": "CPT"}, {"code": "7254270", "type": "CDM"}], "standard_charges": [{"gross_charge": 251.0, "discounted_cash": 188.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SHEATH CLOTTRIEVER", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8177028", "type": "CDM"}], "standard_charges": [{"gross_charge": 2175.0, "discounted_cash": 1631.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SHEATH STEERABLE TOURGUIDE", "code_information": [{"code": "C1766", "type": "HCPCS"}, {"code": "8177128", "type": "CDM"}], "standard_charges": [{"gross_charge": 2370.0, "discounted_cash": 1777.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SHEATH URETERAL ACCESS", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8041028", "type": "CDM"}], "standard_charges": [{"gross_charge": 2309.0, "discounted_cash": 1731.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SHIGA-TOXIN IA", "code_information": [{"code": "87427", "type": "CPT"}, {"code": "4106634", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 255.0, "discounted_cash": 191.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SHIGA-TOXIN IA", "code_information": [{"code": "87427", "type": "CPT"}, {"code": "4176634", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 201.0, "discounted_cash": 150.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SHNT CAROTD BYP", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8177065", "type": "CDM"}], "standard_charges": [{"gross_charge": 2808.0, "discounted_cash": 2106.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SHNT CAROTID", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8145010", "type": "CDM"}], "standard_charges": [{"gross_charge": 719.0, "discounted_cash": 539.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SHNT CAROTID", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8177140", "type": "CDM"}], "standard_charges": [{"gross_charge": 3417.0, "discounted_cash": 2562.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SHNT CATH LUMPR", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8145030", "type": "CDM"}], "standard_charges": [{"gross_charge": 3497.0, "discounted_cash": 2622.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SHNT CONN NEURO", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8145070", "type": "CDM"}], "standard_charges": [{"gross_charge": 1040.0, "discounted_cash": 780.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SHNT CORONARY", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8145086", "type": "CDM"}], "standard_charges": [{"gross_charge": 881.0, "discounted_cash": 660.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SHNT VENTRICULR", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8176075", "type": "CDM"}], "standard_charges": [{"gross_charge": 13660.0, "discounted_cash": 10245.0, "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": 1507.0, "discounted_cash": 1130.25, "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": 1507.0, "discounted_cash": 1130.25, "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": 1507.0, "discounted_cash": 1130.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SHOULDER 2 VWS MINIMUM", "code_information": [{"code": "73030", "type": "CPT"}, {"code": "5123030", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1507.0, "discounted_cash": 1130.25, "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": 2054.0, "discounted_cash": 1540.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SHOULDER ARTHROGRAPHY", "code_information": [{"code": "73040", "type": "CPT"}, {"code": "4913040", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2054.0, "discounted_cash": 1540.5, "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": 848.0, "discounted_cash": 636.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SHOULDER SINGLE VIEW", "code_information": [{"code": "73020", "type": "CPT"}, {"code": "5123020", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1071.0, "discounted_cash": 803.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SHTH AMPLATZ", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8177101", "type": "CDM"}], "standard_charges": [{"gross_charge": 3827.0, "discounted_cash": 2870.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SHTH DILATOR VISISHEATH", "code_information": [{"code": "C1893", "type": "HCPCS"}, {"code": "8177131", "type": "CDM"}], "standard_charges": [{"gross_charge": 1365.0, "discounted_cash": 1023.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SHTH DILATR MECHAN ROTAT", "code_information": [{"code": "C1773", "type": "HCPCS"}, {"code": "8177104", "type": "CDM"}], "standard_charges": [{"gross_charge": 9931.0, "discounted_cash": 7448.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SHTH FEM ACCES RE-COLLPS", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8177132", "type": "CDM"}], "standard_charges": [{"gross_charge": 10312.0, "discounted_cash": 7734.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SHTH GUIDE BI-DIRECTNL", "code_information": [{"code": "C1766", "type": "HCPCS"}, {"code": "8073256", "type": "CDM"}], "standard_charges": [{"gross_charge": 10351.0, "discounted_cash": 7763.25, "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": 6057.0, "discounted_cash": 4542.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SHTH GUIDING ANSEL", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8073257", "type": "CDM"}], "standard_charges": [{"gross_charge": 2020.0, "discounted_cash": 1515.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SHTH GUIDING DESTINATION", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8178597", "type": "CDM"}], "standard_charges": [{"gross_charge": 2616.0, "discounted_cash": 1962.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SHTH INTRO SLENDER KIT", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8177133", "type": "CDM"}], "standard_charges": [{"gross_charge": 716.0, "discounted_cash": 537.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SHTH INTROD PERITONEAL", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8073263", "type": "CDM"}], "standard_charges": [{"gross_charge": 1601.0, "discounted_cash": 1200.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SHTH INTRODUCER DRYSEAL", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8177108", "type": "CDM"}], "standard_charges": [{"gross_charge": 4747.0, "discounted_cash": 3560.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SHTH INTRODUCER MICRA", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8177115", "type": "CDM"}], "standard_charges": [{"gross_charge": 3634.0, "discounted_cash": 2725.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SHTH INTRODUCER SENTRANT", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8177106", "type": "CDM"}], "standard_charges": [{"gross_charge": 775.0, "discounted_cash": 581.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SHTH NEUROVASC AXS INFINITY LS", "code_information": [{"code": "C1766", "type": "HCPCS"}, {"code": "8177116", "type": "CDM"}], "standard_charges": [{"gross_charge": 3056.0, "discounted_cash": 2292.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SHTH STEERABLE FARADRIVE", "code_information": [{"code": "C1766", "type": "HCPCS"}, {"code": "8178590", "type": "CDM"}], "standard_charges": [{"gross_charge": 3815.0, "discounted_cash": 2861.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SHTH STEERBL INTRAVASCLR", "code_information": [{"code": "C1766", "type": "HCPCS"}, {"code": "8177126", "type": "CDM"}], "standard_charges": [{"gross_charge": 6602.0, "discounted_cash": 4951.5, "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": 1006.0, "discounted_cash": 754.5, "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": 1006.0, "discounted_cash": 754.5, "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": 211.0, "discounted_cash": 158.25, "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": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SICKLING OF RBC", "code_information": [{"code": "85660", "type": "CPT"}, {"code": "4173052", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 30.0, "discounted_cash": 22.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SICKLING OF RBC", "code_information": [{"code": "85660", "type": "CPT"}, {"code": "7255660", "type": "CDM"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "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": 367.0, "discounted_cash": 275.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 367.0, "discounted_cash": 275.25, "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": 171.0, "discounted_cash": 128.25, "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": 171.0, "discounted_cash": 128.25, "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": 384.0, "discounted_cash": 288.0, "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": 384.0, "discounted_cash": 288.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SILODOSIN 4MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310780", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SILODOSIN 4MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310780", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SILODOSIN 8MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310779", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SILODOSIN 8MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310779", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "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": 13.0, "discounted_cash": 9.75, "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": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SILVER SALINE WND45GM GL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5337267", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 371.0, "discounted_cash": 278.25, "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": 174.0, "discounted_cash": 130.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 174.0, "discounted_cash": 130.5, "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": 16.0, "discounted_cash": 12.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "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": 621.0, "discounted_cash": 465.75, "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": 621.0, "discounted_cash": 465.75, "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": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SIMETHICONE 40MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5310775", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SIMETHICONE 40MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5310775", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SIMETHICONE 80MG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5310783", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": 3.0, "discounted_cash": 2.25, "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": 3.0, "discounted_cash": 2.25, "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": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SIMVASTATIN 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310791", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SIMVASTATIN 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310792", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SIMVASTATIN 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310792", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SIMVASTATIN 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310793", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 45.0, "discounted_cash": 33.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 45.0, "discounted_cash": 33.75, "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": 19.0, "discounted_cash": 14.25, "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": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SINCALIDE 5MCG", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2805", "type": "HCPCS"}, {"code": "5358290", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1070.0, "discounted_cash": 802.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SINCALIDE 5MCG", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2805", "type": "HCPCS"}, {"code": "5358290", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 1070.0, "discounted_cash": 802.5, "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": 651.0, "discounted_cash": 488.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SINUSES 2VW MAX", "code_information": [{"code": "70210", "type": "CPT"}, {"code": "5120210", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 651.0, "discounted_cash": 488.25, "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": 1698.0, "discounted_cash": 1273.5, "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": 1698.0, "discounted_cash": 1273.5, "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": 1698.0, "discounted_cash": 1273.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SINUSES 3VW MIN", "code_information": [{"code": "70220", "type": "CPT"}, {"code": "5120221", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1698.0, "discounted_cash": 1273.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SIROLIMUS", "code_information": [{"code": "80195", "type": "CPT"}, {"code": "7000254", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 665.0, "discounted_cash": 498.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SIROLIMUS", "code_information": [{"code": "80195", "type": "CPT"}, {"code": "7250254", "type": "CDM"}], "standard_charges": [{"gross_charge": 385.0, "discounted_cash": 288.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 282.0, "discounted_cash": 211.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SIROLIMUS PER 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7520", "type": "HCPCS"}, {"code": "5310800", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 282.0, "discounted_cash": 211.5, "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": 49.0, "discounted_cash": 36.75, "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": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SITAGLIPTIN 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310795", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SITAGLIPTIN 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310795", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "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": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SITAGLIPTIN 50MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310797", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 62.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SKELETAL MUSC RELXNT 1-2", "code_information": [{"code": "80369", "type": "CPT"}, {"code": "7053805", "type": "CDM"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "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": 1458.0, "discounted_cash": 1093.5, "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": 1458.0, "discounted_cash": 1093.5, "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": 1458.0, "discounted_cash": 1093.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SKULL 4VW MIN", "code_information": [{"code": "70260", "type": "CPT"}, {"code": "5120260", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1458.0, "discounted_cash": 1093.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SKULL < 4 VIEWS", "code_information": [{"code": "70250", "type": "CPT"}, {"code": "4900250", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1574.0, "discounted_cash": 1180.5, "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": 1226.0, "discounted_cash": 919.5, "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": 1539.0, "discounted_cash": 1154.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SKULL < 4 VIEWS", "code_information": [{"code": "70250", "type": "CPT"}, {"code": "5120250", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1226.0, "discounted_cash": 919.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SLING ARM FASHON", "code_information": [{"code": "A4565", "type": "HCPCS"}, {"code": "8114445", "type": "CDM"}], "standard_charges": [{"gross_charge": 448.0, "discounted_cash": 336.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SLING URETH ALIGN TO", "code_information": [{"code": "C1771", "type": "HCPCS"}, {"code": "4024701", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11489.0, "discounted_cash": 8616.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SLING URETH STRATASIS 20", "code_information": [{"code": "C1763", "type": "HCPCS"}, {"code": "8243060", "type": "CDM"}], "standard_charges": [{"gross_charge": 12425.0, "discounted_cash": 9318.75, "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": 277.0, "discounted_cash": 207.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SLNG URETH SUPPORT", "code_information": [{"code": "C1771", "type": "HCPCS"}, {"code": "4024700", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 15866.0, "discounted_cash": 11899.5, "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": 1574.0, "discounted_cash": 1180.5, "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": 1574.0, "discounted_cash": 1180.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SM INT IMAGE CAP PROC", "code_information": [{"code": "91110", "type": "CPT"}, {"code": "5070262", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 5027.0, "discounted_cash": 3770.25, "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": 349.0, "discounted_cash": 261.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SMEAR FLUORESCENT/AFS", "code_information": [{"code": "87206", "type": "CPT"}, {"code": "4177201", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 274.0, "discounted_cash": 205.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SMEAR FLUORESCENT/AFS/3", "code_information": [{"code": "87206", "type": "CPT"}, {"code": "4177213", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 150.0, "discounted_cash": 112.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SMEAR FLUORESCENT/AFS/3", "code_information": [{"code": "87206", "type": "CPT"}, {"code": "7257210", "type": "CDM"}], "standard_charges": [{"gross_charge": 191.0, "discounted_cash": 143.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SMEAR FLUORESCENT/AFS/4", "code_information": [{"code": "87206", "type": "CPT"}, {"code": "4177214", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 59.0, "discounted_cash": 44.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SMEAR FLUORESCENT/AFS/4", "code_information": [{"code": "87206", "type": "CPT"}, {"code": "7257211", "type": "CDM"}], "standard_charges": [{"gross_charge": 75.0, "discounted_cash": 56.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SMEAR SALINE/INK/KOH", "code_information": [{"code": "87210", "type": "CPT"}, {"code": "4107215", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 241.0, "discounted_cash": 180.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SMEAR SALINE/INK/KOH", "code_information": [{"code": "87210", "type": "CPT"}, {"code": "4177215", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 190.0, "discounted_cash": 142.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SMEAR SALINE/INK/KOH/2", "code_information": [{"code": "87210", "type": "CPT"}, {"code": "4107220", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 208.0, "discounted_cash": 156.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SMEAR SALINE/INK/KOH/2", "code_information": [{"code": "87210", "type": "CPT"}, {"code": "4177220", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 164.0, "discounted_cash": 123.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SMEAR SALINE/INK/KOH/3", "code_information": [{"code": "87210", "type": "CPT"}, {"code": "4177210", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 189.0, "discounted_cash": 141.75, "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": 261.0, "discounted_cash": 195.75, "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": 160.0, "discounted_cash": 120.0, "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": 172.0, "discounted_cash": 129.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SMOOTH MUSCLE AB", "code_information": [{"code": "86015", "type": "CPT"}, {"code": "7006379", "type": "CDM"}], "standard_charges": [{"gross_charge": 171.0, "discounted_cash": 128.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SMX-TMP 200-40/5 10MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316394", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SMX-TMP 200-40/5 10MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316394", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SMX-TMP 200-40/5 20MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314855", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SMX-TMP 200-40/5 20MLLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314855", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 26.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "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": 14.0, "discounted_cash": 10.5, "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": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SMX-TMP 800/160MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311092", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SMX-TMP PED DOSE LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314856", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SMX-TMP PED DOSE LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5314856", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SNARE POLYPECTOMY", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8082691", "type": "CDM"}], "standard_charges": [{"gross_charge": 1504.0, "discounted_cash": 1128.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 67.5, "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": 90.0, "discounted_cash": 67.5, "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": 90.0, "discounted_cash": 67.5, "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": 90.0, "discounted_cash": 67.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 49.0, "discounted_cash": 36.75, "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": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SODIUM", "code_information": [{"code": "84295", "type": "CPT"}, {"code": "4174295", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SODIUM OTHER SOURCE/3", "code_information": [{"code": "84302", "type": "CPT"}, {"code": "7254302", "type": "CDM"}], "standard_charges": [{"gross_charge": 142.0, "discounted_cash": 106.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SODIUM TETRADECYL3%2MLIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5324290", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 232.0, "discounted_cash": 174.0, "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": 360.0, "discounted_cash": 270.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SODIUM URINE", "code_information": [{"code": "84300", "type": "CPT"}, {"code": "4174296", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 283.0, "discounted_cash": 212.25, "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": 268.0, "discounted_cash": 201.0, "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": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SODIUM URINE/2", "code_information": [{"code": "84300", "type": "CPT"}, {"code": "4174300", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 211.0, "discounted_cash": 158.25, "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": 320.0, "discounted_cash": 240.0, "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": 320.0, "discounted_cash": 240.0, "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": 34.0, "discounted_cash": 25.5, "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": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SOMATOMEDIN", "code_information": [{"code": "84305", "type": "CPT"}, {"code": "7253543", "type": "CDM"}], "standard_charges": [{"gross_charge": 594.0, "discounted_cash": 445.5, "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": "SORBITOL 70% 30ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316373", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SORBITOL 70% 30ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316373", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "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": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "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": 16.0, "discounted_cash": 12.0, "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": 16.0, "discounted_cash": 12.0, "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": 8720.0, "discounted_cash": 6540.0, "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": 9810.0, "discounted_cash": 7357.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SP ANT CERVICAL PLT L3", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011216", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10355.0, "discounted_cash": 7766.25, "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": 807.0, "discounted_cash": 605.25, "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": 39286.0, "discounted_cash": 29464.5, "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": 8369.0, "discounted_cash": 6276.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SP BN GRFT EXT SYNTHETIC", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011204", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11390.0, "discounted_cash": 8542.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SP BUTTRESS SCREW", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011254", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4360.0, "discounted_cash": 3270.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SP CERV INTERBODY DEV", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011206", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8992.0, "discounted_cash": 6744.0, "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": 23435.0, "discounted_cash": 17576.25, "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": 1362.0, "discounted_cash": 1021.5, "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": 4360.0, "discounted_cash": 3270.0, "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": 838.0, "discounted_cash": 628.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP EVAL BEH QUAL A V/RS CMPLX", "code_information": [{"code": "92524", "type": "CPT"}, {"code": "5900531", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 687.0, "discounted_cash": 515.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP EVAL BEH QUAL A V/RS EXTNSV", "code_information": [{"code": "92524", "type": "CPT"}, {"code": "5900532", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 996.0, "discounted_cash": 747.0, "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": 1218.0, "discounted_cash": 913.5, "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": 996.0, "discounted_cash": 747.0, "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": 911.0, "discounted_cash": 683.25, "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": 1141.0, "discounted_cash": 855.75, "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": 933.0, "discounted_cash": 699.75, "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": 1142.0, "discounted_cash": 856.5, "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": 639.0, "discounted_cash": 479.25, "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": 838.0, "discounted_cash": 628.5, "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": 679.0, "discounted_cash": 509.25, "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": 43600.0, "discounted_cash": 32700.0, "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": 870.0, "discounted_cash": 652.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP IBF BN ALLOGRAFT CERV", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011222", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8720.0, "discounted_cash": 6540.0, "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": 26705.0, "discounted_cash": 20028.75, "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": 1570.0, "discounted_cash": 1177.5, "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": 1570.0, "discounted_cash": 1177.5, "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": 1570.0, "discounted_cash": 1177.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SP LUMBAR MIN 6 VWS", "code_information": [{"code": "72114", "type": "CPT"}, {"code": "5122114", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1570.0, "discounted_cash": 1177.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SP MANUAL THERAPY EA 15M", "code_information": [{"code": "97140", "type": "CPT"}, {"code": "5902411", "type": "CDM"}, {"code": "440", "type": "RC"}], "standard_charges": [{"gross_charge": 533.0, "discounted_cash": 399.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP PEDICLE SCREW ADV", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4011229", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 8720.0, "discounted_cash": 6540.0, "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": 7358.0, "discounted_cash": 5518.5, "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": 1908.0, "discounted_cash": 1431.0, "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": 1853.0, "discounted_cash": 1389.75, "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": 6813.0, "discounted_cash": 5109.75, "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": 327.0, "discounted_cash": 245.25, "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": 841.0, "discounted_cash": 630.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP SWAL EVAL ORAL PHARYN EXTNS", "code_information": [{"code": "92610", "type": "CPT"}, {"code": "5902630", "type": "CDM"}, {"code": "444", "type": "RC"}], "standard_charges": [{"gross_charge": 1780.0, "discounted_cash": 1335.0, "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": 409.0, "discounted_cash": 306.75, "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": 190.0, "discounted_cash": 142.5, "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": 762.0, "discounted_cash": 571.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP SWAL/ORAL TX EXTENSIVE", "code_information": [{"code": "92526", "type": "CPT"}, {"code": "5901096", "type": "CDM"}, {"code": "440", "type": "RC"}], "standard_charges": [{"gross_charge": 896.0, "discounted_cash": 672.0, "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": 332.0, "discounted_cash": 249.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SP THERAPEUTIC SP DEV BASIC", "code_information": [{"code": "92609", "type": "CPT"}, {"code": "5902609", "type": "CDM"}, {"code": "440", "type": "RC"}], "standard_charges": [{"gross_charge": 497.0, "discounted_cash": 372.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SPACER FEMORAL MOLD", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137895", "type": "CDM"}], "standard_charges": [{"gross_charge": 13080.0, "discounted_cash": 9810.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SPACER HUMERAL TRAY DEPUY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013125", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 4446.0, "discounted_cash": 3334.5, "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": 15260.0, "discounted_cash": 11445.0, "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": 46870.0, "discounted_cash": 35152.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SPACER TIBIAL MOLD", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137894", "type": "CDM"}], "standard_charges": [{"gross_charge": 12787.0, "discounted_cash": 9590.25, "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": 3879.0, "discounted_cash": 2909.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPEC PROC EA ADDL 15 MIN", "code_information": [{"code": "3221015", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 959.0, "discounted_cash": 719.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPEC PROC INIT 30 MIN", "code_information": [{"code": "3221000", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2226.0, "discounted_cash": 1669.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SPEC PROC W/LITHO", "code_information": [{"code": "3083010", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 15378.0, "discounted_cash": 11533.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SPEC STAIN TRICH OVA/PARA", "code_information": [{"code": "87209", "type": "CPT"}, {"code": "4177209", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 15.0, "discounted_cash": 11.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPEC STAIN TRICH OVA/PARA", "code_information": [{"code": "87209", "type": "CPT"}, {"code": "7008313", "type": "CDM"}], "standard_charges": [{"gross_charge": 45.0, "discounted_cash": 33.75, "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": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPEC STAINS GROUP I", "code_information": [{"code": "88312", "type": "CPT"}, {"code": "4170035", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 389.0, "discounted_cash": 291.75, "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": 495.0, "discounted_cash": 371.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPEC STAINS GROUP I", "code_information": [{"code": "88312", "type": "CPT"}, {"code": "7078312", "type": "CDM"}], "standard_charges": [{"gross_charge": 337.0, "discounted_cash": 252.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SPEC STAINS GROUP I", "code_information": [{"code": "88312", "type": "CPT"}, {"code": "7098330", "type": "CDM"}], "standard_charges": [{"gross_charge": 243.0, "discounted_cash": 182.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPEC STAINS GROUP II", "code_information": [{"code": "88313", "type": "CPT"}, {"code": "4170036", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 359.0, "discounted_cash": 269.25, "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": 457.0, "discounted_cash": 342.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SPEC STAINS GROUP II", "code_information": [{"code": "88313", "type": "CPT"}, {"code": "7078333", "type": "CDM"}], "standard_charges": [{"gross_charge": 267.0, "discounted_cash": 200.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPEC STAINS GROUP II", "code_information": [{"code": "88313", "type": "CPT"}, {"code": "7098301", "type": "CDM"}], "standard_charges": [{"gross_charge": 275.0, "discounted_cash": 206.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPEC STAINS GROUP II/2", "code_information": [{"code": "88313", "type": "CPT"}, {"code": "7018301", "type": "CDM"}], "standard_charges": [{"gross_charge": 516.0, "discounted_cash": 387.0, "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": 2633.0, "discounted_cash": 1974.75, "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": 611.0, "discounted_cash": 458.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPECIAL STAIN ID ENZYM", "code_information": [{"code": "88319", "type": "CPT"}, {"code": "7098319", "type": "CDM"}], "standard_charges": [{"gross_charge": 3858.0, "discounted_cash": 2893.5, "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": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPECIAL STAIN SMEAR", "code_information": [{"code": "87207", "type": "CPT"}, {"code": "4177202", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 136.0, "discounted_cash": 102.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SPECIAL STAIN SMEAR", "code_information": [{"code": "87207", "type": "CPT"}, {"code": "7007202", "type": "CDM"}], "standard_charges": [{"gross_charge": 190.0, "discounted_cash": 142.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SPECIAL STAIN SMEAR", "code_information": [{"code": "87207", "type": "CPT"}, {"code": "7257207", "type": "CDM"}], "standard_charges": [{"gross_charge": 173.0, "discounted_cash": 129.75, "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": 473.0, "discounted_cash": 354.