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["hospital_name","last_updated_on","version","location_name","hospital_address","type_2_npi","license_number | SC","attester_name","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."]
["Beaufort Memorial Hospital","2026-01-01","3.0.0","Beaufort Memorial Hospital","955 Ribaut Road, Beaufort, SC 29902","1366436073 | 1629068531 | 1548250459 | 1063596443","57-600094","Russell Baxley",true]
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Advantage","standard_charge|Wellcare|Medicare Advantage|negotiated_dollar","standard_charge|Wellcare|Medicare Advantage|negotiated_percentage","standard_charge|Wellcare|Medicare Advantage|negotiated_algorithm","median_amount|Wellcare|Medicare Advantage","10th_percentile|Wellcare|Medicare Advantage","90th_percentile|Wellcare|Medicare Advantage","count|Wellcare|Medicare Advantage","standard_charge|Wellcare|Medicare Advantage|methodology","additional_payer_notes|Wellcare|Medicare Advantage"]
["INJ BONESUB MATERIAL INTO BONE",3310000004,"CDM","0707T","CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},8930,5358,3134.43,8930,{"$nulls":37},7144,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},3134.43,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3269.27,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4465,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},8930,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6777.87,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},8930,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",8930,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",8930,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},8930,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},8930,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},7144,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},8930,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7144,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["MAPPING OF BILE DUCT(S)",3310000005,"CDM",null,null,361,"RC",null,null,"facility","outpatient",{"$nulls":3},0.01,0.01,0.01,0.01,{"$nulls":37},0.01,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},0.01,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},0.01,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},0.01,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},0.01,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",0.01,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},0.01,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",0.01,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",0.01,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},0.01,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},0.01,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},0.01,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},0.01,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",0.01,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC MAL LS H F NK SP 0.5CM <",3310001620,"CDM",11620,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3971,2382.6,1393.82,3971,{"$nulls":37},3176.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1393.82,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1453.78,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1985.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3971,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3013.99,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3971,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3971,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3971,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3971,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3971,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3176.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3971,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3176.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["OPEN TX ARTIC FRACT MCP/IP JNT",3310002467,"CDM",26746,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3675,2205,1289.92,3675,{"$nulls":37},2940,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1289.92,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1345.42,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1837.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3675,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2789.32,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3675,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3675,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3675,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3675,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3675,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2940,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3675,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2940,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["NASAL ENDO EUSTACIAN TUBE UNI",3310009745,"CDM",69705,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},11766,7059.6,4129.87,11766,{"$nulls":37},9412.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},4129.87,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4307.53,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5883,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},11766,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",8930.39,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},11766,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",11766,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",11766,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},11766,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},11766,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},9412.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},11766,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",9412.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["I & D ABSCESS SIMPLE OR SINGLE",3310010060,"CDM",10060,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2078,1246.8,729.38,2078,{"$nulls":37},1662.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},729.38,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},760.76,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1039,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1577.2,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1662.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1662.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REMOVE FOREIGN BODY SQ SIMPLE",3310010120,"CDM",10120,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},946,567.6,332.05,946,{"$nulls":37},756.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},332.05,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},346.33,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},473,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},946,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",718.01,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},946,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",946,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",946,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},946,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},946,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},756.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},946,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",756.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["I&D FOREIGN BODY SUBCUT SIMPLE",3310010121,"CDM",10121,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3051,1830.6,1070.9,3051,{"$nulls":37},2440.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1070.9,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1116.97,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1525.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3051,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2315.71,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3051,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3051,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3051,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3051,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3051,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2440.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3051,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2440.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["I&D HEMATOMA/FLUID",3310010140,"CDM",10140,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2078,1246.8,729.38,2078,{"$nulls":37},1662.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},729.38,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},760.76,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1039,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1577.2,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1662.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1662.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["PUNCT ASP - ABSC HEMAT CYST",3310010160,"CDM",10160,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},315,189,110.56,315,{"$nulls":37},252,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},110.56,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},115.32,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},157.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},315,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",239.08,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},315,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",315,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",315,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},315,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},315,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},252,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},315,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",252,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["I&D COMPLEX POST OP WOUND",3310010180,"CDM",10180,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2791,1674.6,979.64,2791,{"$nulls":37},2232.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},979.64,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1021.79,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1395.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2118.37,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2232.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2232.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["DEB SKIN BONE AT FX SITE",3310011012,"CDM",11012,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},1675,1005,587.92,1675,{"$nulls":37},1340,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},587.92,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},613.22,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},837.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1675,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1271.32,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1675,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1675,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1675,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},1675,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1675,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1340,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1675,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1340,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["DEB SUBQ TISSU 20SQ CM/<",3310011042,"CDM",11042,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},1297,778.2,455.25,1297,{"$nulls":37},1037.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},455.25,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},474.83,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},648.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1297,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",984.42,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1297,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1297,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1297,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},1297,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1297,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1037.