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SPECIMEN HANDLING/4", "code_information": [{"code": "99001", "type": "CPT"}, {"code": "4201125", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SPEECH/LANG TX BASIC", "code_information": [{"code": "92507", "type": "CPT"}, {"code": "5901007", "type": "CDM"}, {"code": "440", "type": "RC"}], "standard_charges": [{"gross_charge": 173.0, "discounted_cash": 129.75, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "SPEECH/LANG TX CMPLX", "code_information": [{"code": "92507", "type": "CPT"}, {"code": "5901009", "type": "CDM"}, {"code": "440", "type": "RC"}], "standard_charges": [{"gross_charge": 451.0, "discounted_cash": 338.25, "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": 692.0, "discounted_cash": 519.0, "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": 213.0, "discounted_cash": 159.75, "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": 1607.0, "discounted_cash": 1205.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINAL CAGE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136504", "type": "CDM"}], "standard_charges": [{"gross_charge": 13120.0, "discounted_cash": 9840.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINAL PUNCT LUMB DX WFLUOR/CT", "code_information": [{"code": "4902321", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3739.0, "discounted_cash": 2804.25, "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": 3739.0, "discounted_cash": 2804.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINAL PUNCTR LUMB DIAG", "code_information": [{"code": "4908900", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2655.0, "discounted_cash": 1991.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINAL PUNCTR LUMB DIAG", "code_information": [{"code": "4918900", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2390.0, "discounted_cash": 1792.5, "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": 829.0, "discounted_cash": 621.75, "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": 829.0, "discounted_cash": 621.75, "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": 829.0, "discounted_cash": 621.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE ANY LEVEL SNGL VW", "code_information": [{"code": "72020", "type": "CPT"}, {"code": "5122020", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 829.0, "discounted_cash": 621.75, "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": 1841.0, "discounted_cash": 1380.75, "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": 1841.0, "discounted_cash": 1380.75, "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": 1841.0, "discounted_cash": 1380.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE CERV 6 > VWS", "code_information": [{"code": "72052", "type": "CPT"}, {"code": "5122052", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1841.0, "discounted_cash": 1380.75, "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": 1444.0, "discounted_cash": 1083.0, "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": 1448.0, "discounted_cash": 1086.0, "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": 1444.0, "discounted_cash": 1083.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE CERVICAL 2 VIEWS", "code_information": [{"code": "72040", "type": "CPT"}, {"code": "5122040", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1444.0, "discounted_cash": 1083.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE CERVICAL 3 VIEWS", "code_information": [{"code": "72040", "type": "CPT"}, {"code": "4902042", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1383.0, "discounted_cash": 1037.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE CERVICAL 3 VIEWS", "code_information": [{"code": "72040", "type": "CPT"}, {"code": "5012042", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1366.0, "discounted_cash": 1024.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE CERVICAL 3 VIEWS", "code_information": [{"code": "72040", "type": "CPT"}, {"code": "5112041", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1366.0, "discounted_cash": 1024.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE CERVICAL 3 VIEWS", "code_information": [{"code": "72040", "type": "CPT"}, {"code": "5122041", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1383.0, "discounted_cash": 1037.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE CERVICAL 4 OR 5 VW", "code_information": [{"code": "72050", "type": "CPT"}, {"code": "4902050", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2230.0, "discounted_cash": 1672.5, "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": 2230.0, "discounted_cash": 1672.5, "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": 2230.0, "discounted_cash": 1672.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE CERVICAL 4 OR 5 VW", "code_information": [{"code": "72050", "type": "CPT"}, {"code": "5122050", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2230.0, "discounted_cash": 1672.5, "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": 1732.0, "discounted_cash": 1299.0, "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": 1732.0, "discounted_cash": 1299.0, "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": 1732.0, "discounted_cash": 1299.0, "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": 1732.0, "discounted_cash": 1299.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE LUMBAR 3 VIEWS", "code_information": [{"code": "72100", "type": "CPT"}, {"code": "5122100", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1732.0, "discounted_cash": 1299.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE LUMBAR MIN 4VWS", "code_information": [{"code": "72110", "type": "CPT"}, {"code": "4902110", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1328.0, "discounted_cash": 996.0, "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": 1328.0, "discounted_cash": 996.0, "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": 1328.0, "discounted_cash": 996.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE LUMBAR MIN 4VWS", "code_information": [{"code": "72110", "type": "CPT"}, {"code": "5122110", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1328.0, "discounted_cash": 996.0, "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": 3829.0, "discounted_cash": 2871.75, "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": 1530.0, "discounted_cash": 1147.5, "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": 1530.0, "discounted_cash": 1147.5, "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": 1530.0, "discounted_cash": 1147.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE THORACIC 2 VIEWS", "code_information": [{"code": "72070", "type": "CPT"}, {"code": "5122070", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1530.0, "discounted_cash": 1147.5, "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": 906.0, "discounted_cash": 679.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE THORACIC 4VW MIN", "code_information": [{"code": "72074", "type": "CPT"}, {"code": "5122074", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 906.0, "discounted_cash": 679.5, "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": 1161.0, "discounted_cash": 870.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE THORACO-LUMBAR JCT", "code_information": [{"code": "72080", "type": "CPT"}, {"code": "5112080", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1161.0, "discounted_cash": 870.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE THORACO-LUMBAR JCT", "code_information": [{"code": "72080", "type": "CPT"}, {"code": "5122080", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1161.0, "discounted_cash": 870.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE THORACOLMBR 1 VW", "code_information": [{"code": "72081", "type": "CPT"}, {"code": "4902081", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2315.0, "discounted_cash": 1736.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE THORACOLMBR 1 VW", "code_information": [{"code": "72081", "type": "CPT"}, {"code": "5012081", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2315.0, "discounted_cash": 1736.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE THORACOLMBR 1 VW", "code_information": [{"code": "72081", "type": "CPT"}, {"code": "5122081", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2315.0, "discounted_cash": 1736.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE THORACOLMBR 2-3VW", "code_information": [{"code": "72082", "type": "CPT"}, {"code": "4902082", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2330.0, "discounted_cash": 1747.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE THORACOLMBR 2-3VW", "code_information": [{"code": "72082", "type": "CPT"}, {"code": "5012082", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2330.0, "discounted_cash": 1747.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE THORACOLMBR 2-3VW", "code_information": [{"code": "72082", "type": "CPT"}, {"code": "5112082", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2330.0, "discounted_cash": 1747.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE THORACOLMBR 2-3VW", "code_information": [{"code": "72082", "type": "CPT"}, {"code": "5122082", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2330.0, "discounted_cash": 1747.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE THORACOLMBR 4-5VWS", "code_information": [{"code": "72083", "type": "CPT"}, {"code": "4902083", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2330.0, "discounted_cash": 1747.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE THORACOLMBR 4-5VWS", "code_information": [{"code": "72083", "type": "CPT"}, {"code": "5012083", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2330.0, "discounted_cash": 1747.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE THORACOLMBR 4-5VWS", "code_information": [{"code": "72083", "type": "CPT"}, {"code": "5112083", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2330.0, "discounted_cash": 1747.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE THORACOLMBR 4-5VWS", "code_information": [{"code": "72083", "type": "CPT"}, {"code": "5122083", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2330.0, "discounted_cash": 1747.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE THORACOLMBR 6VWS", "code_information": [{"code": "72084", "type": "CPT"}, {"code": "4902084", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2425.0, "discounted_cash": 1818.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE THORACOLMBR 6VWS", "code_information": [{"code": "72084", "type": "CPT"}, {"code": "5012084", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2425.0, "discounted_cash": 1818.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE THORACOLMBR 6VWS", "code_information": [{"code": "72084", "type": "CPT"}, {"code": "5112084", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2425.0, "discounted_cash": 1818.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SPINE THORACOLMBR 6VWS", "code_information": [{"code": "72084", "type": "CPT"}, {"code": "5122084", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2425.0, "discounted_cash": 1818.75, "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": 1142.0, "discounted_cash": 856.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SPIRONOLAC-HCTZ 25/25 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310902", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SPIRONOLAC-HCTZ 25/25 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310902", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "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": 76.0, "discounted_cash": 57.0, "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": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SPIRONOLACTONE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5310910", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SPLITTING BLD PROD EA UT", "code_information": [{"code": "86985", "type": "CPT"}, {"code": "4206985", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 349.0, "discounted_cash": 261.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SPONGE BLOCK CANCELLOUS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136608", "type": "CDM"}], "standard_charges": [{"gross_charge": 7126.0, "discounted_cash": 5344.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SPONGE COMPRESSABLE ALL SZS", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136606", "type": "CDM"}], "standard_charges": [{"gross_charge": 20142.0, "discounted_cash": 15106.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SPOOL HUMERAL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8137900", "type": "CDM"}], "standard_charges": [{"gross_charge": 20275.0, "discounted_cash": 15206.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SPUTUM INDUCTION", "code_information": [{"code": "94640", "type": "CPT"}, {"code": "5500223", "type": "CDM"}, {"code": "410", "type": "RC"}], "standard_charges": [{"gross_charge": 1652.0, "discounted_cash": 1239.0, "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": 11251.0, "discounted_cash": 8438.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ST ACCESS LIVER TRNSJUG", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8034187", "type": "CDM"}], "standard_charges": [{"gross_charge": 3985.0, "discounted_cash": 2988.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ST AFFIXUS LONG", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8177198", "type": "CDM"}], "standard_charges": [{"gross_charge": 38675.0, "discounted_cash": 29006.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ST AFFIXUS SHORT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8177199", "type": "CDM"}], "standard_charges": [{"gross_charge": 27381.0, "discounted_cash": 20535.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ST CAREGIVER TRNG 1ST 30 MIN", "code_information": [{"code": "97550", "type": "CPT"}, {"code": "5901003", "type": "CDM"}, {"code": "440", "type": "RC"}], "standard_charges": [{"gross_charge": 295.0, "discounted_cash": 221.25, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "ST CAREGIVER TRNG ADD 15 MIN", "code_information": [{"code": "97551", "type": "CPT"}, {"code": "5900025", "type": "CDM"}, {"code": "440", "type": "RC"}], "standard_charges": [{"gross_charge": 148.0, "discounted_cash": 111.0, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "ST CATH EVD BACTISEAL", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8082681", "type": "CDM"}], "standard_charges": [{"gross_charge": 4961.0, "discounted_cash": 3720.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ST CATH URET ILLUMINAT", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8041321", "type": "CDM"}], "standard_charges": [{"gross_charge": 2268.0, "discounted_cash": 1701.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ST CLOSURE ADHESIVE ABRA", "code_information": [{"code": "A4649", "type": "HCPCS"}, {"code": "8082690", "type": "CDM"}], "standard_charges": [{"gross_charge": 496.0, "discounted_cash": 372.0, "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": 1417.0, "discounted_cash": 1062.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ST CONVERSION PICC", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8052041", "type": "CDM"}], "standard_charges": [{"gross_charge": 1514.0, "discounted_cash": 1135.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ST CYLINDR/PUMP SCROTAL", "code_information": [{"code": "C1813", "type": "HCPCS"}, {"code": "8156021", "type": "CDM"}], "standard_charges": [{"gross_charge": 52693.0, "discounted_cash": 39519.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ST INTRO PEEL-AWAY", "code_information": [{"code": "C1892", "type": "HCPCS"}, {"code": "8248550", "type": "CDM"}], "standard_charges": [{"gross_charge": 1558.0, "discounted_cash": 1168.5, "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": 4438.0, "discounted_cash": 3328.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ST INTROD ACQGUIDE MINI W/RF", "code_information": [{"code": "C1893", "type": "HCPCS"}, {"code": "8173329", "type": "CDM"}], "standard_charges": [{"gross_charge": 3030.0, "discounted_cash": 2272.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ST MICROINTRO UNIVERSAL", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8082731", "type": "CDM"}], "standard_charges": [{"gross_charge": 583.0, "discounted_cash": 437.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ST MICROPUNCTURE INTROD W/GW", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8082732", "type": "CDM"}], "standard_charges": [{"gross_charge": 492.0, "discounted_cash": 369.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ST PAD W/ACESSA PRO VU HNDPC", "code_information": [{"code": "A4649", "type": "HCPCS"}, {"code": "8176991", "type": "CDM"}], "standard_charges": [{"gross_charge": 8175.0, "discounted_cash": 6131.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ST PERC INTRO VLV & DIL", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8177251", "type": "CDM"}], "standard_charges": [{"gross_charge": 3764.0, "discounted_cash": 2823.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ST PERCUTANEOUS INTROD", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8034169", "type": "CDM"}], "standard_charges": [{"gross_charge": 2385.0, "discounted_cash": 1788.75, "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": 209611.0, "discounted_cash": 157208.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ST SLF CR/HM MGMT EA 15", "code_information": [{"code": "97535", "type": "CPT"}, {"code": "5905316", "type": "CDM"}, {"code": "440", "type": "RC"}], "standard_charges": [{"gross_charge": 274.0, "discounted_cash": 205.5, "setting": "both", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "ST STNT U AMPLATZ", "code_information": [{"code": "C2625", "type": "HCPCS"}, {"code": "4024731", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1333.0, "discounted_cash": 999.75, "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": 4860.0, "discounted_cash": 3645.0, "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": 19.0, "discounted_cash": 14.25, "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": 19.0, "discounted_cash": 14.25, "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": 207.0, "discounted_cash": 155.25, "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": 207.0, "discounted_cash": 155.25, "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": 467.0, "discounted_cash": 350.25, "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": 467.0, "discounted_cash": 350.25, "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": 31381.0, "discounted_cash": 23535.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM EXTENS KNEE MEDACTA CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013461", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5450.0, "discounted_cash": 4087.5, "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": 22855.0, "discounted_cash": 17141.25, "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": 15492.96, "discounted_cash": 11619.72, "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": 22252.0, "discounted_cash": 16689.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM FEM CTD CTD HA MEDACTA CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013441", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 22554.0, "discounted_cash": 16915.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM FEM FRACTUR STEM DPY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012814", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9964.0, "discounted_cash": 7473.0, "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": 16010.0, "discounted_cash": 12007.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM FEM MOD SLV NCK DEPUY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012815", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2717.0, "discounted_cash": 2037.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM FEM MODULAR STM DEPUY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012816", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12230.0, "discounted_cash": 9172.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM FEM MODULR STEM STRYK CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013058", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 23503.0, "discounted_cash": 17627.25, "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": 19733.0, "discounted_cash": 14799.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM FEMORAL REVSN UOC CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4018011", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 62247.0, "discounted_cash": 46685.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM FEMORAL UNCOAT DEPUY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012817", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12619.72, "discounted_cash": 9464.79, "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": 14541.0, "discounted_cash": 10905.75, "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": 17442.0, "discounted_cash": 13081.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM HD HMRL META TORNIER CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013502", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 34798.0, "discounted_cash": 26098.5, "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": 21652.0, "discounted_cash": 16239.0, "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": 30915.0, "discounted_cash": 23186.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM HUM FRACT REVSN STRYK CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013028", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 30915.0, "discounted_cash": 23186.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM HUM MOD PRX CMP DEPUY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013128", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 13305.0, "discounted_cash": 9978.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM HUM SHRT P2 COATED DJO CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013433", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 31381.0, "discounted_cash": 23535.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM HUM UNCT CEMEN DEPUY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013129", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 28577.0, "discounted_cash": 21432.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM HUM UNCTD CTD MEDACTA CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013472", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 26827.0, "discounted_cash": 20120.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM HUMERAL COATED DJO CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013429", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 20396.0, "discounted_cash": 15297.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM HUMERAL STEMLESS DJO CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013434", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 36610.0, "discounted_cash": 27457.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM HUMERL CT UNCEM DEPUY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013126", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 20997.0, "discounted_cash": 15747.75, "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": 6015.0, "discounted_cash": 4511.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM KNEE DEPU", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8136585", "type": "CDM"}], "standard_charges": [{"gross_charge": 11848.0, "discounted_cash": 8886.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM KNEE EXTEN COATD DEPUY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012819", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9846.0, "discounted_cash": 7384.5, "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": 9347.0, "discounted_cash": 7010.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM KNEE EXTN UNCTED DEPUY CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4012823", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 5434.0, "discounted_cash": 4075.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM TIBIAL MID PLASMA", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8136598", "type": "CDM"}], "standard_charges": [{"gross_charge": 8467.0, "discounted_cash": 6350.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STEM TIBIAL TOP PLASMA", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "8136599", "type": "CDM"}], "standard_charges": [{"gross_charge": 8467.0, "discounted_cash": 6350.25, "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": 556.0, "discounted_cash": 417.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STERNCLAVR JNTS 3VW MIN", "code_information": [{"code": "71130", "type": "CPT"}, {"code": "5011130", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 556.0, "discounted_cash": 417.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STERNCLAVR JNTS 3VW MIN", "code_information": [{"code": "71130", "type": "CPT"}, {"code": "5121130", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 556.0, "discounted_cash": 417.0, "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": 827.0, "discounted_cash": 620.25, "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": 827.0, "discounted_cash": 620.25, "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": 827.0, "discounted_cash": 620.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STERNUM 2VW MIN", "code_information": [{"code": "71120", "type": "CPT"}, {"code": "5121120", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 827.0, "discounted_cash": 620.25, "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": 20469.0, "discounted_cash": 15351.75, "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": 16148.0, "discounted_cash": 12111.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT B ADVANX PRELD NAVF", "code_information": [{"code": "C2625", "type": "HCPCS"}, {"code": "8062212", "type": "CDM"}], "standard_charges": [{"gross_charge": 708.0, "discounted_cash": 531.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT B BLN PALMAZ EXPAND", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8243132", "type": "CDM"}], "standard_charges": [{"gross_charge": 19752.0, "discounted_cash": 14814.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT B DYNALINK", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8243158", "type": "CDM"}], "standard_charges": [{"gross_charge": 15828.0, "discounted_cash": 11871.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT B EXPRESS LD", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8243136", "type": "CDM"}], "standard_charges": [{"gross_charge": 16543.0, "discounted_cash": 12407.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT B NITINOL W/RAD MRK", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8243147", "type": "CDM"}], "standard_charges": [{"gross_charge": 19379.0, "discounted_cash": 14534.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT B OMNILINK", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8243159", "type": "CDM"}], "standard_charges": [{"gross_charge": 15501.0, "discounted_cash": 11625.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT B PALMAZ GENESIS", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8243162", "type": "CDM"}], "standard_charges": [{"gross_charge": 16153.0, "discounted_cash": 12114.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT B PARAMNT MINI GPS", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8062218", "type": "CDM"}], "standard_charges": [{"gross_charge": 11155.0, "discounted_cash": 8366.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT B PROTEGE EVERFLEX", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "4024808", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 14789.0, "discounted_cash": 11091.75, "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": 12549.0, "discounted_cash": 9411.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT B RX HERCULINK PLUS", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "4024806", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12549.0, "discounted_cash": 9411.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT B RX PLASTIC", "code_information": [{"code": "C2625", "type": "HCPCS"}, {"code": "4024807", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2123.0, "discounted_cash": 1592.25, "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": 11619.0, "discounted_cash": 8714.25, "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": 9411.0, "discounted_cash": 7058.25, "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": 13695.0, "discounted_cash": 10271.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT B XCEED S-EXPND", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8243164", "type": "CDM"}], "standard_charges": [{"gross_charge": 16469.0, "discounted_cash": 12351.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT B XPERT OTW", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8243163", "type": "CDM"}], "standard_charges": [{"gross_charge": 25838.0, "discounted_cash": 19378.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT B ZILVER", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8243166", "type": "CDM"}], "standard_charges": [{"gross_charge": 16088.0, "discounted_cash": 12066.0, "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": 14535.0, "discounted_cash": 10901.25, "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": 17478.0, "discounted_cash": 13108.5, "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": 10713.0, "discounted_cash": 8034.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT C ION PACL PLAT CHR", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "8062064", "type": "CDM"}], "standard_charges": [{"gross_charge": 18190.0, "discounted_cash": 13642.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT C JOSTENT GRFTMSTR", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "4024999", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 21466.0, "discounted_cash": 16099.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT C LIBERTE BARE OTW", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8062066", "type": "CDM"}], "standard_charges": [{"gross_charge": 13043.0, "discounted_cash": 9782.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT C ORSIRO SIROL ELUT", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "8062071", "type": "CDM"}], "standard_charges": [{"gross_charge": 11619.0, "discounted_cash": 8714.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT C PACLITAXEL", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "4025005", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 18821.0, "discounted_cash": 14115.75, "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": 15191.0, "discounted_cash": 11393.25, "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": 4200.0, "discounted_cash": 3150.0, "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": 14372.0, "discounted_cash": 10779.0, "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": 17881.0, "discounted_cash": 13410.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT C/CV SYNERGY MR US", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "8062086", "type": "CDM"}], "standard_charges": [{"gross_charge": 5881.0, "discounted_cash": 4410.75, "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": 11081.0, "discounted_cash": 8310.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT C/CV SYNERGY OTW", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "8062041", "type": "CDM"}], "standard_charges": [{"gross_charge": 8419.0, "discounted_cash": 6314.25, "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": 21184.0, "discounted_cash": 15888.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT CAROTID PROTEGE RX", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "4025011", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11695.0, "discounted_cash": 8771.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT CAROTID RX XACT", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8062079", "type": "CDM"}], "standard_charges": [{"gross_charge": 17563.0, "discounted_cash": 13172.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT CATH COVERED PAPYRUS", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "8062048", "type": "CDM"}], "standard_charges": [{"gross_charge": 33243.0, "discounted_cash": 24932.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT COR RESOLUTE ONYX DES RX", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "8062083", "type": "CDM"}], "standard_charges": [{"gross_charge": 6346.0, "discounted_cash": 4759.5, "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": 5955.0, "discounted_cash": 4466.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT DBL J URET", "code_information": [{"code": "C2625", "type": "HCPCS"}, {"code": "8062085", "type": "CDM"}], "standard_charges": [{"gross_charge": 3096.0, "discounted_cash": 2322.0, "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": 15686.0, "discounted_cash": 11764.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT ESOPHAG PC WALLFLEX", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "8062220", "type": "CDM"}], "standard_charges": [{"gross_charge": 22810.0, "discounted_cash": 17107.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT EYE LACRIMAL BICANALICULS", "code_information": [{"code": "A4263", "type": "HCPCS"}, {"code": "8122159", "type": "CDM"}], "standard_charges": [{"gross_charge": 1006.0, "discounted_cash": 754.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT ILIAC SMART CONTROL", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "4025150", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 15622.0, "discounted_cash": 11716.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT MULTLINK VISION OTW", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "4025201", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10667.0, "discounted_cash": 8000.25, "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": 4647.0, "discounted_cash": 3485.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT NEPHROURETERAL", "code_information": [{"code": "C2617", "type": "HCPCS"}, {"code": "4025250", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 1059.0, "discounted_cash": 794.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT P GEENEN W DELV SYS", "code_information": [{"code": "C2625", "type": "HCPCS"}, {"code": "4025329", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 567.0, "discounted_cash": 425.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT PERIPHERAL SUPERA", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8062272", "type": "CDM"}], "standard_charges": [{"gross_charge": 14293.0, "discounted_cash": 10719.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT PERIPHERL PULSAR-18", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8062116", "type": "CDM"}], "standard_charges": [{"gross_charge": 10406.0, "discounted_cash": 7804.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT PERPH INTRACOIL 40", "code_information": [{"code": "C1877", "type": "HCPCS"}, {"code": "8243264", "type": "CDM"}], "standard_charges": [{"gross_charge": 26019.0, "discounted_cash": 19514.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT RENAL", "code_information": [{"code": "C2617", "type": "HCPCS"}, {"code": "8062119", "type": "CDM"}], "standard_charges": [{"gross_charge": 2810.0, "discounted_cash": 2107.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT SIDE BRANCH TRYTON", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8062124", "type": "CDM"}], "standard_charges": [{"gross_charge": 10001.0, "discounted_cash": 7500.75, "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": 27396.0, "discounted_cash": 20547.0, "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": 21959.0, "discounted_cash": 16469.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT U ENDO-SOF DBL PGTL", "code_information": [{"code": "C2617", "type": "HCPCS"}, {"code": "4025494", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 567.0, "discounted_cash": 425.25, "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": 11304.0, "discounted_cash": 8478.0, "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": 2329.0, "discounted_cash": 1746.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT U POLARIS LOOP", "code_information": [{"code": "C2617", "type": "HCPCS"}, {"code": "4025497", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2795.0, "discounted_cash": 2096.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT U POLARIS ULTRA", "code_information": [{"code": "C2617", "type": "HCPCS"}, {"code": "4025498", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2329.0, "discounted_cash": 1746.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT U SOFT FLEX", "code_information": [{"code": "C2617", "type": "HCPCS"}, {"code": "8243169", "type": "CDM"}], "standard_charges": [{"gross_charge": 2094.0, "discounted_cash": 1570.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT URET SILHOUETTE", "code_information": [{"code": "C2625", "type": "HCPCS"}, {"code": "4025499", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 2329.0, "discounted_cash": 1746.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT URETERAL", "code_information": [{"code": "C2625", "type": "HCPCS"}, {"code": "8062145", "type": "CDM"}], "standard_charges": [{"gross_charge": 2305.0, "discounted_cash": 1728.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT URETERAL ASCERTA", "code_information": [{"code": "C2617", "type": "HCPCS"}, {"code": "8062144", "type": "CDM"}], "standard_charges": [{"gross_charge": 621.0, "discounted_cash": 465.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT URIN DIVRS", "code_information": [{"code": "C2627", "type": "HCPCS"}, {"code": "8062160", "type": "CDM"}], "standard_charges": [{"gross_charge": 1713.0, "discounted_cash": 1284.75, "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": 20867.0, "discounted_cash": 15650.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT VASC BIL LIFESTAR", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8062183", "type": "CDM"}], "standard_charges": [{"gross_charge": 7717.0, "discounted_cash": 5787.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT VASC COVERED LIFESTREAM", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "8062194", "type": "CDM"}], "standard_charges": [{"gross_charge": 22489.0, "discounted_cash": 16866.75, "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": 6799.0, "discounted_cash": 5099.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT VASC ILIAC", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8062185", "type": "CDM"}], "standard_charges": [{"gross_charge": 17924.0, "discounted_cash": 13443.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT VASC LIFESTENT", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8062184", "type": "CDM"}], "standard_charges": [{"gross_charge": 34158.0, "discounted_cash": 25618.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT VASCULAR SE INNOVA", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8062181", "type": "CDM"}], "standard_charges": [{"gross_charge": 30113.0, "discounted_cash": 22584.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STNT VENOUS ZILVER VENA", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8062164", "type": "CDM"}], "standard_charges": [{"gross_charge": 16155.0, "discounted_cash": 12116.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STPL FIXATION", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136640", "type": "CDM"}], "standard_charges": [{"gross_charge": 12040.0, "discounted_cash": 9030.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STRAPPING OF PASTE BOOT", "code_information": [{"code": "6900092", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1230.0, "discounted_cash": 922.5, "setting": "both", "billing_class": "facility"}]}, {"description": "STRAPPING OF PASTE BOOT", "code_information": [{"code": "6900092", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 1230.0, "discounted_cash": 922.5, "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": 402.0, "discounted_cash": 301.5, "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": 402.0, "discounted_cash": 301.5, "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": 661.0, "discounted_cash": 495.75, "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": 661.0, "discounted_cash": 495.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STREP A AMP PROBE", "code_information": [{"code": "87651", "type": "CPT"}, {"code": "4107651", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 179.0, "discounted_cash": 134.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STREP B AMP PROBE", "code_information": [{"code": "87653", "type": "CPT"}, {"code": "4108765", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 293.0, "discounted_cash": 219.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STREP B AMP PROBE", "code_information": [{"code": "87653", "type": "CPT"}, {"code": "4177653", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 231.0, "discounted_cash": 173.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STREPTOCOCCUS A DIR OPT", "code_information": [{"code": "87880", "type": "CPT"}, {"code": "4106410", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 559.0, "discounted_cash": 419.25, "setting": "both", "billing_class": "facility"}]}, {"description": "STREPTOCOCCUS A DIR OPT", "code_information": [{"code": "87880", "type": "CPT"}, {"code": "4177880", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 440.0, "discounted_cash": 330.0, "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": 332.0, "discounted_cash": 249.0, "setting": "both", "billing_class": "facility"}]}, {"description": "STREPTOCOCCUS A IA/2", "code_information": [{"code": "87430", "type": "CPT"}, {"code": "4176411", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 261.0, "discounted_cash": 195.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STREPTOMYCIN LEVEL", "code_information": [{"code": "80375", "type": "CPT"}, {"code": "7258281", "type": "CDM"}], "standard_charges": [{"gross_charge": 465.0, "discounted_cash": 348.75, "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": 573.0, "discounted_cash": 429.75, "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": 573.0, "discounted_cash": 429.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STRIATED AB SCR", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "7001260", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 193.0, "discounted_cash": 144.75, "setting": "both", "billing_class": "facility"}]}, {"description": "STRIATED AB SCR", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "7251260", "type": "CDM"}], "standard_charges": [{"gross_charge": 201.0, "discounted_cash": 150.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SUCCINYL UPTO 20MG PFSIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0330", "type": "HCPCS"}, {"code": "5324406", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SUCCINYL UPTO 20MG PFSIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0330", "type": "HCPCS"}, {"code": "5324406", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SUCCINYLCHOL UPTO 20MGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0330", "type": "HCPCS"}, {"code": "5324405", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "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": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SUCRALFATE 1G/10ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316390", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "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": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SUCRALFATE 1GM TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311006", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SUCROSE 24% 11ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316392", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 116.0, "discounted_cash": 87.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SUCROSE 24% 11ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316392", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 116.0, "discounted_cash": 87.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SUCROSE 24% 1ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316404", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SUCROSE 24% 1ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316404", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SUCROSE 24% 2ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316400", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SUCROSE 24% 2ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316400", "type": "CDM"}, {"code": "637", "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": 45.94, "discounted_cash": 34.46, "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": 755.0, "discounted_cash": 566.25, "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": 1198.0, "discounted_cash": 898.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SUGARS CHROMOGRPH/2", "code_information": [{"code": "84375", "type": "CPT"}, {"code": "7004375", "type": "CDM"}], "standard_charges": [{"gross_charge": 106.0, "discounted_cash": 79.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SUGARS MULT QUAL EA SPEC", "code_information": [{"code": "84377", "type": "CPT"}, {"code": "4174377", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "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": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SUGARS QUANT EA SPECIMEN", "code_information": [{"code": "84378", "type": "CPT"}, {"code": "7254393", "type": "CDM"}], "standard_charges": [{"gross_charge": 1322.0, "discounted_cash": 991.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SUGARS SNGL QUAL EA SPEC", "code_information": [{"code": "84376", "type": "CPT"}, {"code": "7004377", "type": "CDM"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "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": 812.0, "discounted_cash": 609.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 812.0, "discounted_cash": 609.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SULFACET/PRED.25%10MLOS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332215", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1162.0, "discounted_cash": 871.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SULFACET/PRED.25%10MLOS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332215", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1162.0, "discounted_cash": 871.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SULFACETAMID NA10%15MLOS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332501", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 473.0, "discounted_cash": 354.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SULFACETAMID NA10%15MLOS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332501", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 473.0, "discounted_cash": 354.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SULFADIAZINE 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311052", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SULFADIAZINE 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311052", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "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": 0.32, "discounted_cash": 0.24, "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": 0.32, "discounted_cash": 0.24, "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": 20.0, "discounted_cash": 15.0, "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": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SULFASALAZINE 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311110", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 23.0, "discounted_cash": 17.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SULFASALAZINE 500MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311110", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 23.0, "discounted_cash": 17.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SULINDAC 150MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311183", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SULINDAC 150MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311183", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SULINDAC 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311187", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SULINDAC 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311187", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "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": 785.0, "discounted_cash": 588.75, "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": 785.0, "discounted_cash": 588.75, "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": 101.0, "discounted_cash": 75.75, "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": 101.0, "discounted_cash": 75.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SUMATRIPTAN NAS 5MG SP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332546", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 658.0, "discounted_cash": 493.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SUMATRIPTAN NAS 5MG SP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332546", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 658.0, "discounted_cash": 493.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SUMATRIPTAN PER 6MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3030", "type": "HCPCS"}, {"code": "5324420", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1335.0, "discounted_cash": 1001.25, "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": 1335.0, "discounted_cash": 1001.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SUPERIOR VENACAVAGRAM", "code_information": [{"code": "75827", "type": "CPT"}, {"code": "4615828", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 6855.0, "discounted_cash": 5141.25, "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": 6855.0, "discounted_cash": 5141.25, "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": 1761.0, "discounted_cash": 1320.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SURFACTANT ADMIN TUBE", "code_information": [{"code": "94610", "type": "CPT"}, {"code": "5504610", "type": "CDM"}, {"code": "410", "type": "RC"}], "standard_charges": [{"gross_charge": 1482.0, "discounted_cash": 1111.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG IRR BIOWASH", "code_information": [{"code": "A6260", "type": "HCPCS"}, {"code": "8034317", "type": "CDM"}], "standard_charges": [{"gross_charge": 2289.0, "discounted_cash": 1716.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG LEVEL I EA ADD 15 MIN", "code_information": [{"code": "3203551", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1736.0, "discounted_cash": 1302.0, "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": 3190.0, "discounted_cash": 2392.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG LEVEL I INT 30 MIN", "code_information": [{"code": "3203550", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3876.0, "discounted_cash": 2907.0, "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": 5780.0, "discounted_cash": 4335.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG LEVEL II EA ADD 15 MIN", "code_information": [{"code": "3203553", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6058.0, "discounted_cash": 4543.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG LEVEL II EA ADD 15 MIN", "code_information": [{"code": "3213553", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4571.0, "discounted_cash": 3428.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG LEVEL II INT 30 MIN", "code_information": [{"code": "3203552", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 14213.0, "discounted_cash": 10659.75, "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": 10185.0, "discounted_cash": 7638.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG LEVEL III EA ADD 15 MIN", "code_information": [{"code": "3203555", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5340.0, "discounted_cash": 4005.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG LEVEL III EA ADD 15 MIN", "code_information": [{"code": "3213555", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5818.0, "discounted_cash": 4363.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG LEVEL III INT 30 MIN", "code_information": [{"code": "3203554", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 12079.0, "discounted_cash": 9059.25, "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": 13095.0, "discounted_cash": 9821.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG LEVEL IV EA ADD 15 MIN", "code_information": [{"code": "3203557", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6636.0, "discounted_cash": 4977.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG LEVEL IV EA ADD 15 MIN", "code_information": [{"code": "3213557", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7879.0, "discounted_cash": 5909.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG LEVEL IV INT 30 MIN", "code_information": [{"code": "3203556", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 14599.0, "discounted_cash": 10949.25, "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": 17335.0, "discounted_cash": 13001.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG PROC I", "code_information": [{"code": "6296000", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1579.0, "discounted_cash": 1184.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG PROC II", "code_information": [{"code": "6296001", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2045.0, "discounted_cash": 1533.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG PROC III", "code_information": [{"code": "6296002", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2126.0, "discounted_cash": 1594.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG PROC LEVEL I", "code_information": [{"code": "5606000", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1885.0, "discounted_cash": 1413.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG PROC LEVEL I", "code_information": [{"code": "6100400", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1161.0, "discounted_cash": 870.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG PROC LEVEL I", "code_information": [{"code": "6166000", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1127.0, "discounted_cash": 845.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG PROC LEVEL II", "code_information": [{"code": "6100402", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 2045.0, "discounted_cash": 1533.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG PROC LEVEL II", "code_information": [{"code": "6166001", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1507.0, "discounted_cash": 1130.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG PROC LEVEL III", "code_information": [{"code": "6100404", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 2126.0, "discounted_cash": 1594.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SURG PROC LEVEL III", "code_information": [{"code": "6166002", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1619.0, "discounted_cash": 1214.25, "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": 3625.0, "discounted_cash": 2718.75, "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": 121.0, "discounted_cash": 90.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SURGICAL PATH III", "code_information": [{"code": "88304", "type": "CPT"}, {"code": "4170027", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 458.0, "discounted_cash": 343.5, "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": 314.0, "discounted_cash": 235.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SURGICAL PATH LEVEL II", "code_information": [{"code": "88302", "type": "CPT"}, {"code": "4170026", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 426.0, "discounted_cash": 319.5, "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": 542.0, "discounted_cash": 406.5, "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": 583.0, "discounted_cash": 437.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SURGICAL PATH LEVEL IV", "code_information": [{"code": "88305", "type": "CPT"}, {"code": "4170028", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 742.0, "discounted_cash": 556.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SURGICAL PATH LEVEL IV", "code_information": [{"code": "88305", "type": "CPT"}, {"code": "4305103", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 943.0, "discounted_cash": 707.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SURGICAL PATH LEVEL IV", "code_information": [{"code": "88305", "type": "CPT"}, {"code": "7018404", "type": "CDM"}], "standard_charges": [{"gross_charge": 516.0, "discounted_cash": 387.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SURGICAL PATH LEVEL IV", "code_information": [{"code": "88305", "type": "CPT"}, {"code": "7075103", "type": "CDM"}], "standard_charges": [{"gross_charge": 317.0, "discounted_cash": 237.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SURGICAL PATH LEVEL IV", "code_information": [{"code": "88305", "type": "CPT"}, {"code": "7090033", "type": "CDM"}], "standard_charges": [{"gross_charge": 243.0, "discounted_cash": 182.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SURGICAL PATH LEVEL V", "code_information": [{"code": "88307", "type": "CPT"}, {"code": "4170029", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 1098.0, "discounted_cash": 823.5, "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": 1396.0, "discounted_cash": 1047.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SURGICAL PATH LEVEL V", "code_information": [{"code": "88307", "type": "CPT"}, {"code": "7090034", "type": "CDM"}], "standard_charges": [{"gross_charge": 1613.0, "discounted_cash": 1209.75, "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": 1705.0, "discounted_cash": 1278.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SURGICAL PATH LVL VI", "code_information": [{"code": "88309", "type": "CPT"}, {"code": "4170030", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 1341.0, "discounted_cash": 1005.75, "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": 974.0, "discounted_cash": 730.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SURGICAL SPECIMEN", "code_information": [{"code": "76098", "type": "CPT"}, {"code": "5016095", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 974.0, "discounted_cash": 730.5, "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": 75.0, "discounted_cash": 56.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SUSCEPTBILTY STDY ENZYME", "code_information": [{"code": "87185", "type": "CPT"}, {"code": "4177036", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 59.0, "discounted_cash": 44.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SUSCEPTBILTY STDY ENZYME", "code_information": [{"code": "87185", "type": "CPT"}, {"code": "7257185", "type": "CDM"}], "standard_charges": [{"gross_charge": 179.0, "discounted_cash": 134.25, "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": 147.0, "discounted_cash": 110.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SUSCEPTIBLTY MACROBROTH", "code_information": [{"code": "87188", "type": "CPT"}, {"code": "4177188", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 116.0, "discounted_cash": 87.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SUSCEPTIBLTY STUDY MIC", "code_information": [{"code": "87186", "type": "CPT"}, {"code": "7007018", "type": "CDM"}], "standard_charges": [{"gross_charge": 173.0, "discounted_cash": 129.75, "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": 288.0, "discounted_cash": 216.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SUSCEPTIBLTY STUDY MIC/3", "code_information": [{"code": "87186", "type": "CPT"}, {"code": "4177194", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 226.0, "discounted_cash": 169.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SUSCEPTIBLTY STUDY MIC/4", "code_information": [{"code": "87186", "type": "CPT"}, {"code": "4177195", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 112.0, "discounted_cash": 84.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SUSCEPTIBLTY STUDY MIC/4", "code_information": [{"code": "87186", "type": "CPT"}, {"code": "7257186", "type": "CDM"}], "standard_charges": [{"gross_charge": 143.0, "discounted_cash": 107.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SUSCEPTIBLTY STUDY MIC/5", "code_information": [{"code": "87186", "type": "CPT"}, {"code": "7257187", "type": "CDM"}], "standard_charges": [{"gross_charge": 384.0, "discounted_cash": 288.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SUSCEPTIBLTY STUDY MIC/6", "code_information": [{"code": "87186", "type": "CPT"}, {"code": "7257188", "type": "CDM"}], "standard_charges": [{"gross_charge": 74.0, "discounted_cash": 55.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SUSCEPTIBLTY STUDY MLC", "code_information": [{"code": "87187", "type": "CPT"}, {"code": "4107187", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 178.0, "discounted_cash": 133.5, "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": 1112.0, "discounted_cash": 834.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SYPHILIS NONTREP QUAL", "code_information": [{"code": "86592", "type": "CPT"}, {"code": "4106592", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 179.0, "discounted_cash": 134.25, "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": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SYPHILIS NONTREP QUAL", "code_information": [{"code": "86592", "type": "CPT"}, {"code": "7006592", "type": "CDM"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 53.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SYPHILIS NONTREP QUAL", "code_information": [{"code": "86592", "type": "CPT"}, {"code": "7256592", "type": "CDM"}], "standard_charges": [{"gross_charge": 134.0, "discounted_cash": 100.5, "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": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SYRUP SIMPLE 30ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316401", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS ACCESS VASC PINNACL", "code_information": [{"code": "C1894", "type": "HCPCS"}, {"code": "8177481", "type": "CDM"}], "standard_charges": [{"gross_charge": 1209.0, "discounted_cash": 906.75, "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": 14439.0, "discounted_cash": 10829.25, "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": 2800.0, "discounted_cash": 2100.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS ACL TIGHTROPE BTB", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136678", "type": "CDM"}], "standard_charges": [{"gross_charge": 4849.0, "discounted_cash": 3636.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS ANCH TRANSFIX BN W/D", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8243502", "type": "CDM"}], "standard_charges": [{"gross_charge": 4361.0, "discounted_cash": 3270.75, "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": 3704.0, "discounted_cash": 2778.0, "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": 24501.0, "discounted_cash": 18375.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS ATHERCT JETSTREAM XC", "code_information": [{"code": "C1724", "type": "HCPCS"}, {"code": "8058501", "type": "CDM"}], "standard_charges": [{"gross_charge": 13052.0, "discounted_cash": 9789.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS BICEP DSTL REPR IMPL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4018061", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10408.0, "discounted_cash": 7806.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS BLLN DILATATION", "code_information": [{"code": "C1726", "type": "HCPCS"}, {"code": "8177482", "type": "CDM"}], "standard_charges": [{"gross_charge": 9859.0, "discounted_cash": 7394.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS CABLE STERNAL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8177488", "type": "CDM"}], "standard_charges": [{"gross_charge": 5704.0, "discounted_cash": 4278.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS CAST TOTAL CONTACT", "code_information": [{"code": "A4590", "type": "HCPCS"}, {"code": "8102043", "type": "CDM"}], "standard_charges": [{"gross_charge": 1889.0, "discounted_cash": 1416.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS CATH BALLOON AVAFLEX", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8178711", "type": "CDM"}], "standard_charges": [{"gross_charge": 27405.0, "discounted_cash": 20553.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS CATH FLASH OSTIAL", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056995", "type": "CDM"}], "standard_charges": [{"gross_charge": 10101.0, "discounted_cash": 7575.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS CATH RE-ENTRY", "code_information": [{"code": "C1725", "type": "HCPCS"}, {"code": "8056999", "type": "CDM"}], "standard_charges": [{"gross_charge": 16478.88, "discounted_cash": 12359.16, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS CLIP DELIV MITRACLIP", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8177480", "type": "CDM"}], "standard_charges": [{"gross_charge": 327000.0, "discounted_cash": 245250.0, "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": 12532.0, "discounted_cash": 9399.0, "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": 12104.0, "discounted_cash": 9078.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS DEL ATTAIN SELECT II", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "8056993", "type": "CDM"}], "standard_charges": [{"gross_charge": 3367.0, "discounted_cash": 2525.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS DEL WATCHMAN W/DVC", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8177477", "type": "CDM"}], "standard_charges": [{"gross_charge": 200880.0, "discounted_cash": 150660.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS DELV OCC AMPLATZER", "code_information": [{"code": "C1766", "type": "HCPCS"}, {"code": "4036798", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 3544.0, "discounted_cash": 2658.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS DIL TB BLN EUSTCHIAN", "code_information": [{"code": "C1726", "type": "HCPCS"}, {"code": "8177448", "type": "CDM"}], "standard_charges": [{"gross_charge": 8538.0, "discounted_cash": 6403.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS DUCTAL OCCLUDER", "code_information": [{"code": "C1817", "type": "HCPCS"}, {"code": "8034553", "type": "CDM"}], "standard_charges": [{"gross_charge": 10344.0, "discounted_cash": 7758.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS EMBOLIC LIQUID", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8034559", "type": "CDM"}], "standard_charges": [{"gross_charge": 39362.0, "discounted_cash": 29521.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS EMBOLIC LIQUID 2", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8038775", "type": "CDM"}], "standard_charges": [{"gross_charge": 3293.0, "discounted_cash": 2469.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS EMBOLIZATN PROTECT", "code_information": [{"code": "C1884", "type": "HCPCS"}, {"code": "8243530", "type": "CDM"}], "standard_charges": [{"gross_charge": 15717.0, "discounted_cash": 11787.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS EMBOLIZTN PROTECT2", "code_information": [{"code": "C1884", "type": "HCPCS"}, {"code": "8243531", "type": "CDM"}], "standard_charges": [{"gross_charge": 14446.0, "discounted_cash": 10834.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS FIBULOCK IMPLANT", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136676", "type": "CDM"}], "standard_charges": [{"gross_charge": 34278.0, "discounted_cash": 25708.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS FIXATION SM BN", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8243532", "type": "CDM"}], "standard_charges": [{"gross_charge": 2807.0, "discounted_cash": 2105.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS FRONTAL SINUS BLN", "code_information": [{"code": "C1726", "type": "HCPCS"}, {"code": "8177456", "type": "CDM"}], "standard_charges": [{"gross_charge": 17848.0, "discounted_cash": 13386.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS GASTRIC BANDING", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8185628", "type": "CDM"}], "standard_charges": [{"gross_charge": 45775.0, "discounted_cash": 34331.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS GASTRIC REFLUX LINX", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8178699", "type": "CDM"}], "standard_charges": [{"gross_charge": 59400.0, "discounted_cash": 44550.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS HEART FAILURE MONITR", "code_information": [{"code": "C2624", "type": "HCPCS"}, {"code": "4004999", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 180763.0, "discounted_cash": 135572.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS ILLUM SINUS", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8178703", "type": "CDM"}], "standard_charges": [{"gross_charge": 7422.0, "discounted_cash": 5566.5, "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": 19852.0, "discounted_cash": 14889.0, "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": 5814.0, "discounted_cash": 4360.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS LD DLV COR SINUS", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "4036804", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 9105.0, "discounted_cash": 6828.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS LEAD DLV ACUITY", "code_information": [{"code": "C1887", "type": "HCPCS"}, {"code": "4036803", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 13489.0, "discounted_cash": 10116.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS LUNG BIOPSY TRACT", "code_information": [{"code": "C2613", "type": "HCPCS"}, {"code": "8177458", "type": "CDM"}], "standard_charges": [{"gross_charge": 3207.0, "discounted_cash": 2405.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS MAXILLARY SINUS BLN", "code_information": [{"code": "C1726", "type": "HCPCS"}, {"code": "8177464", "type": "CDM"}], "standard_charges": [{"gross_charge": 17848.0, "discounted_cash": 13386.0, "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": 1380.0, "discounted_cash": 1035.0, "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": 5365.0, "discounted_cash": 4023.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS MESH H ULTRAPRO MED", "code_information": [{"code": "C1781", "type": "HCPCS"}, {"code": "4025513", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 6785.0, "discounted_cash": 5088.75, "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": 19091.0, "discounted_cash": 14318.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS MITRACLIP BNDL1 SGC & CDS", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8177444", "type": "CDM"}], "standard_charges": [{"gross_charge": 327000.0, "discounted_cash": 245250.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS MPFL FSTDH TGHTRPE SWVELCK", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "4018089", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 19669.01, "discounted_cash": 14751.76, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS NONINCIS BRTH CNTRL", "code_information": [{"code": "A4264", "type": "HCPCS"}, {"code": "8156040", "type": "CDM"}], "standard_charges": [{"gross_charge": 19379.0, "discounted_cash": 14534.25, "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": 7639.0, "discounted_cash": 5729.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS PERIPH INFUS MACH4", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8178722", "type": "CDM"}], "standard_charges": [{"gross_charge": 22282.0, "discounted_cash": 16711.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS REP TRANSVAG", "code_information": [{"code": "C2631", "type": "HCPCS"}, {"code": "8177496", "type": "CDM"}], "standard_charges": [{"gross_charge": 21238.0, "discounted_cash": 15928.5, "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": 14293.0, "discounted_cash": 10719.75, "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": 75043.0, "discounted_cash": 56282.