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1297,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1037.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["DEB MUSC/FASCIA 20 SQ CM/<",3310011043,"CDM",11043,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},763,457.8,267.81,763,{"$nulls":37},610.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},267.81,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},279.33,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},381.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},763,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",579.12,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},763,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",763,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",763,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},763,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},763,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},610.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},763,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",610.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["DEBRIDE TISSUE/MUSCLE/BONE",3310011044,"CDM",11044,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2791,1674.6,979.64,2791,{"$nulls":37},2232.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},979.64,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1021.79,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1395.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2118.37,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2232.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2232.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["DEB SUBQ TISSUE ADDON=<20SQ CM",3310011045,"CDM",11045,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},550,330,193.05,550,{"$nulls":37},440,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},193.05,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},201.36,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},275,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},550,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",417.45,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},550,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",550,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",550,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},550,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},550,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},440,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},550,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",440,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["DEBRIDE MUS/FA ADDL <=20 SQCM",3310011046,"CDM",11046,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},550,330,193.05,550,{"$nulls":37},440,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},193.05,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},201.36,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},275,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},550,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",417.45,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},550,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",550,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",550,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},550,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},550,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},440,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},550,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",440,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["PARE BENIGN LES SINGLE LESION",3310011055,"CDM",11055,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},479,287.4,168.13,479,{"$nulls":37},383.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},168.13,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},175.36,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},239.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},479,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",363.56,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},479,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",479,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",479,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},479,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},479,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},383.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},479,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",383.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["TRIM SKIN LESIONS 2 TO 4",3310011056,"CDM",11056,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},479,287.4,168.13,479,{"$nulls":37},383.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},168.13,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},175.36,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},239.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},479,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",363.56,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},479,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",479,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",479,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},479,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},479,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},383.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},479,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",383.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["BX-SKIN SQ/MM; SGL",3310011100,"CDM",11102,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},879,527.4,308.53,879,{"$nulls":37},703.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},308.53,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},321.8,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},439.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},879,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",667.16,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},879,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",879,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",879,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},879,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},879,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},703.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},879,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",703.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REMOVAL OF SKIN TAGS",3310011200,"CDM",11200,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2078,1246.8,729.38,2078,{"$nulls":37},1662.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},729.38,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},760.76,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1039,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1577.2,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1662.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1662.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["RMV SKIN TAGS ADDON =<10 LES",3310011201,"CDM",11201,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},56,33.6,19.66,56,{"$nulls":37},44.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},19.66,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},20.5,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},28,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},56,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",42.5,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},56,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",56,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",56,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},56,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},56,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},44.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},56,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",44.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SHAVE LES S/N/H/F/G 2.0+ CM",3310011308,"CDM",11308,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},924,554.4,324.32,924,{"$nulls":37},739.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},324.32,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},338.28,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},462,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},924,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",701.32,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},924,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",924,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",924,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},924,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},924,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},739.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},924,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",739.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC TR-EXT B9+MARG 0.5CM/<",3310011400,"CDM",11400,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2078,1246.8,729.38,2078,{"$nulls":37},1662.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},729.38,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},760.76,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1039,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1577.2,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1662.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1662.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["LESION TRUNK/EXTREM 0.6-1 CM",3310011401,"CDM",11401,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2078,1246.8,729.38,2078,{"$nulls":37},1662.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},729.38,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},760.76,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1039,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1577.2,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1662.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1662.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["LESION TRUNK/EXTREM 1.1-2 CM",3310011402,"CDM",11402,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3192,1915.2,1120.39,3192,{"$nulls":37},2553.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1120.39,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1168.59,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1596,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2422.73,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2553.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2553.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC BEN LES T/A/L; 2.1-3.0CM",3310011403,"CDM",11403,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},1527,916.2,535.98,1527,{"$nulls":37},1221.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},535.98,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},559.03,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},763.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1527,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1158.99,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1527,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1527,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1527,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},1527,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1527,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1221.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1527,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1221.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["LESION TRUNK/EXTREM 3.1-4 CM",3310011404,"CDM",11404,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2791,1674.6,979.64,2791,{"$nulls":37},2232.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},979.64,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1021.79,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1395.