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS ROTATOR CUFF DELVRY", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8177476", "type": "CDM"}], "standard_charges": [{"gross_charge": 8111.0, "discounted_cash": 6083.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS SEALANT DURAL", "code_information": [{"code": "A4649", "type": "HCPCS"}, {"code": "4025519", "type": "CDM"}, {"code": "272", "type": "RC"}], "standard_charges": [{"gross_charge": 8407.0, "discounted_cash": 6305.25, "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": 71459.0, "discounted_cash": 53594.25, "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": 14494.0, "discounted_cash": 10870.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS SLING MONARC", "code_information": [{"code": "C1771", "type": "HCPCS"}, {"code": "8243667", "type": "CDM"}], "standard_charges": [{"gross_charge": 13877.0, "discounted_cash": 10407.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS SLING RETROPUBIC", "code_information": [{"code": "C1771", "type": "HCPCS"}, {"code": "4028816", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 12549.0, "discounted_cash": 9411.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS SLING SGL INCISION", "code_information": [{"code": "C1771", "type": "HCPCS"}, {"code": "4028817", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11619.0, "discounted_cash": 8714.25, "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": 39842.0, "discounted_cash": 29881.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS SLNG FIX M INVNC W/S", "code_information": [{"code": "C1771", "type": "HCPCS"}, {"code": "8243664", "type": "CDM"}], "standard_charges": [{"gross_charge": 21862.0, "discounted_cash": 16396.5, "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": 15979.0, "discounted_cash": 11984.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS SLNG MIDURETHRL MSH", "code_information": [{"code": "C1771", "type": "HCPCS"}, {"code": "4028812", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11284.0, "discounted_cash": 8463.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS SLNG SUPRAPUBIC MESH", "code_information": [{"code": "C1771", "type": "HCPCS"}, {"code": "4028815", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 11246.0, "discounted_cash": 8434.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS SLNG URETH MALE ELEV", "code_information": [{"code": "C1771", "type": "HCPCS"}, {"code": "4028813", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 42081.0, "discounted_cash": 31560.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS SPINAL CEMT DELIVRY", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8178691", "type": "CDM"}], "standard_charges": [{"gross_charge": 11738.0, "discounted_cash": 8803.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS STENT VENOUS VENOVO", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8067802", "type": "CDM"}], "standard_charges": [{"gross_charge": 15350.0, "discounted_cash": 11512.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS STNT CAROTID", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8062199", "type": "CDM"}], "standard_charges": [{"gross_charge": 30532.0, "discounted_cash": 22899.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS STNT TRANSCAROTID", "code_information": [{"code": "C1876", "type": "HCPCS"}, {"code": "8062203", "type": "CDM"}], "standard_charges": [{"gross_charge": 26705.0, "discounted_cash": 20028.75, "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": 18043.0, "discounted_cash": 13532.25, "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": 13499.0, "discounted_cash": 10124.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS THROMBECTOMY FLOWTREIVER", "code_information": [{"code": "C1757", "type": "HCPCS"}, {"code": "8178743", "type": "CDM"}], "standard_charges": [{"gross_charge": 97200.0, "discounted_cash": 72900.0, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS THROMBUS RETRIEVER", "code_information": [{"code": "C1773", "type": "HCPCS"}, {"code": "8178749", "type": "CDM"}], "standard_charges": [{"gross_charge": 32154.0, "discounted_cash": 24115.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS TRANSCATH PACE MICRA", "code_information": [{"code": "C1786", "type": "HCPCS"}, {"code": "4005001", "type": "CDM"}, {"code": "275", "type": "RC"}], "standard_charges": [{"gross_charge": 67305.0, "discounted_cash": 50478.75, "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": 89473.0, "discounted_cash": 67104.75, "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": 123331.0, "discounted_cash": 92498.25, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS TRANSSEPTAL DILATOR", "code_information": [{"code": "C1893", "type": "HCPCS"}, {"code": "8185645", "type": "CDM"}], "standard_charges": [{"gross_charge": 11314.0, "discounted_cash": 8485.5, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS TRNSCAR NEUROPROTECT", "code_information": [{"code": "C1884", "type": "HCPCS"}, {"code": "8178744", "type": "CDM"}], "standard_charges": [{"gross_charge": 36493.0, "discounted_cash": 27369.75, "setting": "both", "billing_class": "facility"}]}, {"description": "SYS TUBEROSITY REPAIR FXBRIDGE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8136691", "type": "CDM"}], "standard_charges": [{"gross_charge": 9478.0, "discounted_cash": 7108.5, "setting": "both", "billing_class": "facility"}]}, {"description": "T CELL AG RECEPTOR GAMMA", "code_information": [{"code": "81342", "type": "CPT"}, {"code": "7270040", "type": "CDM"}], "standard_charges": [{"gross_charge": 1281.0, "discounted_cash": 960.75, "setting": "both", "billing_class": "facility"}]}, {"description": "T CELLS T4/T8 INC RATIO", "code_information": [{"code": "86360", "type": "CPT"}, {"code": "7006360", "type": "CDM"}], "standard_charges": [{"gross_charge": 528.0, "discounted_cash": 396.0, "setting": "both", "billing_class": "facility"}]}, {"description": "T CELLS T4/T8 INC RATIO/2", "code_information": [{"code": "86360", "type": "CPT"}, {"code": "7258636", "type": "CDM"}], "standard_charges": [{"gross_charge": 654.0, "discounted_cash": 490.5, "setting": "both", "billing_class": "facility"}]}, {"description": "T CELLS TOTAL COUNT", "code_information": [{"code": "86359", "type": "CPT"}, {"code": "7256359", "type": "CDM"}], "standard_charges": [{"gross_charge": 240.0, "discounted_cash": 180.0, "setting": "both", "billing_class": "facility"}]}, {"description": "T-CATH MTRL VLV RPR ADDL", "code_information": [{"code": "4610344", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 34965.0, "discounted_cash": 26223.75, "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": 435.0, "discounted_cash": 326.25, "setting": "both", "billing_class": "facility"}]}, {"description": "T-CELLS ABSOLUTE CD4 CNT", "code_information": [{"code": "86361", "type": "CPT"}, {"code": "7256361", "type": "CDM"}], "standard_charges": [{"gross_charge": 501.0, "discounted_cash": 375.75, "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": 247.0, "discounted_cash": 185.25, "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": 117.0, "discounted_cash": 87.75, "setting": "both", "billing_class": "facility"}]}, {"description": "T3 FREE", "code_information": [{"code": "84481", "type": "CPT"}, {"code": "4173554", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 194.0, "discounted_cash": 145.5, "setting": "both", "billing_class": "facility"}]}, {"description": "T3 FREE", "code_information": [{"code": "84481", "type": "CPT"}, {"code": "7003554", "type": "CDM"}], "standard_charges": [{"gross_charge": 292.0, "discounted_cash": 219.0, "setting": "both", "billing_class": "facility"}]}, {"description": "T3 FREE", "code_information": [{"code": "84481", "type": "CPT"}, {"code": "7253554", "type": "CDM"}], "standard_charges": [{"gross_charge": 325.0, "discounted_cash": 243.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TACROLIMUS", "code_information": [{"code": "80197", "type": "CPT"}, {"code": "7000348", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 833.0, "discounted_cash": 624.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TACROLIMUS .1%30GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337387", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 183.0, "discounted_cash": 137.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TACROLIMUS .1%30GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337387", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 183.0, "discounted_cash": 137.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TACROLIMUS 0.5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7507", "type": "HCPCS"}, {"code": "5311206", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 157.0, "discounted_cash": 117.75, "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": 157.0, "discounted_cash": 117.75, "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": 368.0, "discounted_cash": 276.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TACROLIMUS PER 1MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7507", "type": "HCPCS"}, {"code": "5311204", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 368.0, "discounted_cash": 276.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TACROLIMUS/2", "code_information": [{"code": "80197", "type": "CPT"}, {"code": "7250348", "type": "CDM"}], "standard_charges": [{"gross_charge": 765.0, "discounted_cash": 573.75, "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": 10.0, "discounted_cash": 7.5, "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": 10.0, "discounted_cash": 7.5, "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": 2510.0, "discounted_cash": 1882.5, "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": 23.0, "discounted_cash": 17.25, "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": 23.0, "discounted_cash": 17.25, "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": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TAMSULOSIN .4MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311215", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TARGETED GENOMIC SEQ ANALYS", "code_information": [{"code": "81445", "type": "CPT"}, {"code": "7081445", "type": "CDM"}], "standard_charges": [{"gross_charge": 4609.0, "discounted_cash": 3456.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TARGETED GENOMIC SEQ ANALYS", "code_information": [{"code": "81445", "type": "CPT"}, {"code": "7270051", "type": "CDM"}], "standard_charges": [{"gross_charge": 3796.0, "discounted_cash": 2847.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TARGT SEQ ANLYS 5-50", "code_information": [{"code": "81450", "type": "CPT"}, {"code": "7270052", "type": "CDM"}], "standard_charges": [{"gross_charge": 8772.0, "discounted_cash": 6579.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TAU PROTEIN", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7253575", "type": "CDM"}], "standard_charges": [{"gross_charge": 526.0, "discounted_cash": 394.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TAVR OPEN AXIL", "code_information": [{"code": "4613363", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 58275.0, "discounted_cash": 43706.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TAVR OPEN FEM", "code_information": [{"code": "4613362", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 58275.0, "discounted_cash": 43706.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TAVR PERC FEM", "code_information": [{"code": "4613361", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 58275.0, "discounted_cash": 43706.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TAVR TRANSCAROTID APPROACH", "code_information": [{"code": "4614003", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 58275.0, "discounted_cash": 43706.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TB TEST CELL AG RESPONSE", "code_information": [{"code": "86480", "type": "CPT"}, {"code": "4106520", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 292.0, "discounted_cash": 219.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TB TEST CELL AG RESPONSE", "code_information": [{"code": "86480", "type": "CPT"}, {"code": "4176480", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 805.0, "discounted_cash": 603.75, "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": 1024.0, "discounted_cash": 768.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TBG-THYROXINE BND GLOBLN", "code_information": [{"code": "84442", "type": "CPT"}, {"code": "7004442", "type": "CDM"}], "standard_charges": [{"gross_charge": 222.0, "discounted_cash": 166.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TBG-THYROXINE BND GLOBLN", "code_information": [{"code": "84442", "type": "CPT"}, {"code": "7254442", "type": "CDM"}], "standard_charges": [{"gross_charge": 483.0, "discounted_cash": 362.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TBO-FILGRASTIM PER1MCGIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1447", "type": "HCPCS"}, {"code": "5324441", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TC99 ALBUMIN MAA DOSE", "code_information": [{"code": "A9540", "type": "HCPCS"}, {"code": "5199540", "type": "CDM"}, {"code": "343", "type": "RC"}], "standard_charges": [{"gross_charge": 800.0, "discounted_cash": 600.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TC99 DISOFENIN VIAL", "code_information": [{"code": "A9510", "type": "HCPCS"}, {"code": "5194050", "type": "CDM"}, {"code": "343", "type": "RC"}], "standard_charges": [{"gross_charge": 391.0, "discounted_cash": 293.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TC99 EXAMETAZIME DOSE", "code_information": [{"code": "A9521", "type": "HCPCS"}, {"code": "5194026", "type": "CDM"}, {"code": "343", "type": "RC"}], "standard_charges": [{"gross_charge": 7831.0, "discounted_cash": 5873.25, "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": 8967.0, "discounted_cash": 6725.25, "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": 322.0, "discounted_cash": 241.5, "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": 114.0, "discounted_cash": 85.5, "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": 1049.0, "discounted_cash": 786.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TC99 PENTET AEROSL DOS", "code_information": [{"code": "A9567", "type": "HCPCS"}, {"code": "5199567", "type": "CDM"}, {"code": "343", "type": "RC"}], "standard_charges": [{"gross_charge": 900.0, "discounted_cash": 675.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TC99 PENTETATE DOSE", "code_information": [{"code": "A9539", "type": "HCPCS"}, {"code": "5199539", "type": "CDM"}, {"code": "343", "type": "RC"}], "standard_charges": [{"gross_charge": 712.0, "discounted_cash": 534.0, "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": 17.0, "discounted_cash": 12.75, "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": 131.0, "discounted_cash": 98.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TC99 RBC DOSE", "code_information": [{"code": "A9560", "type": "HCPCS"}, {"code": "5199560", "type": "CDM"}, {"code": "343", "type": "RC"}], "standard_charges": [{"gross_charge": 446.0, "discounted_cash": 334.5, "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": 601.0, "discounted_cash": 450.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TC99 SULF COLL FILT DOSE", "code_information": [{"code": "A9541", "type": "HCPCS"}, {"code": "5199542", "type": "CDM"}, {"code": "343", "type": "RC"}], "standard_charges": [{"gross_charge": 718.0, "discounted_cash": 538.5, "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": 524.0, "discounted_cash": 393.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TC99 TILMANCPT UPTO.5MCI", "code_information": [{"code": "A9520", "type": "HCPCS"}, {"code": "5194196", "type": "CDM"}, {"code": "343", "type": "RC"}], "standard_charges": [{"gross_charge": 1735.0, "discounted_cash": 1301.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TCAT IMPL WRLS P-ART PRS SNR", "code_information": [{"code": "4613274", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 63113.0, "discounted_cash": 47334.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TCAT IMPL WRLS P-ART PRS SNR", "code_information": [{"code": "4613274", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 63113.0, "discounted_cash": 47334.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TCATH RETRV INTRAVASC FB+IMG", "code_information": [{"code": "4617197", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7518.0, "discounted_cash": 5638.5, "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": 7518.0, "discounted_cash": 5638.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TCATH RETRV INTRAVASC FB+IMG", "code_information": [{"code": "4957197", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7518.0, "discounted_cash": 5638.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TCATH TX A/V NONCOR SUBS", "code_information": [{"code": "4617213", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 10399.0, "discounted_cash": 7799.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TCATH TX A/V NONCOR SUBS", "code_information": [{"code": "4957213", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 10399.0, "discounted_cash": 7799.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TCATH TX CESSATION", "code_information": [{"code": "4617214", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 10399.0, "discounted_cash": 7799.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TCATH TX CESSATION", "code_information": [{"code": "4957214", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 10399.0, "discounted_cash": 7799.25, "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": 3474.0, "discounted_cash": 2605.5, "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": 3474.0, "discounted_cash": 2605.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TCATH TX INIT NONCOR ART", "code_information": [{"code": "4957211", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3474.0, "discounted_cash": 2605.5, "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": 11844.0, "discounted_cash": 8883.0, "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": 11844.0, "discounted_cash": 8883.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TCATH TX INIT NONCOR VEN", "code_information": [{"code": "4957212", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 11844.0, "discounted_cash": 8883.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TDAP > 7YR VAC IJ", "code_information": [{"code": "90715", "type": "CPT"}, {"code": "5320147", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 421.0, "discounted_cash": 315.75, "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": 421.0, "discounted_cash": 315.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TEE W/INTRACARD THERAPY", "code_information": [{"code": "93355", "type": "CPT"}, {"code": "4633354", "type": "CDM"}, {"code": "483", "type": "RC"}], "standard_charges": [{"gross_charge": 6529.0, "discounted_cash": 4896.75, "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": 1557.0, "discounted_cash": 1167.75, "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": 1197.0, "discounted_cash": 897.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TELMISARTAN 80MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311227", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 226.0, "discounted_cash": 169.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TELMISARTAN 80MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311227", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 226.0, "discounted_cash": 169.5, "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": 12.0, "discounted_cash": 9.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 12.0, "discounted_cash": 9.0, "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": 13.0, "discounted_cash": 9.75, "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": 13.0, "discounted_cash": 9.75, "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": 32.0, "discounted_cash": 24.0, "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": 32.0, "discounted_cash": 24.0, "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": 32700.0, "discounted_cash": 24525.0, "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": 401.0, "discounted_cash": 300.75, "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": 401.0, "discounted_cash": 300.75, "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": 158.0, "discounted_cash": 118.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TENOFOVIR 300MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311245", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 158.0, "discounted_cash": 118.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TERAZOSIN 1MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311250", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TERAZOSIN 1MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311250", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TERAZOSIN 2MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311251", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TERAZOSIN 2MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311251", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TERAZOSIN 5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311252", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TERAZOSIN 5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311252", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "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": 75.0, "discounted_cash": 56.25, "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": 75.0, "discounted_cash": 56.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TERBINAFINE 1% 15GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337429", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 241.0, "discounted_cash": 180.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TERBINAFINE 1% 15GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337429", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 241.0, "discounted_cash": 180.75, "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": 78.0, "discounted_cash": 58.5, "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": 78.0, "discounted_cash": 58.5, "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": 447.0, "discounted_cash": 335.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TERBINAFINE 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311255", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 447.0, "discounted_cash": 335.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TERBUTALINE 2.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311260", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 45.0, "discounted_cash": 33.75, "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": 45.0, "discounted_cash": 33.75, "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": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TERBUTALINE 5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311264", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TERBUTALINE UPTO 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3105", "type": "HCPCS"}, {"code": "5324426", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "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": 60.0, "discounted_cash": 45.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TERCONAZOLE 80MG VSU", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337430", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 208.0, "discounted_cash": 156.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TERCONAZOLE 80MG VSU", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337430", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 208.0, "discounted_cash": 156.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TERCONAZOLE.4%45GM VCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337431", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TERCONAZOLE.4%45GM VCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337431", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TERT GENE TARGETED SEQ ALYS", "code_information": [{"code": "81345", "type": "CPT"}, {"code": "7270041", "type": "CDM"}], "standard_charges": [{"gross_charge": 807.0, "discounted_cash": 605.25, "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": 3810.0, "discounted_cash": 2857.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 191.0, "discounted_cash": 143.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 191.0, "discounted_cash": 143.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TESTOSTERONE 1%5GM PK GL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5337439", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TESTOSTERONE 1%5GM PK GL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3590", "type": "HCPCS"}, {"code": "5337439", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "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": "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": "4124402", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 177.0, "discounted_cash": 132.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TESTOSTERONE FREE", "code_information": [{"code": "84402", "type": "CPT"}, {"code": "7004407", "type": "CDM"}], "standard_charges": [{"gross_charge": 98.0, "discounted_cash": 73.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TESTOSTERONE FREE", "code_information": [{"code": "84402", "type": "CPT"}, {"code": "7254407", "type": "CDM"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TESTOSTERONE TOTAL", "code_information": [{"code": "84403", "type": "CPT"}, {"code": "4174403", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 58.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TESTOSTERONE TOTAL", "code_information": [{"code": "84403", "type": "CPT"}, {"code": "7004403", "type": "CDM"}], "standard_charges": [{"gross_charge": 98.0, "discounted_cash": 73.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TESTOSTERONE TOTAL", "code_information": [{"code": "84403", "type": "CPT"}, {"code": "7254403", "type": "CDM"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TETANUS AB", "code_information": [{"code": "86774", "type": "CPT"}, {"code": "7006774", "type": "CDM"}], "standard_charges": [{"gross_charge": 569.0, "discounted_cash": 426.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 4392.0, "discounted_cash": 3294.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TETANUS IG UPTO 250U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1670", "type": "HCPCS"}, {"code": "5324499", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 4392.0, "discounted_cash": 3294.0, "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": 101.0, "discounted_cash": 75.75, "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": 456.0, "discounted_cash": 342.0, "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": 149.0, "discounted_cash": 111.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TETRACAINE .5% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332588", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 238.0, "discounted_cash": 178.5, "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": 187.0, "discounted_cash": 140.25, "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": 514.0, "discounted_cash": 385.5, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 76.0, "discounted_cash": 57.0, "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": 76.0, "discounted_cash": 57.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TETRAHYDRAZOL.05%15ML OS", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5332662", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "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": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "THEOPHYLLIN 600MG XR24TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311407", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THEOPHYLLIN 600MG XR24TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311407", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THEOPHYLLIN PER40MGPMXIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2810", "type": "HCPCS"}, {"code": "5324604", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "setting": "both", "billing_class": "facility"}]}, {"description": "THEOPHYLLIN PER40MGPMXIJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2810", "type": "HCPCS"}, {"code": "5324604", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "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": 286.0, "discounted_cash": 214.5, "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": 98.0, "discounted_cash": 73.5, "setting": "both", "billing_class": "facility"}]}, {"description": "THEOPHYLLINE", "code_information": [{"code": "80198", "type": "CPT"}, {"code": "4172137", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 225.0, "discounted_cash": 168.75, "setting": "both", "billing_class": "facility"}]}, {"description": "THEOPHYLLINE 100MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311388", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "THEOPHYLLINE 100MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311388", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "setting": "both", "billing_class": "facility"}]}, {"description": "THEOPHYLLINE 100MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311385", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "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": 21.0, "discounted_cash": 15.75, "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": 31.0, "discounted_cash": 23.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 41.25, "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": 55.0, "discounted_cash": 41.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "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": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "THEOPHYLLINE300MG XR24CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311410", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THEOPHYLLINE300MG XR24CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311410", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "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": 17.0, "discounted_cash": 12.75, "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": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "THEOPHYLLINE80MG/15ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316433", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 364.0, "discounted_cash": 273.0, "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": 364.0, "discounted_cash": 273.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THERAPEUTIC APHERESIS", "code_information": [{"code": "5600365", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5188.0, "discounted_cash": 3891.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THERASKIN PER SQ CM", "code_information": [{"code": "Q4121", "type": "HCPCS"}, {"code": "4025532", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 238.0, "discounted_cash": 178.5, "setting": "both", "billing_class": "facility"}]}, {"description": "THERASKIN PER SQ CM", "code_information": [{"code": "Q4121", "type": "HCPCS"}, {"code": "4025532", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 238.0, "discounted_cash": 178.5, "setting": "both", "billing_class": "facility"}]}, {"description": "THERM DSTR IOS NRV LUM/SAC 1ST", "code_information": [{"code": "4910034", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 35709.0, "discounted_cash": 26781.75, "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": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 322.0, "discounted_cash": 241.5, "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": 322.0, "discounted_cash": 241.5, "setting": "both", "billing_class": "facility"}]}, {"description": "THIAMINE(VITAMIN B1)", "code_information": [{"code": "84425", "type": "CPT"}, {"code": "7004425", "type": "CDM"}], "standard_charges": [{"gross_charge": 222.0, "discounted_cash": 166.5, "setting": "both", "billing_class": "facility"}]}, {"description": "THIAMINE(VITAMIN B1)", "code_information": [{"code": "84425", "type": "CPT"}, {"code": "7254423", "type": "CDM"}], "standard_charges": [{"gross_charge": 82.0, "discounted_cash": 61.5, "setting": "both", "billing_class": "facility"}]}, {"description": "THIAMINE(VITAMIN B1)/2", "code_information": [{"code": "84425", "type": "CPT"}, {"code": "7254429", "type": "CDM"}], "standard_charges": [{"gross_charge": 256.0, "discounted_cash": 192.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THIOCYANATE", "code_information": [{"code": "84430", "type": "CPT"}, {"code": "7004430", "type": "CDM"}], "standard_charges": [{"gross_charge": 205.0, "discounted_cash": 153.75, "setting": "both", "billing_class": "facility"}]}, {"description": "THIOCYANATE", "code_information": [{"code": "84430", "type": "CPT"}, {"code": "7254430", "type": "CDM"}], "standard_charges": [{"gross_charge": 530.0, "discounted_cash": 397.5, "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": 467.0, "discounted_cash": 350.25, "setting": "both", "billing_class": "facility"}]}, {"description": "THIOPURINE/2", "code_information": [{"code": "80375", "type": "CPT"}, {"code": "7252555", "type": "CDM"}], "standard_charges": [{"gross_charge": 584.0, "discounted_cash": 438.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THIORIDAZINE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311556", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "THIORIDAZINE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311556", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "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": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "THIORIDAZINE 10MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311537", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "THIORIDAZINE 25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311548", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "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": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "THIOTHIXENE 10MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311594", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "THIOTHIXENE 1MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311583", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "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": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "THIOTHIXENE 5MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311591", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "THORACENTSIS W/IMAGING", "code_information": [{"code": "4912555", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4211.0, "discounted_cash": 3158.25, "setting": "both", "billing_class": "facility"}]}, {"description": "THORACENTSIS W/IMAGING", "code_information": [{"code": "5052555", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3239.0, "discounted_cash": 2429.25, "setting": "both", "billing_class": "facility"}]}, {"description": "THORACENTSIS W/IMAGING", "code_information": [{"code": "5062555", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4211.0, "discounted_cash": 3158.25, "setting": "both", "billing_class": "facility"}]}, {"description": "THORACIC MYELO LUMB INJ", "code_information": [{"code": "4902302", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6117.0, "discounted_cash": 4587.75, "setting": "both", "billing_class": "facility"}]}, {"description": "THORACIC MYELO LUMB INJ", "code_information": [{"code": "4912303", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7034.0, "discounted_cash": 5275.5, "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": 9054.0, "discounted_cash": 6790.5, "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": 9054.0, "discounted_cash": 6790.5, "setting": "both", "billing_class": "facility"}]}, {"description": "THROMB NONCOR ADD VESSLS", "code_information": [{"code": "4617185", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 14221.0, "discounted_cash": 10665.75, "setting": "both", "billing_class": "facility"}]}, {"description": "THROMB NONCOR ADD VESSLS", "code_information": [{"code": "4914101", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 14221.0, "discounted_cash": 10665.75, "setting": "both", "billing_class": "facility"}]}, {"description": "THROMB NONCOR INITL VSL", "code_information": [{"code": "4617184", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 18896.0, "discounted_cash": 14172.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THROMB NONCOR INITL VSL", "code_information": [{"code": "4914100", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 18896.0, "discounted_cash": 14172.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THROMB NONCOR INITL VSL", "code_information": [{"code": "4957184", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 18896.0, "discounted_cash": 14172.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THROMBECT ART/VEN GRFT", "code_information": [{"code": "4613589", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 23343.0, "discounted_cash": 17507.25, "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": 1201.0, "discounted_cash": 900.75, "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": 1013.0, "discounted_cash": 759.75, "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": 1604.0, "discounted_cash": 1203.0, "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": 1500.0, "discounted_cash": 1125.0, "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": 388.0, "discounted_cash": 291.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THROMBIN TIME PLASMA", "code_information": [{"code": "85670", "type": "CPT"}, {"code": "7005670", "type": "CDM"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "THROMBIN TIME PLASMA/3", "code_information": [{"code": "85670", "type": "CPT"}, {"code": "7255670", "type": "CDM"}], "standard_charges": [{"gross_charge": 229.0, "discounted_cash": 171.75, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROGLOBULIN", "code_information": [{"code": "84432", "type": "CPT"}, {"code": "4174432", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 125.0, "discounted_cash": 93.75, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROGLOBULIN", "code_information": [{"code": "84432", "type": "CPT"}, {"code": "7004432", "type": "CDM"}], "standard_charges": [{"gross_charge": 256.0, "discounted_cash": 192.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROGLOBULIN", "code_information": [{"code": "84432", "type": "CPT"}, {"code": "7254432", "type": "CDM"}], "standard_charges": [{"gross_charge": 159.0, "discounted_cash": 119.25, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROGLOBULIN AB", "code_information": [{"code": "86800", "type": "CPT"}, {"code": "7006175", "type": "CDM"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 47.25, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROGLOBULIN AB", "code_information": [{"code": "86800", "type": "CPT"}, {"code": "7256175", "type": "CDM"}], "standard_charges": [{"gross_charge": 190.0, "discounted_cash": 142.5, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROID C/M IMG WHOL BDY", "code_information": [{"code": "78018", "type": "CPT"}, {"code": "5208018", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 4288.0, "discounted_cash": 3216.0, "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": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "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": 26.0, "discounted_cash": 19.5, "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": 26.0, "discounted_cash": 19.5, "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": 17.0, "discounted_cash": 12.75, "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": 17.0, "discounted_cash": 12.75, "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": 2057.0, "discounted_cash": 1542.75, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROID IMG W/VASC FLOW", "code_information": [{"code": "78013", "type": "CPT"}, {"code": "5208013", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 1162.0, "discounted_cash": 871.5, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROID STIM IMMUNGLBN", "code_information": [{"code": "84445", "type": "CPT"}, {"code": "4174444", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 863.0, "discounted_cash": 647.25, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROID STIM IMMUNGLBN", "code_information": [{"code": "84445", "type": "CPT"}, {"code": "7254444", "type": "CDM"}], "standard_charges": [{"gross_charge": 1098.0, "discounted_cash": 823.5, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROID UPTK SNG/MULT", "code_information": [{"code": "78012", "type": "CPT"}, {"code": "5208012", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 1162.0, "discounted_cash": 871.5, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROTROPIN RECEPTOR AB", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7253528", "type": "CDM"}], "standard_charges": [{"gross_charge": 193.0, "discounted_cash": 144.75, "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": 269.0, "discounted_cash": 201.75, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROXINE FREE", "code_information": [{"code": "84439", "type": "CPT"}, {"code": "4173531", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 212.0, "discounted_cash": 159.0, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROXINE FREE", "code_information": [{"code": "84439", "type": "CPT"}, {"code": "7253534", "type": "CDM"}], "standard_charges": [{"gross_charge": 315.0, "discounted_cash": 236.25, "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": 219.0, "discounted_cash": 164.25, "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": 47.0, "discounted_cash": 35.25, "setting": "both", "billing_class": "facility"}]}, {"description": "THYROXINE TOTAL", "code_information": [{"code": "84436", "type": "CPT"}, {"code": "4174436", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 172.0, "discounted_cash": 129.0, "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": 255.0, "discounted_cash": 191.25, "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": 255.0, "discounted_cash": 191.25, "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": 900.0, "discounted_cash": 675.0, "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": 900.0, "discounted_cash": 675.0, "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": 900.0, "discounted_cash": 675.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TIBIA/FIBULA 2 VIEWS", "code_information": [{"code": "73590", "type": "CPT"}, {"code": "5123590", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 900.0, "discounted_cash": 675.0, "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": 38.0, "discounted_cash": 28.5, "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": 38.0, "discounted_cash": 28.5, "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": 34.0, "discounted_cash": 25.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "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": 611.0, "discounted_cash": 458.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TICLOPIDINE 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311682", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TICLOPIDINE 250MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311682", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "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": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TIGECYCLINE PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3243", "type": "HCPCS"}, {"code": "5324739", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TIGERTAPE CERCLAGE", "code_information": [{"code": "A4649", "type": "HCPCS"}, {"code": "8137045", "type": "CDM"}], "standard_charges": [{"gross_charge": 1903.0, "discounted_cash": 1427.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TIGHTROPE ABS NO BUTTON", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137001", "type": "CDM"}], "standard_charges": [{"gross_charge": 2099.0, "discounted_cash": 1574.25, "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": 1633.0, "discounted_cash": 1224.75, "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": 3115.0, "discounted_cash": 2336.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TILT TABLE SCAN PROC", "code_information": [{"code": "93660", "type": "CPT"}, {"code": "4633660", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 3115.0, "discounted_cash": 2336.25, "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": 52.0, "discounted_cash": 39.0, "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": 52.0, "discounted_cash": 39.0, "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": 717.0, "discounted_cash": 537.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 717.0, "discounted_cash": 537.75, "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": 21.0, "discounted_cash": 15.75, "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": 21.0, "discounted_cash": 15.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 788.0, "discounted_cash": 591.0, "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": 788.0, "discounted_cash": 591.0, "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": 553.0, "discounted_cash": 414.75, "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": 553.0, "discounted_cash": 414.75, "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": 172.0, "discounted_cash": 129.0, "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": 172.0, "discounted_cash": 129.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "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": 108.0, "discounted_cash": 81.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TIROFIBAN PER .25MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3246", "type": "HCPCS"}, {"code": "5324763", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 156.0, "discounted_cash": 117.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TIROFIBAN PER .25MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3246", "type": "HCPCS"}, {"code": "5324763", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 156.0, "discounted_cash": 117.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TISS CONNECTIVE N-HUMAN", "code_information": [{"code": "C1763", "type": "HCPCS"}, {"code": "8240409", "type": "CDM"}], "standard_charges": [{"gross_charge": 3599.0, "discounted_cash": 2699.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TISS CONNECTIVE N-HUMAN2", "code_information": [{"code": "C1763", "type": "HCPCS"}, {"code": "8240411", "type": "CDM"}], "standard_charges": [{"gross_charge": 2680.0, "discounted_cash": 2010.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TISS CULT INOC/OBSERV", "code_information": [{"code": "87252", "type": "CPT"}, {"code": "4177084", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 181.0, "discounted_cash": 135.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TISS CULT INOC/OBSERV", "code_information": [{"code": "87252", "type": "CPT"}, {"code": "7257227", "type": "CDM"}], "standard_charges": [{"gross_charge": 230.0, "discounted_cash": 172.5, "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": 425.0, "discounted_cash": 318.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TISS CULT INOC/OBSERV/3", "code_information": [{"code": "87252", "type": "CPT"}, {"code": "7009356", "type": "CDM"}], "standard_charges": [{"gross_charge": 419.0, "discounted_cash": 314.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TISS CULT INOC/OBSERV/4", "code_information": [{"code": "87252", "type": "CPT"}, {"code": "7259356", "type": "CDM"}], "standard_charges": [{"gross_charge": 179.0, "discounted_cash": 134.25, "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": 204.0, "discounted_cash": 153.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TISS CULT SOLID TUMOR", "code_information": [{"code": "88239", "type": "CPT"}, {"code": "7270108", "type": "CDM"}], "standard_charges": [{"gross_charge": 937.0, "discounted_cash": 702.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TISS CULT SOLID TUMOR/3", "code_information": [{"code": "88239", "type": "CPT"}, {"code": "7270071", "type": "CDM"}], "standard_charges": [{"gross_charge": 1020.0, "discounted_cash": 765.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TISS MEMBRN SOFT AVIVE", "code_information": [{"code": "C1762", "type": "HCPCS"}, {"code": "4025534", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 16345.0, "discounted_cash": 12258.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TISS MTRX ACEL DERM SQCM", "code_information": [{"code": "Q4100", "type": "HCPCS"}, {"code": "8243791", "type": "CDM"}], "standard_charges": [{"gross_charge": 727.0, "discounted_cash": 545.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TISS TRANSGLUTAMINASE AB/2", "code_information": [{"code": "86364", "type": "CPT"}, {"code": "7003562", "type": "CDM"}], "standard_charges": [{"gross_charge": 353.0, "discounted_cash": 264.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TISS TRANSGLUTAMINASE AB/2", "code_information": [{"code": "86364", "type": "CPT"}, {"code": "7253562", "type": "CDM"}], "standard_charges": [{"gross_charge": 222.0, "discounted_cash": 166.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TISS TRANSGLUTAMINASE AB/3", "code_information": [{"code": "86364", "type": "CPT"}, {"code": "7003979", "type": "CDM"}], "standard_charges": [{"gross_charge": 783.0, "discounted_cash": 587.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TISS TRANSGLUTAMINASE AB/5", "code_information": [{"code": "86364", "type": "CPT"}, {"code": "7253979", "type": "CDM"}], "standard_charges": [{"gross_charge": 262.0, "discounted_cash": 196.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TISSUE CULT BONE MARROW", "code_information": [{"code": "88237", "type": "CPT"}, {"code": "7270070", "type": "CDM"}], "standard_charges": [{"gross_charge": 1428.0, "discounted_cash": 1071.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TISSUE CULT BONE MARROW/2", "code_information": [{"code": "88237", "type": "CPT"}, {"code": "7008237", "type": "CDM"}], "standard_charges": [{"gross_charge": 2423.0, "discounted_cash": 1817.25, "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": 1545.0, "discounted_cash": 1158.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TISSUE CULT BONE MARROW/2", "code_information": [{"code": "88237", "type": "CPT"}, {"code": "7270106", "type": "CDM"}], "standard_charges": [{"gross_charge": 996.0, "discounted_cash": 747.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TISSUE CULTURE LYMPHOCYTE", "code_information": [{"code": "88230", "type": "CPT"}, {"code": "7270067", "type": "CDM"}], "standard_charges": [{"gross_charge": 382.0, "discounted_cash": 286.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TISSUE CULTURE LYMPHOCYTE/4", "code_information": [{"code": "88230", "type": "CPT"}, {"code": "7258229", "type": "CDM"}], "standard_charges": [{"gross_charge": 1401.0, "discounted_cash": 1050.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TISSUE CULTURE SKIN/BIOPSY", "code_information": [{"code": "88233", "type": "CPT"}, {"code": "7048232", "type": "CDM"}], "standard_charges": [{"gross_charge": 5745.0, "discounted_cash": 4308.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TISSUE CULTURE SKIN/BIOPSY/2", "code_information": [{"code": "88233", "type": "CPT"}, {"code": "7258232", "type": "CDM"}], "standard_charges": [{"gross_charge": 716.0, "discounted_cash": 537.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TISSUE EXPANDER", "code_information": [{"code": "C1789", "type": "HCPCS"}, {"code": "8177585", "type": "CDM"}], "standard_charges": [{"gross_charge": 14610.0, "discounted_cash": 10957.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TISSUE GRIND FOR CULTURE", "code_information": [{"code": "87176", "type": "CPT"}, {"code": "4108717", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 149.0, "discounted_cash": 111.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TISSUE GRIND FOR CULTURE", "code_information": [{"code": "87176", "type": "CPT"}, {"code": "4178717", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "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": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TIZANIDINE 4MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311692", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TL201 CHLORIDE 1MCI", "code_information": [{"code": "A9505", "type": "HCPCS"}, {"code": "5194800", "type": "CDM"}, {"code": "343", "type": "RC"}], "standard_charges": [{"gross_charge": 617.0, "discounted_cash": 462.75, "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": 579.0, "discounted_cash": 434.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TMVI PERCUTANOUS APPROACH", "code_information": [{"code": "4610483", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 58275.0, "discounted_cash": 43706.25, "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": 438.0, "discounted_cash": 328.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 438.0, "discounted_cash": 328.5, "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": 692.0, "discounted_cash": 519.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 692.0, "discounted_cash": 519.0, "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": 300.0, "discounted_cash": 225.0, "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": 111.0, "discounted_cash": 83.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TOBRAMYCIN", "code_information": [{"code": "80200", "type": "CPT"}, {"code": "4174468", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 236.0, "discounted_cash": 177.0, "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": 402.0, "discounted_cash": 301.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TOBRAMYCIN .3% 3.5GM OO", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332725", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 402.0, "discounted_cash": 301.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TOBRAMYCIN .3% 5ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332726", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 19.0, "discounted_cash": 14.25, "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": 19.0, "discounted_cash": 14.25, "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": 1672.0, "discounted_cash": 1254.0, "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": 143.0, "discounted_cash": 107.25, "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": 143.0, "discounted_cash": 107.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TOBRAMYCIN UPTO 80MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3260", "type": "HCPCS"}, {"code": "5324780", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 94.0, "discounted_cash": 70.5, "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": 94.0, "discounted_cash": 70.5, "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": 300.0, "discounted_cash": 225.0, "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": 300.0, "discounted_cash": 225.0, "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": 28.0, "discounted_cash": 21.0, "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": 28.0, "discounted_cash": 21.0, "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": 28.0, "discounted_cash": 21.0, "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": 1006.0, "discounted_cash": 754.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TOE(S) 2 VIEWS", "code_information": [{"code": "73660", "type": "CPT"}, {"code": "5013660", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1006.0, "discounted_cash": 754.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TOE(S) 2 VIEWS", "code_information": [{"code": "73660", "type": "CPT"}, {"code": "5113660", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1006.0, "discounted_cash": 754.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TOE(S) 2 VIEWS", "code_information": [{"code": "73660", "type": "CPT"}, {"code": "5123660", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1006.0, "discounted_cash": 754.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TOLNAFTATE 1% 15GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337493", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TOLNAFTATE 1% 15GM CR", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337493", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TOLTERODINE 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311751", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 194.0, "discounted_cash": 145.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TOLTERODINE 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311751", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 194.0, "discounted_cash": 145.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TOLTERODINE 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311752", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 133.0, "discounted_cash": 99.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TOLTERODINE 2MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311752", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 133.0, "discounted_cash": 99.75, "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": 222.0, "discounted_cash": 166.5, "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": 222.0, "discounted_cash": 166.5, "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": 286.0, "discounted_cash": 214.5, "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": 286.0, "discounted_cash": 214.5, "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": 1602.0, "discounted_cash": 1201.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1602.0, "discounted_cash": 1201.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1660.0, "discounted_cash": 1245.0, "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": 1660.0, "discounted_cash": 1245.0, "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": 1449.0, "discounted_cash": 1086.75, "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": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TOPIRAMATE 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311755", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 32.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TOPIRAMATE 25MG SPRK CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311746", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 253.0, "discounted_cash": 189.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TOPIRAMATE 25MG SPRK CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311746", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 253.0, "discounted_cash": 189.75, "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": 225.0, "discounted_cash": 168.75, "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": 225.0, "discounted_cash": 168.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TOPIRAMATE LVL", "code_information": [{"code": "80201", "type": "CPT"}, {"code": "7004470", "type": "CDM"}], "standard_charges": [{"gross_charge": 256.0, "discounted_cash": 192.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TOPIRAMATE LVL", "code_information": [{"code": "80201", "type": "CPT"}, {"code": "7254470", "type": "CDM"}], "standard_charges": [{"gross_charge": 444.0, "discounted_cash": 333.0, "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": 116.0, "discounted_cash": 87.0, "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": 116.0, "discounted_cash": 87.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 156.0, "discounted_cash": 117.0, "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": 156.0, "discounted_cash": 117.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TORSEMIDE 10MG/ML 2ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3265", "type": "HCPCS"}, {"code": "5324821", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 348.0, "discounted_cash": 261.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TORSEMIDE 10MG/ML 2ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3265", "type": "HCPCS"}, {"code": "5324821", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 348.0, "discounted_cash": 261.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TORSEMIDE 10MG/ML 5ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3265", "type": "HCPCS"}, {"code": "5324820", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 187.0, "discounted_cash": 140.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TORSEMIDE 10MG/ML 5ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3265", "type": "HCPCS"}, {"code": "5324820", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 187.0, "discounted_cash": 140.25, "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": 32.0, "discounted_cash": 24.0, "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": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TOXOPLASMA AB", "code_information": [{"code": "86777", "type": "CPT"}, {"code": "7006600", "type": "CDM"}], "standard_charges": [{"gross_charge": 483.0, "discounted_cash": 362.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TOXOPLASMA AB IGM", "code_information": [{"code": "86778", "type": "CPT"}, {"code": "7256923", "type": "CDM"}], "standard_charges": [{"gross_charge": 403.0, "discounted_cash": 302.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TOXOPLASMA AB IGM/4", "code_information": [{"code": "86778", "type": "CPT"}, {"code": "7006909", "type": "CDM"}], "standard_charges": [{"gross_charge": 219.0, "discounted_cash": 164.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TOXOPLASMA AB/3", "code_information": [{"code": "86777", "type": "CPT"}, {"code": "7256777", "type": "CDM"}], "standard_charges": [{"gross_charge": 266.0, "discounted_cash": 199.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TOXOPLASMA AB/4", "code_information": [{"code": "86777", "type": "CPT"}, {"code": "7006922", "type": "CDM"}], "standard_charges": [{"gross_charge": 157.0, "discounted_cash": 117.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TOXOPLASMA AB/5", "code_information": [{"code": "86777", "type": "CPT"}, {"code": "7256922", "type": "CDM"}], "standard_charges": [{"gross_charge": 305.0, "discounted_cash": 228.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TPN NEONATAL 2-1 250ML", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5412950", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 252.0, "discounted_cash": 189.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TPN NEONATAL 2-1 250ML", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5412950", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 252.0, "discounted_cash": 189.0, "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": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRACE METAL 5ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5324848", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "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": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRACE METAL NEO 2ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5324845", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRACE METAL PED 1ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5324837", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 45.0, "discounted_cash": 33.75, "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": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRAMADOL QUANT", "code_information": [{"code": "80373", "type": "CPT"}, {"code": "7052547", "type": "CDM"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 81.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRAMADOL/APAP 37/325 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311771", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRAMADOL/APAP 37/325 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311771", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 71.25, "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": 49.0, "discounted_cash": 36.75, "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": 49.0, "discounted_cash": 36.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRANEXAMIC ACID PER 5MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3290", "type": "HCPCS"}, {"code": "5324874", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 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": "TRANEXAMIC ACID PER 5MG PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3290", "type": "HCPCS"}, {"code": "5324876", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.12, "discounted_cash": 0.09, "setting": "both", "billing_class": "facility"}]}, {"description": "TRANEXAMIC ACID PER 5MG PMX IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3290", "type": "HCPCS"}, {"code": "5324876", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 0.12, "discounted_cash": 0.09, "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": 180.0, "discounted_cash": 135.0, "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": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRANSAMINASE-SGPT (ALT)", "code_information": [{"code": "84460", "type": "CPT"}, {"code": "4174460", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 142.0, "discounted_cash": 106.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRANSAMINASE-SGPT (ALT)", "code_information": [{"code": "84460", "type": "CPT"}, {"code": "7254460", "type": "CDM"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 37.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRANSBRONCH LUNG BIOPSY", "code_information": [{"code": "5500665", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 23800.0, "discounted_cash": 17850.0, "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": 51306.0, "discounted_cash": 38479.5, "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": 1783.0, "discounted_cash": 1337.25, "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": 857.0, "discounted_cash": 642.75, "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": 705.0, "discounted_cash": 528.75, "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": 7579.0, "discounted_cash": 5684.25, "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": 7579.0, "discounted_cash": 5684.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRANSFERRIN", "code_information": [{"code": "84466", "type": "CPT"}, {"code": "4104462", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 284.0, "discounted_cash": 213.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRANSFERRIN", "code_information": [{"code": "84466", "type": "CPT"}, {"code": "4174462", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 224.0, "discounted_cash": 168.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRANSFERRIN", "code_information": [{"code": "84466", "type": "CPT"}, {"code": "7004462", "type": "CDM"}], "standard_charges": [{"gross_charge": 128.0, "discounted_cash": 96.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRANSFERRIN", "code_information": [{"code": "84466", "type": "CPT"}, {"code": "7254462", "type": "CDM"}], "standard_charges": [{"gross_charge": 396.0, "discounted_cash": 297.0, "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": 349.0, "discounted_cash": 261.75, "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": 180.0, "discounted_cash": 135.0, "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": 35.0, "discounted_cash": 26.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRANSTERASE AST(SGOT)", "code_information": [{"code": "84450", "type": "CPT"}, {"code": "4174450", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 142.0, "discounted_cash": 106.5, "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": 1342.0, "discounted_cash": 1006.5, "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": 1342.0, "discounted_cash": 1006.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRAUMA III-FULL TEAM", "code_information": [{"code": "G0390", "type": "HCPCS"}, {"code": "6119006", "type": "CDM"}, {"code": "683", "type": "RC"}], "standard_charges": [{"gross_charge": 15094.0, "discounted_cash": 11320.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRAUMA III-PARTIAL TEAM", "code_information": [{"code": "G0390", "type": "HCPCS"}, {"code": "6119007", "type": "CDM"}, {"code": "683", "type": "RC"}], "standard_charges": [{"gross_charge": 12415.0, "discounted_cash": 9311.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRAUMA III-SMALL TEAM", "code_information": [{"code": "G0390", "type": "HCPCS"}, {"code": "6119008", "type": "CDM"}, {"code": "683", "type": "RC"}], "standard_charges": [{"gross_charge": 9736.0, "discounted_cash": 7302.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 590.0, "discounted_cash": 442.5, "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": 590.0, "discounted_cash": 442.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRAZADONE", "code_information": [{"code": "80338", "type": "CPT"}, {"code": "7250301", "type": "CDM"}], "standard_charges": [{"gross_charge": 165.0, "discounted_cash": 123.75, "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": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRB AMPLIFICATION METHOD", "code_information": [{"code": "81340", "type": "CPT"}, {"code": "7270039", "type": "CDM"}], "standard_charges": [{"gross_charge": 1328.0, "discounted_cash": 996.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TREPONEMA PALLIDUM AB", "code_information": [{"code": "86780", "type": "CPT"}, {"code": "4176002", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 264.0, "discounted_cash": 198.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TREPONEMA PALLIDUM AB", "code_information": [{"code": "86780", "type": "CPT"}, {"code": "7006274", "type": "CDM"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TREPONEMA PALLIDUM AB", "code_information": [{"code": "86780", "type": "CPT"}, {"code": "7256650", "type": "CDM"}], "standard_charges": [{"gross_charge": 336.0, "discounted_cash": 252.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TREPONEMA PALLIDUM AB/2", "code_information": [{"code": "86780", "type": "CPT"}, {"code": "7006650", "type": "CDM"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TREPONEMA PALLIDUM AB/4", "code_information": [{"code": "86780", "type": "CPT"}, {"code": "7256781", "type": "CDM"}], "standard_charges": [{"gross_charge": 171.0, "discounted_cash": 128.25, "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": 220.0, "discounted_cash": 165.0, "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": 220.0, "discounted_cash": 165.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRETINOIN.05% 20GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337512", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 457.0, "discounted_cash": 342.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRETINOIN.05% 20GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337512", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 457.0, "discounted_cash": 342.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMCIN-A .1% 5GM PASTE", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337620", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 129.0, "discounted_cash": 96.75, "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": 129.0, "discounted_cash": 96.75, "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": 292.0, "discounted_cash": 219.0, "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": 292.0, "discounted_cash": 219.0, "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": 124.0, "discounted_cash": 93.0, "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": 124.0, "discounted_cash": 93.0, "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": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMCINOLONE .1%15GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337575", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMCINOLONE .1%15GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337575", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 39.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMCINOLONE .1%80GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337585", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 134.0, "discounted_cash": 100.