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2118.37,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2232.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2232.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC BEN LES T/A/L; > 4.0CM",3310011406,"CDM",11406,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2791,1674.6,979.64,2791,{"$nulls":37},2232.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},979.64,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1021.79,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1395.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2118.37,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2232.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2232.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["LESION SCALP/NCK/HND 0.5CM/<",3310011420,"CDM",11420,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2078,1246.8,729.38,2078,{"$nulls":37},1662.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},729.38,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},760.76,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1039,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1577.2,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1662.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1662.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["LESION SCALP/NCK/HND 0.6-1 CM",3310011421,"CDM",11421,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2078,1246.8,729.38,2078,{"$nulls":37},1662.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},729.38,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},760.76,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1039,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1577.2,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1662.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1662.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC BLES S/N/EX G; 1.1-2.0CM",3310011422,"CDM",11422,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2400,1440,842.4,2400,{"$nulls":37},1920,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},842.4,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},878.64,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1200,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2400,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1821.6,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2400,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2400,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2400,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2400,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2400,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1920,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2400,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1920,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC BLES S/N/EX G; 2.1-3.0CM",3310011423,"CDM",11423,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2791,1674.6,979.64,2791,{"$nulls":37},2232.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},979.64,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1021.79,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1395.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2118.37,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2232.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2232.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["LESION SCALP/NCK/HND 3.1-4 CM",3310011424,"CDM",11424,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},4335,2601,1521.58,4335,{"$nulls":37},3468,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1521.58,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1587.04,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2167.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4335,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3290.26,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},4335,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4335,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4335,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},4335,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},4335,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3468,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4335,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3468,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC BLES S/N/EX G; > 4.0CM",3310011426,"CDM",11426,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3754,2252.4,1317.65,3754,{"$nulls":37},3003.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1317.65,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1374.34,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1877,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3754,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2849.29,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3754,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3754,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3754,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3754,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3754,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3003.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3754,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3003.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC FACE-MM B9+MARG 0.5CM/<",3310011440,"CDM",11440,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},441,264.6,154.79,441,{"$nulls":37},352.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},154.79,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},161.45,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},220.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},441,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",334.72,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},441,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",441,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",441,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},441,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},441,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},352.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},441,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",352.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC FACE MM B9+MARG 0.6-1.0 CM",3310011441,"CDM",11441,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},972,583.2,341.17,972,{"$nulls":37},777.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},341.17,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},355.85,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},486,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},972,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",737.75,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},972,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",972,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",972,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},972,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},972,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},777.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},972,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",777.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["LESION FACE/EARS 1.1-2 CM",3310011442,"CDM",11442,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2078,1246.8,729.38,2078,{"$nulls":37},1662.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},729.38,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},760.76,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1039,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1577.2,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1662.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1662.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["LESION FACE/EAR  2.1-3 CM",3310011443,"CDM",11443,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2078,1246.8,729.38,2078,{"$nulls":37},1662.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},729.38,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},760.76,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1039,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1577.2,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1662.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1662.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC FACE-MM B9+MARG 3.1-4 CM",3310011444,"CDM",11444,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2078,1246.8,729.38,2078,{"$nulls":37},1662.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},729.38,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},760.76,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1039,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1577.2,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1662.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1662.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC FACE-MM B9+MARG > 4 CM",3310011446,"CDM",11446,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},5292,3175.2,1857.49,5292,{"$nulls":37},4233.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1857.49,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1937.4,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2646,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5292,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4016.63,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},5292,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5292,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5292,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},5292,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},5292,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4233.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5292,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4233.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["HIDRADENITIS EXC, INGUINAL",3310011450,"CDM",11450,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},5292,3175.2,1857.49,5292,{"$nulls":37},4233.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1857.49,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1937.4,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2646,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5292,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4016.63,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},5292,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5292,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5292,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},5292,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},5292,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4233.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5292,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4233.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC TR-EXT MAL+MARG 0.5 < CM",3310011600,"CDM",11600,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},1280,768,449.28,1280,{"$nulls":37},1024,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},449.28,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},468.61,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},640,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1280,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",971.52,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1280,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1280,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1280,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},1280,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1280,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1024,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1280,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1024,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXCISION MAL LES T/A/L 0.6-1CM",3310011601,"CDM",11601,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},1765,1059,619.52,1765,{"$nulls":37},1412,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},619.52,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},646.17,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},882.