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMCINOLONE .1%80GM CR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337585", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 134.0, "discounted_cash": 100.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMCINOLONE .5%15GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337600", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 105.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMCINOLONE .5%15GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337600", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 105.75, "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": 1058.0, "discounted_cash": 793.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1058.0, "discounted_cash": 793.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMCINOLONE 16.5GM SP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332737", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 412.0, "discounted_cash": 309.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMCINOLONE 16.5GM SP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332737", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 412.0, "discounted_cash": 309.0, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMCINOLONE.025%80GMCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337560", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 592.0, "discounted_cash": 444.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMCINOLONE.025%80GMCR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337560", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 592.0, "discounted_cash": 444.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMCINOLONE.1%454GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337593", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 514.0, "discounted_cash": 385.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMCINOLONE.1%454GM OI", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337593", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 514.0, "discounted_cash": 385.5, "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": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMTER-HCTZ 37.5/25 TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311863", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMTER-HCTZ 50/25 CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311865", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMTER-HCTZ 50/25 CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311865", "type": "CDM"}, {"code": "637", "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMTERENE 100MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311861", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMTERENE 100MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311861", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMTERENE 50MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311857", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 133.0, "discounted_cash": 99.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAMTERENE 50MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311857", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 133.0, "discounted_cash": 99.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAZOLAM .25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311888", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIAZOLAM .25MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5311888", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRICH VAGINALIS DIR OPT", "code_information": [{"code": "87808", "type": "CPT"}, {"code": "4107808", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 97.0, "discounted_cash": 72.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRICHOMONAS AMP PROBE", "code_information": [{"code": "87661", "type": "CPT"}, {"code": "4177661", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 191.0, "discounted_cash": 143.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRICHOMONAS AMP PROBE", "code_information": [{"code": "87661", "type": "CPT"}, {"code": "7257661", "type": "CDM"}], "standard_charges": [{"gross_charge": 242.0, "discounted_cash": 181.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 284.0, "discounted_cash": 213.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 284.0, "discounted_cash": 213.0, "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": 32.0, "discounted_cash": 24.0, "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": 32.0, "discounted_cash": 24.0, "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": 5.0, "discounted_cash": 3.75, "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": 5.0, "discounted_cash": 3.75, "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": 592.0, "discounted_cash": 444.0, "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": 592.0, "discounted_cash": 444.0, "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": 133.0, "discounted_cash": 99.75, "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": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIGLYCERIDES", "code_information": [{"code": "84478", "type": "CPT"}, {"code": "4174475", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 105.0, "discounted_cash": 78.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIGLYCERIDES", "code_information": [{"code": "84478", "type": "CPT"}, {"code": "7004475", "type": "CDM"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIGLYCERIDES MED 30 ML", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5340241", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 89.0, "discounted_cash": 66.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIGLYCERIDES MED 30 ML", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5340241", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 89.0, "discounted_cash": 66.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIGLYCERIDES/2", "code_information": [{"code": "84478", "type": "CPT"}, {"code": "4104478", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIGLYCERIDES/2", "code_information": [{"code": "84478", "type": "CPT"}, {"code": "4174478", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 89.0, "discounted_cash": 66.75, "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": 3.0, "discounted_cash": 2.25, "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": 3.0, "discounted_cash": 2.25, "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": 230.0, "discounted_cash": 172.5, "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": 45.0, "discounted_cash": 33.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIIODTHYRN (T3/T4) UPTAKE", "code_information": [{"code": "84479", "type": "CPT"}, {"code": "4174250", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 181.0, "discounted_cash": 135.75, "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": 98.0, "discounted_cash": 73.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIIODTHYRNINE TOTAL T3", "code_information": [{"code": "84480", "type": "CPT"}, {"code": "4173538", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 137.0, "discounted_cash": 102.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIIODTHYRNINE TOTAL T3", "code_information": [{"code": "84480", "type": "CPT"}, {"code": "7003539", "type": "CDM"}], "standard_charges": [{"gross_charge": 114.0, "discounted_cash": 85.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIIODTHYRNINE TOTAL T3", "code_information": [{"code": "84480", "type": "CPT"}, {"code": "7253539", "type": "CDM"}], "standard_charges": [{"gross_charge": 174.0, "discounted_cash": 130.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIM SKIN LESION 2-4", "code_information": [{"code": "6900071", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 443.0, "discounted_cash": 332.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIM SKIN LESION 2-4", "code_information": [{"code": "6900071", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 443.0, "discounted_cash": 332.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIM SKIN LESION SINGLE", "code_information": [{"code": "6900070", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 443.0, "discounted_cash": 332.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIM SKIN LESION SINGLE", "code_information": [{"code": "6900070", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 443.0, "discounted_cash": 332.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 392.0, "discounted_cash": 294.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIMETHOBENZ TO 200MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3250", "type": "HCPCS"}, {"code": "5324953", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 392.0, "discounted_cash": 294.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIMETHOBENZAMIDE100MGCP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312023", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIMETHOBENZAMIDE100MGCP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312023", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "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": 114.0, "discounted_cash": 85.5, "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": 114.0, "discounted_cash": 85.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIMETHOPRIM 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312050", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIMETHOPRIM 100MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312050", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIMETHPRM/POLYMYX10MLOS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332760", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIMETHPRM/POLYMYX10MLOS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332760", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRIPLE DYE APPL SWAB EA", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5337645", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 62.0, "discounted_cash": 46.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRNSCTH BIOPSY", "code_information": [{"code": "4918005", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 20343.0, "discounted_cash": 15257.25, "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": 4921.0, "discounted_cash": 3690.75, "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": 6633.0, "discounted_cash": 4974.75, "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": 6633.0, "discounted_cash": 4974.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRNSCTH EMBOLIZATN", "code_information": [{"code": "75894", "type": "CPT"}, {"code": "4955894", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 12737.0, "discounted_cash": 9552.75, "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": 1926.0, "discounted_cash": 1444.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRNSVN INTRHEP PORT SHNT", "code_information": [{"code": "4917182", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 21763.0, "discounted_cash": 16322.25, "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": 33.0, "discounted_cash": 24.75, "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": 33.0, "discounted_cash": 24.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TROPICAMIDE .5% 15ML OS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5332774", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "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": 13.0, "discounted_cash": 9.75, "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": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TROPONIN QUAN", "code_information": [{"code": "84484", "type": "CPT"}, {"code": "4104484", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 512.0, "discounted_cash": 384.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TROPONIN QUAN", "code_information": [{"code": "84484", "type": "CPT"}, {"code": "4174484", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 403.0, "discounted_cash": 302.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 159.0, "discounted_cash": 119.25, "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": 159.0, "discounted_cash": 119.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRY CATH ACE IV BASIC 18G", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8083291", "type": "CDM"}], "standard_charges": [{"gross_charge": 449.0, "discounted_cash": 336.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRY CATH MDLN PW INJ BSC", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8178762", "type": "CDM"}], "standard_charges": [{"gross_charge": 1207.0, "discounted_cash": 905.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRY CATH POLY MDLN MAXBR", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8177673", "type": "CDM"}], "standard_charges": [{"gross_charge": 2378.0, "discounted_cash": 1783.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRY CVP TRI LUM", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8083315", "type": "CDM"}], "standard_charges": [{"gross_charge": 1391.0, "discounted_cash": 1043.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRY INTRD PERC SHLY TRCH", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8083682", "type": "CDM"}], "standard_charges": [{"gross_charge": 3284.0, "discounted_cash": 2463.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TRY PICC", "code_information": [{"code": "C1751", "type": "HCPCS"}, {"code": "8084018", "type": "CDM"}], "standard_charges": [{"gross_charge": 2859.0, "discounted_cash": 2144.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRY SPACER HUMERAL DJO CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013427", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 10460.0, "discounted_cash": 7845.0, "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": 65373.0, "discounted_cash": 49029.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TRY TIBL KNEE REVSN MEDACTA CL", "code_information": [{"code": "C1776", "type": "HCPCS"}, {"code": "4013463", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 27250.0, "discounted_cash": 20437.5, "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": 82.0, "discounted_cash": 61.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 82.0, "discounted_cash": 61.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRYPSIN BLOOD TOTAL", "code_information": [{"code": "83519", "type": "CPT"}, {"code": "7254489", "type": "CDM"}], "standard_charges": [{"gross_charge": 339.0, "discounted_cash": 254.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRYPSIN FECES QUAL", "code_information": [{"code": "84488", "type": "CPT"}, {"code": "7254488", "type": "CDM"}], "standard_charges": [{"gross_charge": 334.0, "discounted_cash": 250.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TRYPTASE LEVEL", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7003529", "type": "CDM"}], "standard_charges": [{"gross_charge": 339.0, "discounted_cash": 254.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TRYPTASE LEVEL", "code_information": [{"code": "83520", "type": "CPT"}, {"code": "7253529", "type": "CDM"}], "standard_charges": [{"gross_charge": 238.0, "discounted_cash": 178.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TSH", "code_information": [{"code": "84443", "type": "CPT"}, {"code": "4104443", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 600.0, "discounted_cash": 450.0, "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": 116.0, "discounted_cash": 87.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TSH", "code_information": [{"code": "84443", "type": "CPT"}, {"code": "4174443", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 471.0, "discounted_cash": 353.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TSH", "code_information": [{"code": "84443", "type": "CPT"}, {"code": "7254443", "type": "CDM"}], "standard_charges": [{"gross_charge": 268.0, "discounted_cash": 201.0, "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": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TUMOR IMM PER SPEC COMPT", "code_information": [{"code": "88361", "type": "CPT"}, {"code": "4178361", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 630.0, "discounted_cash": 472.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TUMOR IMM PER SPEC COMPT", "code_information": [{"code": "88361", "type": "CPT"}, {"code": "7098836", "type": "CDM"}], "standard_charges": [{"gross_charge": 607.0, "discounted_cash": 455.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TUMOR IMM PER SPEC COMPT", "code_information": [{"code": "88361", "type": "CPT"}, {"code": "7270090", "type": "CDM"}], "standard_charges": [{"gross_charge": 1961.0, "discounted_cash": 1470.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TUMOR IMM PER SPEC COMPT/2", "code_information": [{"code": "88361", "type": "CPT"}, {"code": "7270142", "type": "CDM"}], "standard_charges": [{"gross_charge": 1961.0, "discounted_cash": 1470.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TUMOR IMM PER SPEC COMPT/4", "code_information": [{"code": "88361", "type": "CPT"}, {"code": "4308364", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 800.0, "discounted_cash": 600.0, "setting": "both", "billing_class": "facility"}]}, {"description": "TUMOR IMM PER SPEC MAN", "code_information": [{"code": "88360", "type": "CPT"}, {"code": "4170046", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 668.0, "discounted_cash": 501.0, "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": 849.0, "discounted_cash": 636.75, "setting": "both", "billing_class": "facility"}]}, {"description": "TUMOR IMM PER SPEC MAN", "code_information": [{"code": "88360", "type": "CPT"}, {"code": "7098363", "type": "CDM"}], "standard_charges": [{"gross_charge": 766.0, "discounted_cash": 574.5, "setting": "both", "billing_class": "facility"}]}, {"description": "TUMOR IMM PER SPEC MAN", "code_information": [{"code": "88360", "type": "CPT"}, {"code": "7270089", "type": "CDM"}], "standard_charges": [{"gross_charge": 995.0, "discounted_cash": 746.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TUMOR IMM PER SPEC MAN/2", "code_information": [{"code": "88360", "type": "CPT"}, {"code": "7270141", "type": "CDM"}], "standard_charges": [{"gross_charge": 995.0, "discounted_cash": 746.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TUMOR IMM PER SPEC MAN/3", "code_information": [{"code": "88360", "type": "CPT"}, {"code": "7270145", "type": "CDM"}], "standard_charges": [{"gross_charge": 995.0, "discounted_cash": 746.25, "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": 4019.0, "discounted_cash": 3014.25, "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": 4587.0, "discounted_cash": 3440.25, "setting": "both", "billing_class": "facility"}]}, {"description": "TUMOR LOCAL PLANAR SNGL AREA", "code_information": [{"code": "78800", "type": "CPT"}, {"code": "5202002", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 3071.0, "discounted_cash": 2303.25, "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": 5059.0, "discounted_cash": 3794.25, "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": 3895.0, "discounted_cash": 2921.25, "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": 1383.0, "discounted_cash": 1037.25, "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": 1504.0, "discounted_cash": 1128.0, "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": 862.0, "discounted_cash": 646.5, "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": 168.0, "discounted_cash": 126.0, "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": 277.0, "discounted_cash": 207.75, "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": 21.0, "discounted_cash": 15.75, "setting": "both", "billing_class": "facility"}]}, {"description": "UA AUTO W/MICRO", "code_information": [{"code": "81001", "type": "CPT"}, {"code": "4171001", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 218.0, "discounted_cash": 163.5, "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": 114.0, "discounted_cash": 85.5, "setting": "both", "billing_class": "facility"}]}, {"description": "UA NON-AUTO W/MICRO", "code_information": [{"code": "81000", "type": "CPT"}, {"code": "4121000", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 29.0, "discounted_cash": 21.75, "setting": "both", "billing_class": "facility"}]}, {"description": "UA NON-AUTO W/O MICRO", "code_information": [{"code": "81002", "type": "CPT"}, {"code": "4101002", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 83.25, "setting": "both", "billing_class": "facility"}]}, {"description": "UA NON-AUTO W/O MICRO", "code_information": [{"code": "81002", "type": "CPT"}, {"code": "4171002", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 87.0, "discounted_cash": 65.25, "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": 134.0, "discounted_cash": 100.5, "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": 148.0, "discounted_cash": 111.0, "setting": "both", "billing_class": "facility"}]}, {"description": "UA QUAL/SEMIQUANT", "code_information": [{"code": "81005", "type": "CPT"}, {"code": "4171005", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 87.75, "setting": "both", "billing_class": "facility"}]}, {"description": "UA QUAL/SEMIQUANT/2", "code_information": [{"code": "81005", "type": "CPT"}, {"code": "4109250", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "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": 2800.0, "discounted_cash": 2100.0, "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": 1705.0, "discounted_cash": 1278.75, "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": 1705.0, "discounted_cash": 1278.75, "setting": "both", "billing_class": "facility"}]}, {"description": "UE ART IMAGING UNI/LTD", "code_information": [{"code": "93931", "type": "CPT"}, {"code": "5123931", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 1705.0, "discounted_cash": 1278.75, "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": 1795.0, "discounted_cash": 1346.25, "setting": "both", "billing_class": "facility"}]}, {"description": "UE/LE ART STUD COMP 3+LVL", "code_information": [{"code": "93923", "type": "CPT"}, {"code": "4633925", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 1795.0, "discounted_cash": 1346.25, "setting": "both", "billing_class": "facility"}]}, {"description": "UE/LE ART STUD COMP 3+LVL", "code_information": [{"code": "93923", "type": "CPT"}, {"code": "6620802", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 1795.0, "discounted_cash": 1346.25, "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": 1347.0, "discounted_cash": 1010.25, "setting": "both", "billing_class": "facility"}]}, {"description": "UE/LE ART STUD LTD 1-2LV", "code_information": [{"code": "93922", "type": "CPT"}, {"code": "6620804", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 1347.0, "discounted_cash": 1010.25, "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": 4349.0, "discounted_cash": 3261.75, "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": 4349.0, "discounted_cash": 3261.75, "setting": "both", "billing_class": "facility"}]}, {"description": "UE/LE IMG VEINS COMP BILAT", "code_information": [{"code": "93970", "type": "CPT"}, {"code": "5112013", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 4349.0, "discounted_cash": 3261.75, "setting": "both", "billing_class": "facility"}]}, {"description": "UE/LE IMG VEINS COMP BILAT", "code_information": [{"code": "93970", "type": "CPT"}, {"code": "5123970", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 4349.0, "discounted_cash": 3261.75, "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": 3275.0, "discounted_cash": 2456.25, "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": 3275.0, "discounted_cash": 2456.25, "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": 3275.0, "discounted_cash": 2456.25, "setting": "both", "billing_class": "facility"}]}, {"description": "UE/LE IMG VEINS UNI/LTD", "code_information": [{"code": "93971", "type": "CPT"}, {"code": "5123971", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 3275.0, "discounted_cash": 2456.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ULIPRISTAL 30MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312230", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 265.0, "discounted_cash": 198.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ULIPRISTAL 30MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312230", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 265.0, "discounted_cash": 198.75, "setting": "both", "billing_class": "facility"}]}, {"description": "UMBILICAL ART LINE NB", "code_information": [{"code": "3112120", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2126.0, "discounted_cash": 1594.5, "setting": "both", "billing_class": "facility"}]}, {"description": "UMBILICAL ART LINE NB", "code_information": [{"code": "3112120", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 2126.0, "discounted_cash": 1594.5, "setting": "both", "billing_class": "facility"}]}, {"description": "UMBILICAL VEIN LINE NB", "code_information": [{"code": "3112130", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 350.0, "discounted_cash": 262.5, "setting": "both", "billing_class": "facility"}]}, {"description": "UMBILICAL VEIN LINE NB", "code_information": [{"code": "3112130", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 350.0, "discounted_cash": 262.5, "setting": "both", "billing_class": "facility"}]}, {"description": "UMECLID/VILANT 14DS IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5332809", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 462.0, "discounted_cash": 346.5, "setting": "both", "billing_class": "facility"}]}, {"description": "UMECLID/VILANT 14DS IH", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3535", "type": "HCPCS"}, {"code": "5332809", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 462.0, "discounted_cash": 346.5, "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": 462.0, "discounted_cash": 346.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 462.0, "discounted_cash": 346.5, "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": 388.0, "discounted_cash": 291.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 388.0, "discounted_cash": 291.0, "setting": "both", "billing_class": "facility"}]}, {"description": "UNLISTED MOLEC PROC", "code_information": [{"code": "81479", "type": "CPT"}, {"code": "7081479", "type": "CDM"}], "standard_charges": [{"gross_charge": 9129.0, "discounted_cash": 6846.75, "setting": "both", "billing_class": "facility"}]}, {"description": "UNLISTED MOLEC PROC", "code_information": [{"code": "81479", "type": "CPT"}, {"code": "7141479", "type": "CDM"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 29.25, "setting": "both", "billing_class": "facility"}]}, {"description": "UNLISTED MOLEC PROC", "code_information": [{"code": "81479", "type": "CPT"}, {"code": "7270054", "type": "CDM"}], "standard_charges": [{"gross_charge": 1053.0, "discounted_cash": 789.75, "setting": "both", "billing_class": "facility"}]}, {"description": "UNLISTED MOLEC PROC/10", "code_information": [{"code": "81479", "type": "CPT"}, {"code": "7270134", "type": "CDM"}], "standard_charges": [{"gross_charge": 1324.0, "discounted_cash": 993.0, "setting": "both", "billing_class": "facility"}]}, {"description": "UNLISTED MOLEC PROC/11", "code_information": [{"code": "81479", "type": "CPT"}, {"code": "7270169", "type": "CDM"}], "standard_charges": [{"gross_charge": 4289.0, "discounted_cash": 3216.75, "setting": "both", "billing_class": "facility"}]}, {"description": "UNLISTED MOLEC PROC/12", "code_information": [{"code": "81479", "type": "CPT"}, {"code": "7270171", "type": "CDM"}], "standard_charges": [{"gross_charge": 5205.0, "discounted_cash": 3903.75, "setting": "both", "billing_class": "facility"}]}, {"description": "UNLISTED MOLEC PROC/13", "code_information": [{"code": "81479", "type": "CPT"}, {"code": "7270172", "type": "CDM"}], "standard_charges": [{"gross_charge": 1540.0, "discounted_cash": 1155.0, "setting": "both", "billing_class": "facility"}]}, {"description": "UNLISTED MOLEC PROC/2", "code_information": [{"code": "81479", "type": "CPT"}, {"code": "7270126", "type": "CDM"}], "standard_charges": [{"gross_charge": 1130.0, "discounted_cash": 847.5, "setting": "both", "billing_class": "facility"}]}, {"description": "UNLISTED MOLEC PROC/3", "code_information": [{"code": "81479", "type": "CPT"}, {"code": "7270127", "type": "CDM"}], "standard_charges": [{"gross_charge": 1347.0, "discounted_cash": 1010.25, "setting": "both", "billing_class": "facility"}]}, {"description": "UNLISTED MOLEC PROC/4", "code_information": [{"code": "81479", "type": "CPT"}, {"code": "7270128", "type": "CDM"}], "standard_charges": [{"gross_charge": 5050.0, "discounted_cash": 3787.5, "setting": "both", "billing_class": "facility"}]}, {"description": "UNLISTED MOLEC PROC/5", "code_information": [{"code": "81479", "type": "CPT"}, {"code": "7270129", "type": "CDM"}], "standard_charges": [{"gross_charge": 2796.0, "discounted_cash": 2097.0, "setting": "both", "billing_class": "facility"}]}, {"description": "UNLISTED MOLEC PROC/6", "code_information": [{"code": "81479", "type": "CPT"}, {"code": "7270130", "type": "CDM"}], "standard_charges": [{"gross_charge": 10295.0, "discounted_cash": 7721.25, "setting": "both", "billing_class": "facility"}]}, {"description": "UNLISTED MOLEC PROC/7", "code_information": [{"code": "81479", "type": "CPT"}, {"code": "7270131", "type": "CDM"}], "standard_charges": [{"gross_charge": 11384.0, "discounted_cash": 8538.0, "setting": "both", "billing_class": "facility"}]}, {"description": "UNLISTED MOLEC PROC/8", "code_information": [{"code": "81479", "type": "CPT"}, {"code": "7270132", "type": "CDM"}], "standard_charges": [{"gross_charge": 665.0, "discounted_cash": 498.75, "setting": "both", "billing_class": "facility"}]}, {"description": "UNLISTED MOLEC PROC/9", "code_information": [{"code": "81479", "type": "CPT"}, {"code": "7270133", "type": "CDM"}], "standard_charges": [{"gross_charge": 8682.0, "discounted_cash": 6511.5, "setting": "both", "billing_class": "facility"}]}, {"description": "UNSCHED DIAL ESRD PT", "code_information": [{"code": "G0257", "type": "HCPCS"}, {"code": "5600257", "type": "CDM"}, {"code": "809", "type": "RC"}], "standard_charges": [{"gross_charge": 1642.0, "discounted_cash": 1231.5, "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": 1642.0, "discounted_cash": 1231.5, "setting": "both", "billing_class": "facility"}]}, {"description": "UPPER GI DOUBLE CM STDY", "code_information": [{"code": "74246", "type": "CPT"}, {"code": "4904244", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1810.0, "discounted_cash": 1357.5, "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": 1810.0, "discounted_cash": 1357.5, "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": 1320.0, "discounted_cash": 990.0, "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": 2140.0, "discounted_cash": 1605.0, "setting": "both", "billing_class": "facility"}]}, {"description": "UPPER GI W/SNGL CM STDY", "code_information": [{"code": "74240", "type": "CPT"}, {"code": "5014242", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2140.0, "discounted_cash": 1605.0, "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": 33.0, "discounted_cash": 24.75, "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": 204.0, "discounted_cash": 153.0, "setting": "both", "billing_class": "facility"}]}, {"description": "UREA NITROGEN URINE", "code_information": [{"code": "84540", "type": "CPT"}, {"code": "4174540", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 160.0, "discounted_cash": 120.0, "setting": "both", "billing_class": "facility"}]}, {"description": "UREA NITROGEN URINE", "code_information": [{"code": "84540", "type": "CPT"}, {"code": "7254540", "type": "CDM"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "UREA NITROGEN URINE/2", "code_information": [{"code": "84540", "type": "CPT"}, {"code": "4174541", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 51.0, "discounted_cash": 38.25, "setting": "both", "billing_class": "facility"}]}, {"description": "UREA NITROGEN URINE/2", "code_information": [{"code": "84540", "type": "CPT"}, {"code": "7254541", "type": "CDM"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "URETERAL REFLUX STUDY", "code_information": [{"code": "78740", "type": "CPT"}, {"code": "5208740", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 2193.0, "discounted_cash": 1644.75, "setting": "both", "billing_class": "facility"}]}, {"description": "URETEROSCOPE", "code_information": [{"code": "C1747", "type": "HCPCS"}, {"code": "8098891", "type": "CDM"}], "standard_charges": [{"gross_charge": 4768.0, "discounted_cash": 3576.0, "setting": "both", "billing_class": "facility"}]}, {"description": "URETHROCYSTOGRAPHY RETR", "code_information": [{"code": "74450", "type": "CPT"}, {"code": "4904450", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2066.0, "discounted_cash": 1549.5, "setting": "both", "billing_class": "facility"}]}, {"description": "URETHROCYSTOGRAPHY RETR", "code_information": [{"code": "74450", "type": "CPT"}, {"code": "4914450", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2066.0, "discounted_cash": 1549.5, "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": 2119.0, "discounted_cash": 1589.25, "setting": "both", "billing_class": "facility"}]}, {"description": "URIC ACID BLOOD", "code_information": [{"code": "84550", "type": "CPT"}, {"code": "4104550", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 237.0, "discounted_cash": 177.75, "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": 32.0, "discounted_cash": 24.0, "setting": "both", "billing_class": "facility"}]}, {"description": "URIC ACID BLOOD", "code_information": [{"code": "84550", "type": "CPT"}, {"code": "4174550", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 186.0, "discounted_cash": 139.5, "setting": "both", "billing_class": "facility"}]}, {"description": "URIC ACID OTHR SOURCE", "code_information": [{"code": "84560", "type": "CPT"}, {"code": "4174557", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "URIC ACID OTHR SOURCE", "code_information": [{"code": "84560", "type": "CPT"}, {"code": "7004557", "type": "CDM"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 28.5, "setting": "both", "billing_class": "facility"}]}, {"description": "URIC ACID OTHR SOURCE", "code_information": [{"code": "84560", "type": "CPT"}, {"code": "7254557", "type": "CDM"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "URIC ACID OTHR SOURCE/2", "code_information": [{"code": "84560", "type": "CPT"}, {"code": "4104559", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 179.0, "discounted_cash": 134.25, "setting": "both", "billing_class": "facility"}]}, {"description": "URIC ACID OTHR SOURCE/2", "code_information": [{"code": "84560", "type": "CPT"}, {"code": "4174559", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 105.75, "setting": "both", "billing_class": "facility"}]}, {"description": "URIC ACID OTHR SOURCE/2", "code_information": [{"code": "84560", "type": "CPT"}, {"code": "7254559", "type": "CDM"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 64.5, "setting": "both", "billing_class": "facility"}]}, {"description": "URINALYSIS MICRO ONLY", "code_information": [{"code": "81015", "type": "CPT"}, {"code": "4101015", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 34.5, "setting": "both", "billing_class": "facility"}]}, {"description": "URINALYSIS MICRO ONLY", "code_information": [{"code": "81015", "type": "CPT"}, {"code": "4171015", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 27.0, "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": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "URINE PREG TEST QUAL", "code_information": [{"code": "81025", "type": "CPT"}, {"code": "4121026", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 45.75, "setting": "both", "billing_class": "facility"}]}, {"description": "URINE PREG TEST QUAL", "code_information": [{"code": "81025", "type": "CPT"}, {"code": "4171026", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 36.0, "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": 2820.0, "discounted_cash": 2115.0, "setting": "both", "billing_class": "facility"}]}, {"description": "UROG/PYELOGRAPHY