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1765,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1339.64,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1765,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1765,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1765,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},1765,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1765,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1412,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1765,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1412,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC TR-EXT MAL+MARG 1.1-2 CM",3310011602,"CDM",11602,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},694,416.4,243.59,694,{"$nulls":37},555.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},243.59,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},254.07,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},347,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},694,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",526.75,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},694,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",694,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",694,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},694,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},694,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},555.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},694,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",555.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["MALG LES TRNK/EXTREM 2.1-3 CM",3310011603,"CDM",11603,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},6233,3739.8,2187.78,6233,{"$nulls":37},4986.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2187.78,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2281.9,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3116.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6233,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4730.85,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},6233,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6233,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6233,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},6233,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},6233,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4986.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6233,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4986.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC TR_MALIG+MARG_3.1-4 CM",3310011604,"CDM",11604,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},1680,1008,589.68,1680,{"$nulls":37},1344,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},589.68,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},615.05,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},840,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1680,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1275.12,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1680,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1680,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1680,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},1680,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1680,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1344,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1680,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1344,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC TR-EXT MAL+MARG >4CM",3310011606,"CDM",11606,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3902,2341.2,1369.6,3902,{"$nulls":37},3121.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1369.6,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1428.52,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1951,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3902,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2961.62,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3902,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3902,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3902,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3902,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3902,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3121.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3902,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3121.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC S/N/H/F/G MAL+MRG 0.6-1",3310011621,"CDM",11621,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},1050,630,368.55,1050,{"$nulls":37},840,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},368.55,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},384.4,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},525,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1050,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",796.95,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1050,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1050,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1050,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},1050,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1050,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},840,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1050,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",840,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC S/N/H/F/G MAL+MRG 1.1-2",3310011622,"CDM",11622,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},1413,847.8,495.96,1413,{"$nulls":37},1130.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},495.96,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},517.3,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},706.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1413,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1072.47,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1413,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1413,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1413,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},1413,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1413,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1130.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1413,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1130.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC S/N/H/F/G MAL+MRG 2.1-3",3310011623,"CDM",11623,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},1418,850.8,497.72,1418,{"$nulls":37},1134.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},497.72,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},519.13,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},709,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1418,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1076.26,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1418,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1418,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1418,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},1418,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1418,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1134.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1418,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1134.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["MALG LES SCLP/NCK/HND 3.1-4 CM",3310011624,"CDM",11624,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2791,1674.6,979.64,2791,{"$nulls":37},2232.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},979.64,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1021.79,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1395.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2118.37,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2232.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2232.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["MALG LES FACE/EAR .5CM OR LESS",3310011640,"CDM",11640,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2378,1426.8,834.68,2378,{"$nulls":37},1902.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},834.68,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},870.59,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1189,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2378,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1804.9,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2378,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2378,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2378,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2378,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2378,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1902.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2378,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1902.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["MALG LES FACE/EAR 0.6-1.0CM",3310011641,"CDM",11641,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2078,1246.8,729.38,2078,{"$nulls":37},1662.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},729.38,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},760.76,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1039,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1577.2,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1662.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1662.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["MALG LES FACE/EAR 1.1-2.0CM",3310011642,"CDM",11642,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2078,1246.8,729.38,2078,{"$nulls":37},1662.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},729.38,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},760.76,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1039,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1577.2,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1662.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1662.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["MALG LES FACE/EAR 2.1-3.0CM",3310011643,"CDM",11643,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2078,1246.8,729.38,2078,{"$nulls":37},1662.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},729.38,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},760.76,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1039,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1577.2,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1662.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1662.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REMOVAL LES-MAL 3.1- 4.0CM",3310011644,"CDM",11644,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2791,1674.6,979.64,2791,{"$nulls":37},2232.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},979.64,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1021.79,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1395.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2118.37,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2232.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2232.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SPL AVULSE NP; SGL",3310011730,"CDM",11730,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},238,142.8,83.54,238,{"$nulls":37},190.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},83.54,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},87.13,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},119,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},238,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",180.64,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},238,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",238,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",238,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},238,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},238,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},190.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},238,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",190.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SPL AVULSE NP; EA ADDTL",3310011732,"CDM",11732,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},144,86.4,50.54,144,{"$nulls":37},115.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},50.54,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},52.72,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},72,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},144,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",109.3,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},144,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",144,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",144,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},144,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},144,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},115.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},144,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",115.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["DRAIN BLOOD FROM UNDER NAIL",3310011740,"CDM",11740,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},348,208.8,122.15,348,{"$nulls":37},278.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},122.15,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},127.4,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},174,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},348,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",264.13,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},348,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",348,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",348,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},348,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},348,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},278.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},348,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",278.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["INGROWN NAIL EXC PERM REMOVAL",3310011750,"CDM",11750,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2078,1246.8,729.38,2078,{"$nulls":37},1662.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},729.38,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},760.76,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1039,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1577.2,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1662.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1662.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REMOVAL OF PILONIDAL LESION",3310011770,"CDM",11770,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},6123,3673.8,2149.17,6123,{"$nulls":37},4898.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2149.17,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2241.63,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3061.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6123,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4647.36,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},6123,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6123,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6123,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},6123,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},6123,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4898.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6123,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4898.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC PILONIDAL CYST; EXTENSIVE",3310011771,"CDM",11771,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},6589,3953.4,2312.74,6589,{"$nulls":37},5271.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2312.74,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2412.23,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3294.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6589,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5001.05,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},6589,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6589,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6589,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},6589,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},6589,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5271.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6589,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5271.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC PILONIDAL CYST/SINUS EXT",3310011772,"CDM",11772,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3192,1915.2,1120.39,3192,{"$nulls":37},2553.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1120.39,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1168.59,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1596,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2422.73,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2553.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2553.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["INSERT DRUG IMPLANT",3310011981,"CDM",11981,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},302,181.2,106,302,{"$nulls":37},241.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},106,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},110.56,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},151,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},302,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",229.22,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},302,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",302,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",302,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},302,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},302,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},241.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},302,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",241.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REMOVE DRUG IMPLANT",3310011982,"CDM",11982,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},630,378,221.13,630,{"$nulls":37},504,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},221.13,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},230.64,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},315,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},630,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",478.17,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},630,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",630,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",630,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},630,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},630,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},504,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},630,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",504,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SREP S/N/A/G/TR/EXT 2.5CM/<",3310012001,"CDM",12001,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},501,300.6,175.85,501,{"$nulls":37},400.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},175.85,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},183.42,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},250.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},501,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",380.26,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},501,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",501,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",501,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},501,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},501,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},400.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},501,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",400.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REPAIR SUPERFICIAL WOUND(S)",3310012011,"CDM",12011,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},289,173.4,101.44,289,{"$nulls":37},231.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},101.44,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},105.8,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},144.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},289,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",219.35,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},289,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",289,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",289,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},289,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},289,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},231.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},289,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",231.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REPAIR SUPERFICIAL WOUNDS(S)",3310012014,"CDM",12014,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},340,204,119.34,340,{"$nulls":37},272,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},119.34,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},124.47,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},170,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},340,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",258.06,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},340,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",340,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",340,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},340,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},340,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},272,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},340,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",272,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["INTMD WND REPAIR S/A/T/EXT",3310012031,"CDM",12031,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},473,283.8,166.02,473,{"$nulls":37},378.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},166.02,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},173.17,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},236.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},473,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",359.01,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},473,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",473,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",473,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},473,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},473,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},378.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},473,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",378.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["WND INT EXCL HND/FT 2.6-7.5CM",3310012032,"CDM",12032,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2378,1426.8,834.68,2378,{"$nulls":37},1902.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},834.68,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},870.59,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1189,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2378,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1804.9,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2378,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2378,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2378,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2378,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2378,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1902.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2378,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1902.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["INT WND RPR TR/EXT 7.6-12.5 CM",3310012034,"CDM",12034,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},578,346.8,202.88,578,{"$nulls":37},462.