RETRO", "code_information": [{"code": "74420", "type": "CPT"}, {"code": "4914420", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2820.0, "discounted_cash": 2115.0, "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": 2764.0, "discounted_cash": 2073.0, "setting": "both", "billing_class": "facility"}]}, {"description": "UROKINASE PER 250000U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3365", "type": "HCPCS"}, {"code": "5325052", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 6855.0, "discounted_cash": 5141.25, "setting": "both", "billing_class": "facility"}]}, {"description": "UROKINASE PER 250000U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3365", "type": "HCPCS"}, {"code": "5325052", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 6855.0, "discounted_cash": 5141.25, "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": 108.0, "discounted_cash": 81.0, "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": 108.0, "discounted_cash": 81.0, "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": 2602.0, "discounted_cash": 1951.5, "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": 3502.0, "discounted_cash": 2626.5, "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": 3502.0, "discounted_cash": 2626.5, "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": 3502.0, "discounted_cash": 2626.5, "setting": "both", "billing_class": "facility"}]}, {"description": "US ABDOMEN COMPLETE", "code_information": [{"code": "76700", "type": "CPT"}, {"code": "5126700", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 3502.0, "discounted_cash": 2626.5, "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": 2543.0, "discounted_cash": 1907.25, "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": 2253.0, "discounted_cash": 1689.75, "setting": "both", "billing_class": "facility"}]}, {"description": "US ABDOMEN LTD/QUAD/FU", "code_information": [{"code": "76705", "type": "CPT"}, {"code": "5126705", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2253.0, "discounted_cash": 1689.75, "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": 984.0, "discounted_cash": 738.0, "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": 984.0, "discounted_cash": 738.0, "setting": "both", "billing_class": "facility"}]}, {"description": "US BREAST UNI COMPLETE", "code_information": [{"code": "76641", "type": "CPT"}, {"code": "5126645", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 984.0, "discounted_cash": 738.0, "setting": "both", "billing_class": "facility"}]}, {"description": "US BREAST UNI LTD", "code_information": [{"code": "76642", "type": "CPT"}, {"code": "5016642", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1165.0, "discounted_cash": 873.75, "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": 1165.0, "discounted_cash": 873.75, "setting": "both", "billing_class": "facility"}]}, {"description": "US BREAST UNI LTD", "code_information": [{"code": "76642", "type": "CPT"}, {"code": "5126642", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1165.0, "discounted_cash": 873.75, "setting": "both", "billing_class": "facility"}]}, {"description": "US CHEST INCLD MEDIASTNM", "code_information": [{"code": "76604", "type": "CPT"}, {"code": "4636604", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1480.0, "discounted_cash": 1110.0, "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": 1480.0, "discounted_cash": 1110.0, "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": 1480.0, "discounted_cash": 1110.0, "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": 1480.0, "discounted_cash": 1110.0, "setting": "both", "billing_class": "facility"}]}, {"description": "US CHEST INCLD MEDIASTNM", "code_information": [{"code": "76604", "type": "CPT"}, {"code": "5126604", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1480.0, "discounted_cash": 1110.0, "setting": "both", "billing_class": "facility"}]}, {"description": "US COMPRESSN REP PSEUDAN", "code_information": [{"code": "76936", "type": "CPT"}, {"code": "4636936", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 3258.0, "discounted_cash": 2443.5, "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": 3258.0, "discounted_cash": 2443.5, "setting": "both", "billing_class": "facility"}]}, {"description": "US ELASTOGRAPHY 1ST TRGT LES", "code_information": [{"code": "76982", "type": "CPT"}, {"code": "5066982", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 678.0, "discounted_cash": 508.5, "setting": "both", "billing_class": "facility"}]}, {"description": "US ELASTOGRAPHY ORGAN", "code_information": [{"code": "76981", "type": "CPT"}, {"code": "5060346", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 980.0, "discounted_cash": 735.0, "setting": "both", "billing_class": "facility"}]}, {"description": "US ELASTOGRPHY EA ADL TRGT LES", "code_information": [{"code": "76983", "type": "CPT"}, {"code": "5066983", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 335.0, "discounted_cash": 251.25, "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": 616.0, "discounted_cash": 462.0, "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": 616.0, "discounted_cash": 462.0, "setting": "both", "billing_class": "facility"}]}, {"description": "US EXAM AAA SCREEN", "code_information": [{"code": "76706", "type": "CPT"}, {"code": "5120389", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 616.0, "discounted_cash": 462.0, "setting": "both", "billing_class": "facility"}]}, {"description": "US GUIDANCE INTRAOPERATV", "code_information": [{"code": "76998", "type": "CPT"}, {"code": "4636986", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1926.0, "discounted_cash": 1444.5, "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": 1926.0, "discounted_cash": 1444.5, "setting": "both", "billing_class": "facility"}]}, {"description": "US GUIDE AMNIOCENTESIS", "code_information": [{"code": "76946", "type": "CPT"}, {"code": "3120385", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1254.0, "discounted_cash": 940.5, "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": 3891.0, "discounted_cash": 2918.25, "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": 3891.0, "discounted_cash": 2918.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US GUIDE NEEDLE PLACEMNT", "code_information": [{"code": "76942", "type": "CPT"}, {"code": "5016960", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 3891.0, "discounted_cash": 2918.25, "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": 3891.0, "discounted_cash": 2918.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US GUIDE NEEDLE PLACEMNT", "code_information": [{"code": "76942", "type": "CPT"}, {"code": "6936942", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 3891.0, "discounted_cash": 2918.25, "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": 516.0, "discounted_cash": 387.0, "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": 516.0, "discounted_cash": 387.0, "setting": "both", "billing_class": "facility"}]}, {"description": "US GUIDE VASCULAR ACCESS", "code_information": [{"code": "76937", "type": "CPT"}, {"code": "4956937", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 516.0, "discounted_cash": 387.0, "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": 516.0, "discounted_cash": 387.0, "setting": "both", "billing_class": "facility"}]}, {"description": "US INFANT HIPS DYNAMIC", "code_information": [{"code": "76885", "type": "CPT"}, {"code": "5066885", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 675.0, "discounted_cash": 506.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US INFANT HIPS DYNAMIC", "code_information": [{"code": "76885", "type": "CPT"}, {"code": "5116885", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 619.0, "discounted_cash": 464.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US INFANT HIPS DYNAMIC", "code_information": [{"code": "76885", "type": "CPT"}, {"code": "5126885", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 619.0, "discounted_cash": 464.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US INFANT HIPS LTD STATC", "code_information": [{"code": "76886", "type": "CPT"}, {"code": "5066886", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 833.0, "discounted_cash": 624.75, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB COMP W FETL ANATMY", "code_information": [{"code": "76811", "type": "CPT"}, {"code": "3126811", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2206.0, "discounted_cash": 1654.5, "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": 2206.0, "discounted_cash": 1654.5, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB COMP W FETL ANATMY", "code_information": [{"code": "76811", "type": "CPT"}, {"code": "5126811", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2206.0, "discounted_cash": 1654.5, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB COMP<14WK ADD GEST", "code_information": [{"code": "76802", "type": "CPT"}, {"code": "3126802", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 938.0, "discounted_cash": 703.5, "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": 938.0, "discounted_cash": 703.5, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB COMP<14WK ADD GEST", "code_information": [{"code": "76802", "type": "CPT"}, {"code": "5126802", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 938.0, "discounted_cash": 703.5, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB COMP<14WKS 1STGEST", "code_information": [{"code": "76801", "type": "CPT"}, {"code": "3126801", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2585.0, "discounted_cash": 1938.75, "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": 2585.0, "discounted_cash": 1938.75, "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": 2585.0, "discounted_cash": 1938.75, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB COMP<14WKS 1STGEST", "code_information": [{"code": "76801", "type": "CPT"}, {"code": "5126801", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2585.0, "discounted_cash": 1938.75, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB COMP>14WK ADD GEST", "code_information": [{"code": "76810", "type": "CPT"}, {"code": "3120390", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1983.0, "discounted_cash": 1487.25, "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": 1983.0, "discounted_cash": 1487.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB COMP>14WK ADD GEST", "code_information": [{"code": "76810", "type": "CPT"}, {"code": "5126810", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1983.0, "discounted_cash": 1487.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB COMP>14WK SGL GEST", "code_information": [{"code": "76805", "type": "CPT"}, {"code": "3120395", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 3998.0, "discounted_cash": 2998.5, "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": 3998.0, "discounted_cash": 2998.5, "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": 3998.0, "discounted_cash": 2998.5, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB COMP>14WK SGL GEST", "code_information": [{"code": "76805", "type": "CPT"}, {"code": "5126805", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 3998.0, "discounted_cash": 2998.5, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB F/U PER FETUS", "code_information": [{"code": "76816", "type": "CPT"}, {"code": "3126826", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2151.0, "discounted_cash": 1613.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB F/U PER FETUS", "code_information": [{"code": "76816", "type": "CPT"}, {"code": "5066826", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2151.0, "discounted_cash": 1613.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB F/U PER FETUS", "code_information": [{"code": "76816", "type": "CPT"}, {"code": "5126816", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2151.0, "discounted_cash": 1613.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB FETLANAT ADDL GEST", "code_information": [{"code": "76812", "type": "CPT"}, {"code": "3126812", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1206.0, "discounted_cash": 904.5, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB FETLANAT ADDL GEST", "code_information": [{"code": "76812", "type": "CPT"}, {"code": "5126943", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1206.0, "discounted_cash": 904.5, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB FTLNUC ABD ADD GES", "code_information": [{"code": "76814", "type": "CPT"}, {"code": "3126814", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 829.0, "discounted_cash": 621.75, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB FTLNUC ABD SNG GES", "code_information": [{"code": "76813", "type": "CPT"}, {"code": "3126813", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 909.0, "discounted_cash": 681.75, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB FTLNUC VAG ADD GES", "code_information": [{"code": "76814", "type": "CPT"}, {"code": "3126815", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 829.0, "discounted_cash": 621.75, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB FTLNUC VAG SNG GES", "code_information": [{"code": "76813", "type": "CPT"}, {"code": "3126818", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 909.0, "discounted_cash": 681.75, "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": 1112.0, "discounted_cash": 834.0, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB LTD 1OR> FETUS", "code_information": [{"code": "76815", "type": "CPT"}, {"code": "3120405", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1112.0, "discounted_cash": 834.0, "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": 1112.0, "discounted_cash": 834.0, "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": 1112.0, "discounted_cash": 834.0, "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": 1112.0, "discounted_cash": 834.0, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB LTD 1OR> FETUS", "code_information": [{"code": "76815", "type": "CPT"}, {"code": "5126815", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1112.0, "discounted_cash": 834.0, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB TRANSVAGINAL", "code_information": [{"code": "76817", "type": "CPT"}, {"code": "3126817", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2397.0, "discounted_cash": 1797.75, "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": 2397.0, "discounted_cash": 1797.75, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB TRANSVAGINAL", "code_information": [{"code": "76817", "type": "CPT"}, {"code": "5116817", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2397.0, "discounted_cash": 1797.75, "setting": "both", "billing_class": "facility"}]}, {"description": "US OB TRANSVAGINAL", "code_information": [{"code": "76817", "type": "CPT"}, {"code": "5126817", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2397.0, "discounted_cash": 1797.75, "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": 2886.0, "discounted_cash": 2164.5, "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": 2886.0, "discounted_cash": 2164.5, "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": 2886.0, "discounted_cash": 2164.5, "setting": "both", "billing_class": "facility"}]}, {"description": "US PELVIC COMPLETE", "code_information": [{"code": "76856", "type": "CPT"}, {"code": "5126856", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2886.0, "discounted_cash": 2164.5, "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": 1813.0, "discounted_cash": 1359.75, "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": 1365.0, "discounted_cash": 1023.75, "setting": "both", "billing_class": "facility"}]}, {"description": "US PELVIC LTD/FU", "code_information": [{"code": "76857", "type": "CPT"}, {"code": "5126857", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1365.0, "discounted_cash": 1023.75, "setting": "both", "billing_class": "facility"}]}, {"description": "US RETROPERITONEAL COMP", "code_information": [{"code": "76770", "type": "CPT"}, {"code": "5066770", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2251.0, "discounted_cash": 1688.25, "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": 2251.0, "discounted_cash": 1688.25, "setting": "both", "billing_class": "facility"}]}, {"description": "US RETROPERITONEAL COMP", "code_information": [{"code": "76770", "type": "CPT"}, {"code": "5126770", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2251.0, "discounted_cash": 1688.25, "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": 2032.0, "discounted_cash": 1524.0, "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": 2032.0, "discounted_cash": 1524.0, "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": 2032.0, "discounted_cash": 1524.0, "setting": "both", "billing_class": "facility"}]}, {"description": "US RETROPERITONEAL LTD", "code_information": [{"code": "76775", "type": "CPT"}, {"code": "5126775", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2032.0, "discounted_cash": 1524.0, "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": 2094.0, "discounted_cash": 1570.5, "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": 2094.0, "discounted_cash": 1570.5, "setting": "both", "billing_class": "facility"}]}, {"description": "US SCROTUM CONTENTS", "code_information": [{"code": "76870", "type": "CPT"}, {"code": "5126870", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2094.0, "discounted_cash": 1570.5, "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": 1910.0, "discounted_cash": 1432.5, "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": 1768.0, "discounted_cash": 1326.0, "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": 1753.0, "discounted_cash": 1314.75, "setting": "both", "billing_class": "facility"}]}, {"description": "US SOFT TISSUE HEAD/NECK", "code_information": [{"code": "76536", "type": "CPT"}, {"code": "5126536", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1768.0, "discounted_cash": 1326.0, "setting": "both", "billing_class": "facility"}]}, {"description": "US SPINAL CANAL", "code_information": [{"code": "76800", "type": "CPT"}, {"code": "5066800", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2001.0, "discounted_cash": 1500.75, "setting": "both", "billing_class": "facility"}]}, {"description": "US SPINAL CANAL", "code_information": [{"code": "76800", "type": "CPT"}, {"code": "5116800", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2001.0, "discounted_cash": 1500.75, "setting": "both", "billing_class": "facility"}]}, {"description": "US SPINAL CANAL", "code_information": [{"code": "76800", "type": "CPT"}, {"code": "5126800", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2001.0, "discounted_cash": 1500.75, "setting": "both", "billing_class": "facility"}]}, {"description": "US TRANSPLANT KIDNEY", "code_information": [{"code": "76776", "type": "CPT"}, {"code": "5066778", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2857.0, "discounted_cash": 2142.75, "setting": "both", "billing_class": "facility"}]}, {"description": "US TRANSPLANT KIDNEY", "code_information": [{"code": "76776", "type": "CPT"}, {"code": "5126776", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2857.0, "discounted_cash": 2142.75, "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": 2645.0, "discounted_cash": 1983.75, "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": 2645.0, "discounted_cash": 1983.75, "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": 2645.0, "discounted_cash": 1983.75, "setting": "both", "billing_class": "facility"}]}, {"description": "US TRANSVAGINAL NOT OB", "code_information": [{"code": "76830", "type": "CPT"}, {"code": "5126830", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 2645.0, "discounted_cash": 1983.75, "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": 1880.0, "discounted_cash": 1410.0, "setting": "both", "billing_class": "facility"}]}, {"description": "US XTR JOINT COMPLETE", "code_information": [{"code": "76881", "type": "CPT"}, {"code": "5116860", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1880.0, "discounted_cash": 1410.0, "setting": "both", "billing_class": "facility"}]}, {"description": "US XTR JOINT COMPLETE", "code_information": [{"code": "76881", "type": "CPT"}, {"code": "5126860", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1880.0, "discounted_cash": 1410.0, "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": 1706.0, "discounted_cash": 1279.5, "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": 1706.0, "discounted_cash": 1279.5, "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": 1706.0, "discounted_cash": 1279.5, "setting": "both", "billing_class": "facility"}]}, {"description": "US XTR JOINT LMTD", "code_information": [{"code": "76882", "type": "CPT"}, {"code": "5126850", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1706.0, "discounted_cash": 1279.5, "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": 1706.0, "discounted_cash": 1279.5, "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": 1706.0, "discounted_cash": 1279.5, "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": 1706.0, "discounted_cash": 1279.5, "setting": "both", "billing_class": "facility"}]}, {"description": "US XTR SOFT TISSUE LMTD", "code_information": [{"code": "76882", "type": "CPT"}, {"code": "5126851", "type": "CDM"}, {"code": "402", "type": "RC"}], "standard_charges": [{"gross_charge": 1706.0, "discounted_cash": 1279.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 368.0, "discounted_cash": 276.0, "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": 368.0, "discounted_cash": 276.0, "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": 919.0, "discounted_cash": 689.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VALGANCICLOVIR 450MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312263", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 919.0, "discounted_cash": 689.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VALPROATE 250MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312261", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 45.0, "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": 60.0, "discounted_cash": 45.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VALPROATE 250MG/5ML LQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316585", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 5.0, "discounted_cash": 3.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VALPROATE 500MG/5ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5325065", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 292.0, "discounted_cash": 219.0, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VALPROIC ACID FREE", "code_information": [{"code": "80165", "type": "CPT"}, {"code": "7250165", "type": "CDM"}], "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": 338.0, "discounted_cash": 253.5, "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": 94.0, "discounted_cash": 70.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VALPROIC ACID TOTAL", "code_information": [{"code": "80164", "type": "CPT"}, {"code": "4174584", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 266.0, "discounted_cash": 199.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VALSARTAN 160MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312266", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 10.0, "discounted_cash": 7.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VALSARTAN 160MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312266", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 10.0, "discounted_cash": 7.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VALSARTAN 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312262", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VALSARTAN 40MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312262", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VALSARTAN 80MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312265", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 211.0, "discounted_cash": 158.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 211.0, "discounted_cash": 158.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VALVE AORTIC AVALUS BIOPROSTH", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8145304", "type": "CDM"}], "standard_charges": [{"gross_charge": 57315.0, "discounted_cash": 42986.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VALVE HEART", "code_information": [{"code": "L8699", "type": "HCPCS"}, {"code": "8143522", "type": "CDM"}], "standard_charges": [{"gross_charge": 44812.0, "discounted_cash": 33609.0, "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": 50166.0, "discounted_cash": 37624.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VANCOMYCIN", "code_information": [{"code": "80202", "type": "CPT"}, {"code": "4100031", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 191.0, "discounted_cash": 143.25, "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": 94.0, "discounted_cash": 70.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VANCOMYCIN", "code_information": [{"code": "80202", "type": "CPT"}, {"code": "4170031", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 150.0, "discounted_cash": 112.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VANCOMYCIN 10G/120MLPWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316599", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 7973.0, "discounted_cash": 5979.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VANCOMYCIN 10G/120MLPWLQ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5316599", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 7973.0, "discounted_cash": 5979.75, "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": 10.0, "discounted_cash": 7.5, "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": 10.0, "discounted_cash": 7.5, "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": 10.0, "discounted_cash": 7.5, "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": 10.0, "discounted_cash": 7.5, "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": 23.0, "discounted_cash": 17.25, "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": 23.0, "discounted_cash": 17.25, "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": 26.0, "discounted_cash": 19.5, "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": 26.0, "discounted_cash": 19.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VANCOMYCIN NEO CMPD IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5325075", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.26, "discounted_cash": 0.2, "setting": "both", "billing_class": "facility"}]}, {"description": "VANCOMYCIN NEO CMPD IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7999", "type": "HCPCS"}, {"code": "5325075", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 0.26, "discounted_cash": 0.2, "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": 0.22, "discounted_cash": 0.17, "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": 0.22, "discounted_cash": 0.17, "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": 0.93, "discounted_cash": 0.7, "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": 0.93, "discounted_cash": 0.7, "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": 223.0, "discounted_cash": 167.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VANCOMYCIN/2", "code_information": [{"code": "80202", "type": "CPT"}, {"code": "4170032", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 176.0, "discounted_cash": 132.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VANCOMYCIN/2", "code_information": [{"code": "80202", "type": "CPT"}, {"code": "7250032", "type": "CDM"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "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": 142.0, "discounted_cash": 106.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VANCOMYCIN/3", "code_information": [{"code": "80202", "type": "CPT"}, {"code": "4170033", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 83.25, "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": 102.0, "discounted_cash": 76.5, "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": 102.0, "discounted_cash": 76.5, "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": 1386.0, "discounted_cash": 1039.5, "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": 1386.0, "discounted_cash": 1039.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VARICELLA ZOSTER AB", "code_information": [{"code": "86787", "type": "CPT"}, {"code": "4106787", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VARICELLA ZOSTER AB", "code_information": [{"code": "86787", "type": "CPT"}, {"code": "4176787", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 63.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VARICELLA ZOSTER AB/2", "code_information": [{"code": "86787", "type": "CPT"}, {"code": "4176786", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 190.0, "discounted_cash": 142.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VARICELLA ZOSTER AB/2", "code_information": [{"code": "86787", "type": "CPT"}, {"code": "7006273", "type": "CDM"}], "standard_charges": [{"gross_charge": 670.0, "discounted_cash": 502.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VARICELLA ZOSTER AB/2", "code_information": [{"code": "86787", "type": "CPT"}, {"code": "7256273", "type": "CDM"}], "standard_charges": [{"gross_charge": 241.0, "discounted_cash": 180.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VARICELLA ZOSTER AB/3", "code_information": [{"code": "86787", "type": "CPT"}, {"code": "7006786", "type": "CDM"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 87.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VARICELLA ZOSTER AB/3", "code_information": [{"code": "86787", "type": "CPT"}, {"code": "7256786", "type": "CDM"}], "standard_charges": [{"gross_charge": 241.0, "discounted_cash": 180.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VAS CLS ANGIOSEAL", "code_information": [{"code": "C1760", "type": "HCPCS"}, {"code": "8177901", "type": "CDM"}], "standard_charges": [{"gross_charge": 2061.0, "discounted_cash": 1545.75, "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": 2367.0, "discounted_cash": 1775.25, "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": 3738.0, "discounted_cash": 2803.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VASC EMB/OCC ARTERY", "code_information": [{"code": "4617242", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 57509.0, "discounted_cash": 43131.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VASC EMB/OCC ARTERY", "code_information": [{"code": "4917242", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 57509.0, "discounted_cash": 43131.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VASC EMB/OCC BLEED", "code_information": [{"code": "4917244", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 52902.0, "discounted_cash": 39676.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VASC EMB/OCC ORGAN", "code_information": [{"code": "4917243", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 52759.0, "discounted_cash": 39569.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VASC EMB/OCC VENOUS", "code_information": [{"code": "4917241", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 52856.0, "discounted_cash": 39642.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VASOACTIVE INTST POLYPEP", "code_information": [{"code": "84586", "type": "CPT"}, {"code": "7004238", "type": "CDM"}], "standard_charges": [{"gross_charge": 425.0, "discounted_cash": 318.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VASOACTIVE INTST POLYPEP", "code_information": [{"code": "84586", "type": "CPT"}, {"code": "7254238", "type": "CDM"}], "standard_charges": [{"gross_charge": 266.0, "discounted_cash": 199.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VASOPRESSIN (ADH)", "code_information": [{"code": "84588", "type": "CPT"}, {"code": "7004588", "type": "CDM"}], "standard_charges": [{"gross_charge": 425.0, "discounted_cash": 318.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VASOPRESSIN (ADH)", "code_information": [{"code": "84588", "type": "CPT"}, {"code": "7254588", "type": "CDM"}], "standard_charges": [{"gross_charge": 432.0, "discounted_cash": 324.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VASOPRESSIN DRIP PER 1U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2598", "type": "HCPCS"}, {"code": "5325095", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VASOPRESSIN DRIP PER 1U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2598", "type": "HCPCS"}, {"code": "5325095", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 4.0, "discounted_cash": 3.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VASOPRESSIN PER 1U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2598", "type": "HCPCS"}, {"code": "5325094", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VECURONIUM 10MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5325114", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 58.0, "discounted_cash": 43.5, "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": 983.0, "discounted_cash": 737.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VEDOLIZUMAB", "code_information": [{"code": "80280", "type": "CPT"}, {"code": "7250012", "type": "CDM"}], "standard_charges": [{"gross_charge": 249.0, "discounted_cash": 186.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VEDOLIZUMAB IV PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3380", "type": "HCPCS"}, {"code": "5325119", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VEDOLIZUMAB IV PER 1MG IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3380", "type": "HCPCS"}, {"code": "5325119", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 74.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VEEG EA 12-26 HR UNMNTR", "code_information": [{"code": "95714", "type": "CPT"}, {"code": "4805710", "type": "CDM"}, {"code": "740", "type": "RC"}], "standard_charges": [{"gross_charge": 6380.0, "discounted_cash": 4785.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VENA CAVA FILT J", "code_information": [{"code": "C1880", "type": "HCPCS"}, {"code": "8145760", "type": "CDM"}], "standard_charges": [{"gross_charge": 19379.0, "discounted_cash": 14534.25, "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": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VENIPUNCTURE/4", "code_information": [{"code": "36415", "type": "CPT"}, {"code": "4209011", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "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": 13.0, "discounted_cash": 9.75, "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": 13.0, "discounted_cash": 9.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VENLAFAXINE 37.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312276", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 177.0, "discounted_cash": 132.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VENLAFAXINE 37.5MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312276", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 177.0, "discounted_cash": 132.75, "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": 307.0, "discounted_cash": 230.25, "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": 307.0, "discounted_cash": 230.25, "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": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VENLAFAXINE 75MG XR CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312274", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VENOGRAM EXTREMITY BI", "code_information": [{"code": "75822", "type": "CPT"}, {"code": "4615823", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2264.0, "discounted_cash": 1698.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VENOGRAM EXTREMITY BI", "code_information": [{"code": "75822", "type": "CPT"}, {"code": "4915823", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2264.0, "discounted_cash": 1698.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VENOGRAM EXTREMITY UNI", "code_information": [{"code": "75820", "type": "CPT"}, {"code": "4615821", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 2248.0, "discounted_cash": 1686.0, "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": 2248.0, "discounted_cash": 1686.0, "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": 2248.0, "discounted_cash": 1686.0, "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": 11494.0, "discounted_cash": 8620.5, "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": 6684.2, "discounted_cash": 5013.15, "setting": "both", "billing_class": "facility"}]}, {"description": "VENT INITIAL DAY", "code_information": [{"code": "94002", "type": "CPT"}, {"code": "3110620", "type": "CDM"}, {"code": "410", "type": "RC"}], "standard_charges": [{"gross_charge": 4513.0, "discounted_cash": 3384.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VENT NEONATAL INITIAL", "code_information": [{"code": "94002", "type": "CPT"}, {"code": "5505020", "type": "CDM"}, {"code": "410", "type": "RC"}], "standard_charges": [{"gross_charge": 4284.0, "discounted_cash": 3213.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VENT SUBSQ/DLY", "code_information": [{"code": "94003", "type": "CPT"}, {"code": "3110621", "type": "CDM"}, {"code": "410", "type": "RC"}], "standard_charges": [{"gross_charge": 4231.0, "discounted_cash": 3173.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VERAPAMIL 100MG XR24 CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312280", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 147.0, "discounted_cash": 110.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VERAPAMIL 100MG XR24 CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312280", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 147.0, "discounted_cash": 110.25, "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": 23.0, "discounted_cash": 17.25, "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": 23.0, "discounted_cash": 17.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VERAPAMIL 120MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312291", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 23.25, "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": 31.0, "discounted_cash": 23.25, "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": 34.0, "discounted_cash": 25.5, "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": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VERAPAMIL 200MG XR24 CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312281", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 220.0, "discounted_cash": 165.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VERAPAMIL 200MG XR24 CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312281", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 220.0, "discounted_cash": 165.0, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 23.0, "discounted_cash": 17.25, "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": 23.0, "discounted_cash": 17.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VERAPAMIL 300MG XR24 CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312282", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 338.0, "discounted_cash": 253.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VERAPAMIL 300MG XR24 CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312282", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 338.0, "discounted_cash": 253.5, "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": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VERAPAMIL 80MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312284", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VERAPAMIL2.5MG/ML 2ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5325125", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 52.5, "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": 1206.0, "discounted_cash": 904.5, "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": 10.0, "discounted_cash": 7.5, "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": 10.0, "discounted_cash": 7.5, "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": 64.0, "discounted_cash": 48.0, "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": 64.0, "discounted_cash": 48.0, "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": 353.0, "discounted_cash": 264.75, "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": 353.0, "discounted_cash": 264.75, "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": 1195.0, "discounted_cash": 896.25, "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": 1195.0, "discounted_cash": 896.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VIRUS ANTIBODY NES", "code_information": [{"code": "86790", "type": "CPT"}, {"code": "7006184", "type": "CDM"}], "standard_charges": [{"gross_charge": 359.0, "discounted_cash": 269.25, "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": 102.0, "discounted_cash": 76.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VIRUS INOC SHELL EACH/7", "code_information": [{"code": "87254", "type": "CPT"}, {"code": "7257258", "type": "CDM"}], "standard_charges": [{"gross_charge": 23.0, "discounted_cash": 17.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VISCOSITY", "code_information": [{"code": "85810", "type": "CPT"}, {"code": "4175810", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 134.0, "discounted_cash": 100.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VISCOSITY", "code_information": [{"code": "85810", "type": "CPT"}, {"code": "7257192", "type": "CDM"}], "standard_charges": [{"gross_charge": 171.0, "discounted_cash": 128.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VISCOSITY/3", "code_information": [{"code": "85810", "type": "CPT"}, {"code": "7007192", "type": "CDM"}], "standard_charges": [{"gross_charge": 147.0, "discounted_cash": 110.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VIT D1 25-DIHYDROXY", "code_information": [{"code": "82652", "type": "CPT"}, {"code": "7002652", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 488.0, "discounted_cash": 366.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VIT D1 25-DIHYDROXY", "code_information": [{"code": "82652", "type": "CPT"}, {"code": "7254594", "type": "CDM"}], "standard_charges": [{"gross_charge": 488.0, "discounted_cash": 366.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VIT E 50U/ML 30ML DR LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316639", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VIT E 50U/ML 30ML DR LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316639", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 48.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN A", "code_information": [{"code": "84590", "type": "CPT"}, {"code": "7004590", "type": "CDM"}], "standard_charges": [{"gross_charge": 204.0, "discounted_cash": 153.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN A", "code_information": [{"code": "84590", "type": "CPT"}, {"code": "7254590", "type": "CDM"}], "standard_charges": [{"gross_charge": 201.0, "discounted_cash": 150.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN A 100000U/2ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5325229", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 922.0, "discounted_cash": 691.5, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN A 25MU CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312334", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN A 25MU CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312334", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 108.0, "discounted_cash": 81.0, "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": 108.0, "discounted_cash": 81.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN A&D 60GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334325", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN A&D 60GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334325", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 20.0, "discounted_cash": 15.0, "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": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN A&D 60GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337735", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN B-12 1000MCG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312364", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN B-12 1000MCG TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312364", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN B3 NIACIN", "code_information": [{"code": "80375", "type": "CPT"}, {"code": "7254591", "type": "CDM"}], "standard_charges": [{"gross_charge": 292.0, "discounted_cash": 219.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN C 100/1 50MLDRLQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316617", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 160.0, "discounted_cash": 120.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN C 100/1 50MLDRLQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316617", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 160.0, "discounted_cash": 120.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN C 500MG/5ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316615", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 10.0, "discounted_cash": 7.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN C 500MG/5ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316615", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 10.0, "discounted_cash": 7.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN C500/5 120ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316620", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 230.0, "discounted_cash": 172.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN C500/5 120ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316620", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 230.0, "discounted_cash": 172.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN D 1000U TB", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312375", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 0.14, "discounted_cash": 0.11, "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": 0.14, "discounted_cash": 0.11, "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": 556.0, "discounted_cash": 417.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN D/25 HYDROXY", "code_information": [{"code": "82306", "type": "CPT"}, {"code": "4172306", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 437.0, "discounted_cash": 327.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN D/25 HYDROXY", "code_information": [{"code": "82306", "type": "CPT"}, {"code": "7004595", "type": "CDM"}], "standard_charges": [{"gross_charge": 423.0, "discounted_cash": 317.25, "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": 526.0, "discounted_cash": 394.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN D/25 HYDROXY/3", "code_information": [{"code": "82306", "type": "CPT"}, {"code": "7254596", "type": "CDM"}], "standard_charges": [{"gross_charge": 205.0, "discounted_cash": 153.75, "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": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN D3 400U/1ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316634", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN D3 400U/1ML LQ", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5316634", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 3.0, "discounted_cash": 2.25, "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": 1.0, "discounted_cash": 0.75, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN E 100U CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312403", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN E 100U CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312403", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN E 200U CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312405", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN E 200U CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312405", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN E 400U CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312407", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN K", "code_information": [{"code": "84597", "type": "CPT"}, {"code": "7254597", "type": "CDM"}], "standard_charges": [{"gross_charge": 247.0, "discounted_cash": 185.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN NOS", "code_information": [{"code": "84591", "type": "CPT"}, {"code": "7004209", "type": "CDM"}], "standard_charges": [{"gross_charge": 342.0, "discounted_cash": 256.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN NOS/2", "code_information": [{"code": "84591", "type": "CPT"}, {"code": "7254592", "type": "CDM"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 81.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMIN NOS/3", "code_information": [{"code": "84591", "type": "CPT"}, {"code": "7254593", "type": "CDM"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMN E(TOCOPHRL ALPHA)", "code_information": [{"code": "84446", "type": "CPT"}, {"code": "7004446", "type": "CDM"}], "standard_charges": [{"gross_charge": 159.0, "discounted_cash": 119.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VITAMN E(TOCOPHRL ALPHA)", "code_information": [{"code": "84446", "type": "CPT"}, {"code": "7254446", "type": "CDM"}], "standard_charges": [{"gross_charge": 271.0, "discounted_cash": 203.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VLV HAKIM PRGM W CATH", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8145796", "type": "CDM"}], "standard_charges": [{"gross_charge": 43615.0, "discounted_cash": 32711.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VLV HAKIM STD", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8145795", "type": "CDM"}], "standard_charges": [{"gross_charge": 43810.0, "discounted_cash": 32857.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VLV HYDROCEPH", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8177945", "type": "CDM"}], "standard_charges": [{"gross_charge": 47464.0, "discounted_cash": 35598.0, "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": 83314.0, "discounted_cash": 62485.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VLV PRGMMBL CERTAS PLUS", "code_information": [{"code": "C1729", "type": "HCPCS"}, {"code": "8145810", "type": "CDM"}], "standard_charges": [{"gross_charge": 33463.0, "discounted_cash": 25097.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VLV TAVR AORTIC EVOLUTFX", "code_information": [{"code": "C1889", "type": "HCPCS"}, {"code": "8145296", "type": "CDM"}], "standard_charges": [{"gross_charge": 327000.0, "discounted_cash": 245250.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VMA URINE", "code_information": [{"code": "84585", "type": "CPT"}, {"code": "7254585", "type": "CDM"}], "standard_charges": [{"gross_charge": 196.0, "discounted_cash": 147.0, "setting": "both", "billing_class": "facility"}]}, {"description": "VMA URINE/2", "code_information": [{"code": "84585", "type": "CPT"}, {"code": "7004585", "type": "CDM"}], "standard_charges": [{"gross_charge": 159.0, "discounted_cash": 119.25, "setting": "both", "billing_class": "facility"}]}, {"description": "VMA URINE/2", "code_information": [{"code": "84585", "type": "CPT"}, {"code": "7258458", "type": "CDM"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 88.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VOLATILES", "code_information": [{"code": "84600", "type": "CPT"}, {"code": "7254600", "type": "CDM"}], "standard_charges": [{"gross_charge": 210.0, "discounted_cash": 157.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VOLTAGE GATED CALCIUM/2", "code_information": [{"code": "86596", "type": "CPT"}, {"code": "7253587", "type": "CDM"}], "standard_charges": [{"gross_charge": 265.0, "discounted_cash": 198.75, "setting": "both", "billing_class": "facility"}]}, {"description": "VOLTAGE GATED CALCIUM/3", "code_information": [{"code": "86596", "type": "CPT"}, {"code": "7259625", "type": "CDM"}], "standard_charges": [{"gross_charge": 868.0, "discounted_cash": 651.0, "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": 4284.0, "discounted_cash": 3213.0, "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": 4284.0, "discounted_cash": 3213.0, "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": 5.0, "discounted_cash": 3.75, "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": 266.0, "discounted_cash": 199.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VORICONAZOLE 200MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312451", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 266.0, "discounted_cash": 199.5, "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": 415.0, "discounted_cash": 311.25, "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": 415.0, "discounted_cash": 311.25, "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": 82.0, "discounted_cash": 61.5, "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": 82.0, "discounted_cash": 61.5, "setting": "both", "billing_class": "facility"}]}, {"description": "VWF/FAC 8 WILATE 1U IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7183", "type": "HCPCS"}, {"code": "5325236", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 93.0, "discounted_cash": 69.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "WARFARIN 1MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312481", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 16.0, "discounted_cash": 12.0, "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": 16.0, "discounted_cash": 12.0, "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": 2.0, "discounted_cash": 1.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": 28.0, "discounted_cash": 21.0, "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": 28.0, "discounted_cash": 21.0, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "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": 34.0, "discounted_cash": 25.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 34.0, "discounted_cash": 25.5, "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": 68.0, "discounted_cash": 51.0, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 51.0, "setting": "both", "billing_class": "facility"}]}, {"description": "WASHER", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137065", "type": "CDM"}], "standard_charges": [{"gross_charge": 309.0, "discounted_cash": 231.75, "setting": "both", "billing_class": "facility"}]}, {"description": "WATER INJ BACST 30ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5325247", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 19.5, "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": 1.0, "discounted_cash": 0.75, "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": 43.0, "discounted_cash": 32.25, "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": 28.0, "discounted_cash": 21.0, "setting": "both", "billing_class": "facility"}]}, {"description": "WATER INJ STERL 30ML IJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J3490", "type": "HCPCS"}, {"code": "5325251", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 245.0, "discounted_cash": 183.75, "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": 77.0, "discounted_cash": 57.75, "setting": "both", "billing_class": "facility"}]}, {"description": "WATER STERL INJ .5L IVF", "code_information": [{"code": "A4217", "type": "HCPCS"}, {"code": "5412785", "type": "CDM"}, {"code": "270", "type": "RC"}], "standard_charges": [{"gross_charge": 363.0, "discounted_cash": 272.25, "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": 483.0, "discounted_cash": 362.25, "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": 172.0, "discounted_cash": 129.0, "setting": "both", "billing_class": "facility"}]}, {"description": "WBC AUTO", "code_information": [{"code": "85048", "type": "CPT"}, {"code": "4175013", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 135.0, "discounted_cash": 101.25, "setting": "both", "billing_class": "facility"}]}, {"description": "WBC AUTO", "code_information": [{"code": "85048", "type": "CPT"}, {"code": "7255048", "type": "CDM"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 12.75, "setting": "both", "billing_class": "facility"}]}, {"description": "WDC SURG PROC LEVEL I", "code_information": [{"code": "6900400", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 523.0, "discounted_cash": 392.25, "setting": "both", "billing_class": "facility"}]}, {"description": "WDC SURG PROC LEVEL I", "code_information": [{"code": "6900400", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 523.0, "discounted_cash": 392.25, "setting": "both", "billing_class": "facility"}]}, {"description": "WDC SURG PROC LEVEL II", "code_information": [{"code": "6900402", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 616.0, "discounted_cash": 462.0, "setting": "both", "billing_class": "facility"}]}, {"description": "WDC SURG PROC LEVEL II", "code_information": [{"code": "6900402", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 616.0, "discounted_cash": 462.0, "setting": "both", "billing_class": "facility"}]}, {"description": "WDC SURG PROC LEVEL III", "code_information": [{"code": "6900404", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1403.0, "discounted_cash": 1052.25, "setting": "both", "billing_class": "facility"}]}, {"description": "WDC SURG PROC LEVEL III", "code_information": [{"code": "6900404", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 1403.0, "discounted_cash": 1052.25, "setting": "both", "billing_class": "facility"}]}, {"description": "WDC SURG PROC LEVEL IV", "code_information": [{"code": "6900406", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1330.0, "discounted_cash": 997.5, "setting": "both", "billing_class": "facility"}]}, {"description": "WDC SURG PROC LEVEL IV", "code_information": [{"code": "6900406", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 1330.0, "discounted_cash": 997.5, "setting": "both", "billing_class": "facility"}]}, {"description": "WDC SURG PROC LEVEL V", "code_information": [{"code": "6900408", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1531.0, "discounted_cash": 1148.25, "setting": "both", "billing_class": "facility"}]}, {"description": "WDC SURG PROC LEVEL V", "code_information": [{"code": "6900408", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 1531.0, "discounted_cash": 1148.25, "setting": "both", "billing_class": "facility"}]}, {"description": "WEST NILE VIRUS", "code_information": [{"code": "86789", "type": "CPT"}, {"code": "7256784", "type": "CDM"}], "standard_charges": [{"gross_charge": 137.0, "discounted_cash": 102.75, "setting": "both", "billing_class": "facility"}]}, {"description": "WEST NILE VIRUS IGM", "code_information": [{"code": "86788", "type": "CPT"}, {"code": "7256783", "type": "CDM"}], "standard_charges": [{"gross_charge": 130.0, "discounted_cash": 97.5, "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": 159.0, "discounted_cash": 119.25, "setting": "both", "billing_class": "facility"}]}, {"description": "WEST NILE VIRUS/2", "code_information": [{"code": "86789", "type": "CPT"}, {"code": "7256785", "type": "CDM"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 83.25, "setting": "both", "billing_class": "facility"}]}, {"description": "WESTERN BLOT BAND ID", "code_information": [{"code": "84182", "type": "CPT"}, {"code": "7251521", "type": "CDM"}], "standard_charges": [{"gross_charge": 1100.0, "discounted_cash": 825.0, "setting": "both", "billing_class": "facility"}]}, {"description": "WIRE CERCLAGE", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8177975", "type": "CDM"}], "standard_charges": [{"gross_charge": 2093.0, "discounted_cash": 1569.75, "setting": "both", "billing_class": "facility"}]}, {"description": "WIRE CERCLAGE LOOP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8177976", "type": "CDM"}], "standard_charges": [{"gross_charge": 1612.0, "discounted_cash": 1209.0, "setting": "both", "billing_class": "facility"}]}, {"description": "WIRE FIXATON COM", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8177985", "type": "CDM"}], "standard_charges": [{"gross_charge": 457.75, "discounted_cash": 343.31, "setting": "both", "billing_class": "facility"}]}, {"description": "WIRE KIRCHNER PL", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137095", "type": "CDM"}], "standard_charges": [{"gross_charge": 377.0, "discounted_cash": 282.75, "setting": "both", "billing_class": "facility"}]}, {"description": "WIRE KIRCHNER TH", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137100", "type": "CDM"}], "standard_charges": [{"gross_charge": 1690.0, "discounted_cash": 1267.5, "setting": "both", "billing_class": "facility"}]}, {"description": "WIRE KIRSCHNER W STOP", "code_information": [{"code": "C1713", "type": "HCPCS"}, {"code": "8137102", "type": "CDM"}], "standard_charges": [{"gross_charge": 2449.0, "discounted_cash": 1836.75, "setting": "both", "billing_class": "facility"}]}, {"description": "WIREGDE AMPLTZ", "code_information": [{"code": "C1769", "type": "HCPCS"}, {"code": "8177990", "type": "CDM"}], "standard_charges": [{"gross_charge": 1283.0, "discounted_cash": 962.25, "setting": "both", "billing_class": "facility"}]}, {"description": "WRAP NRV PROTCT AXOGUARD", "code_information": [{"code": "C1763", "type": "HCPCS"}, {"code": "4027010", "type": "CDM"}, {"code": "278", "type": "RC"}], "standard_charges": [{"gross_charge": 19913.0, "discounted_cash": 14934.75, "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": 841.0, "discounted_cash": 630.75, "setting": "both", "billing_class": "facility"}]}, {"description": "WRIST 2 VIEWS", "code_information": [{"code": "73100", "type": "CPT"}, {"code": "5113100", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 841.0, "discounted_cash": 630.75, "setting": "both", "billing_class": "facility"}]}, {"description": "WRIST 2 VIEWS", "code_information": [{"code": "73100", "type": "CPT"}, {"code": "5123100", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 841.0, "discounted_cash": 630.75, "setting": "both", "billing_class": "facility"}]}, {"description": "WRIST 3 VIEWS MINIMUM", "code_information": [{"code": "73110", "type": "CPT"}, {"code": "4903110", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1427.0, "discounted_cash": 1070.25, "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": 1427.0, "discounted_cash": 1070.25, "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": 1427.0, "discounted_cash": 1070.25, "setting": "both", "billing_class": "facility"}]}, {"description": "WRIST 3 VIEWS MINIMUM", "code_information": [{"code": "73110", "type": "CPT"}, {"code": "5123110", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1427.0, "discounted_cash": 1070.25, "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": 2194.0, "discounted_cash": 1645.5, "setting": "both", "billing_class": "facility"}]}, {"description": "WSTNT B ENDOPROS VIATOR", "code_information": [{"code": "C1874", "type": "HCPCS"}, {"code": "8240423", "type": "CDM"}], "standard_charges": [{"gross_charge": 35727.0, "discounted_cash": 26795.25, "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": 1256.0, "discounted_cash": 942.0, "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": 1256.0, "discounted_cash": 942.0, "setting": "both", "billing_class": "facility"}]}, {"description": "YO ANTIBODY SCRN", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "7004192", "type": "CDM"}], "standard_charges": [{"gross_charge": 604.0, "discounted_cash": 453.0, "setting": "both", "billing_class": "facility"}]}, {"description": "YO ANTIBODY SCRN", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "7254192", "type": "CDM"}], "standard_charges": [{"gross_charge": 604.0, "discounted_cash": 453.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ZAFIRLUKAST 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312502", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 87.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ZAFIRLUKAST 20MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312502", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 87.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ZIDOV/LAMI300MG/150MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306344", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 530.0, "discounted_cash": 397.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ZIDOV/LAMI300MG/150MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5306344", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 530.0, "discounted_cash": 397.5, "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": 255.0, "discounted_cash": 191.25, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 255.0, "discounted_cash": 191.25, "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": 23.0, "discounted_cash": 17.25, "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": 23.0, "discounted_cash": 17.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 21.0, "discounted_cash": 15.75, "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": 21.0, "discounted_cash": 15.75, "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": "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": "ZILEUTON 600MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312516", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 262.0, "discounted_cash": 196.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ZILEUTON 600MG TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312516", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 262.0, "discounted_cash": 196.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ZILEUTON 600MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312513", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ZILEUTON 600MG XR TB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312513", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 93.0, "discounted_cash": 69.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC", "code_information": [{"code": "84630", "type": "CPT"}, {"code": "7004630", "type": "CDM"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 84.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC OX/CALAMINE3X360 EA", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335302", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 424.0, "discounted_cash": 318.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC OX/CALAMINE3X360 EA", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5335302", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 424.0, "discounted_cash": 318.0, "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": 99.0, "discounted_cash": 74.25, "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": 99.0, "discounted_cash": 74.25, "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": 304.0, "discounted_cash": 228.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC OX/MENTHOL 113GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334688", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 304.0, "discounted_cash": 228.0, "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": 192.0, "discounted_cash": 144.0, "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": 192.0, "discounted_cash": 144.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC OXIDE 16% 60GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337777", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 83.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC OXIDE 16% 60GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337777", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 83.25, "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": 3.0, "discounted_cash": 2.25, "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": 3.0, "discounted_cash": 2.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC OXIDE 20% 60GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337774", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 207.0, "discounted_cash": 155.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC OXIDE 20% 60GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337774", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 207.0, "discounted_cash": 155.25, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC OXIDE 40% 60GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5337755", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 10.0, "discounted_cash": 7.5, "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": 10.0, "discounted_cash": 7.5, "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": 2.0, "discounted_cash": 1.5, "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": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC SULFATE 220MG CP", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5312523", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC/2", "code_information": [{"code": "84630", "type": "CPT"}, {"code": "7254631", "type": "CDM"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 105.75, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC/COD LIV 40%120GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334938", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ZINC/COD LIV 40%120GM OI", "code_information": [{"code": "A9150", "type": "HCPCS"}, {"code": "5334938", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 14.0, "discounted_cash": 10.5, "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": 84.0, "discounted_cash": 63.0, "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": 84.0, "discounted_cash": 63.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ZIPRASIDONE 20MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312532", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 400.0, "discounted_cash": 300.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ZIPRASIDONE 20MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312532", "type": "CDM"}, {"code": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 400.0, "discounted_cash": 300.0, "setting": "both", "billing_class": "facility"}]}, {"description": "ZIPRASIDONE 80MG CP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8499", "type": "HCPCS"}, {"code": "5312536", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 349.0, "discounted_cash": 261.75, "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": 349.0, "discounted_cash": 261.75, "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": 1085.0, "discounted_cash": 813.75, "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": 1085.0, "discounted_cash": 813.75, "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": 1123.0, "discounted_cash": 842.25, "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": 1123.0, "discounted_cash": 842.25, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 858.0, "discounted_cash": 643.5, "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": 858.0, "discounted_cash": 643.5, "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": 293.0, "discounted_cash": 219.75, "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": 293.0, "discounted_cash": 219.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 2.0, "discounted_cash": 1.5, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": "637", "type": "RC"}], "standard_charges": [{"gross_charge": 1.0, "discounted_cash": 0.75, "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": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 39.75, "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": 53.0, "discounted_cash": 39.75, "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": 2.0, "discounted_cash": 1.5, "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": 2.0, "discounted_cash": 1.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ZONISAMIDE/2", "code_information": [{"code": "80203", "type": "CPT"}, {"code": "7252543", "type": "CDM"}], "standard_charges": [{"gross_charge": 230.0, "discounted_cash": 172.5, "setting": "both", "billing_class": "facility"}]}, {"description": "ZONISAMIDE/3", "code_information": [{"code": "80203", "type": "CPT"}, {"code": "7252561", "type": "CDM"}], "standard_charges": [{"gross_charge": 230.0, "discounted_cash": 172.5, "setting": "both", "billing_class": "facility"}]}]}