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},202.88,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},211.61,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},289,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},578,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",438.7,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},578,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",578,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",578,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},578,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},578,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},462.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},578,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",462.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["INTMD WND REPAIR S/A/T/EXT",3310012036,"CDM",12036,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3192,1915.2,1120.39,3192,{"$nulls":37},2553.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1120.39,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1168.59,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1596,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2422.73,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2553.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2553.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["INTMD WND RPR S/TR/EXT 30+ CM",3310012037,"CDM",12037,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},4445,2667,1560.2,4445,{"$nulls":37},3556,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1560.2,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1627.31,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2222.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4445,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3373.76,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},4445,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4445,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4445,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},4445,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},4445,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3556,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4445,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3556,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CLOSURE OF WOUND <2.6CM",3310012041,"CDM",12041,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},315,189,110.56,315,{"$nulls":37},252,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},110.56,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},115.32,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},157.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},315,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",239.08,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},315,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",315,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",315,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},315,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},315,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},252,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},315,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",252,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CLOSURE OF WOUND 2.6-7.5CM",3310012042,"CDM",12042,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2791,1674.6,979.64,2791,{"$nulls":37},2232.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},979.64,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1021.79,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1395.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2118.37,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2232.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2232.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["WND INTER FACE/MM 2.5CM/<",3310012051,"CDM",12051,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2205,1323,773.96,2205,{"$nulls":37},1764,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},773.96,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},807.25,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1102.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2205,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1673.6,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2205,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2205,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2205,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2205,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2205,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1764,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2205,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1764,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["INT WND RPR FACE/MM 2.6-5.0 CM",3310012052,"CDM",12052,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},552,331.2,193.75,552,{"$nulls":37},441.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},193.75,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},202.09,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},276,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},552,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",418.97,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},552,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",552,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",552,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},552,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},552,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},441.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},552,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",441.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CLSE FACE WND W SUT 5.1-7.5CM",3310012053,"CDM",12053,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},1119,671.4,392.77,1119,{"$nulls":37},895.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},392.77,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},409.67,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},559.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1119,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",849.32,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1119,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1119,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1119,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},1119,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1119,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},895.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1119,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",895.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["INTMD WND RPR FACE 7.6-12.5CM",3310012054,"CDM",12054,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},447,268.2,156.9,447,{"$nulls":37},357.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},156.9,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},163.65,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},223.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},447,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",339.27,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},447,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",447,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",447,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},447,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},447,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},357.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},447,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",357.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["COMPLX REPAIR TRUNK 2.6-7.5 CM",3310013101,"CDM",13101,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},1159,695.4,406.81,1159,{"$nulls":37},927.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},406.81,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},424.31,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},579.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1159,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",879.68,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1159,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1159,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1159,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},1159,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1159,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},927.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1159,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",927.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CMPLX RPR TRUNK EA ADDL 5CM/<",3310013102,"CDM",13102,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},111,66.6,38.96,111,{"$nulls":37},88.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},38.96,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},40.64,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},55.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},111,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",84.25,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},111,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",111,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",111,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},111,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},111,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},88.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},111,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",88.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["WND CPLX SCLP/EXTREM 2.6-7.5CM",3310013121,"CDM",13121,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3192,1915.2,1120.39,3192,{"$nulls":37},2553.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1120.39,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1168.59,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1596,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2422.73,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2553.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2553.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["WND COMPLEX F/G/H/F 1.1-2.5 CM",3310013131,"CDM",13131,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2791,1674.6,979.64,2791,{"$nulls":37},2232.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},979.64,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1021.79,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1395.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2118.37,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2232.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2232.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CREP F/G/H/F; 2.6-7.5CM",3310013132,"CDM",13132,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},788,472.8,276.59,788,{"$nulls":37},630.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},276.59,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},288.49,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},394,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},788,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",598.09,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},788,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",788,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",788,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},788,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},788,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},630.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},788,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",630.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["COMPLEX REPAIR AXILLARY MASSES",3310013152,"CDM",13152,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3192,1915.2,1120.39,3192,{"$nulls":37},2553.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1120.39,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1168.59,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1596,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2422.73,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2553.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2553.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["2ND CLOSE WND/DEHIS EXT/COMP",3310013160,"CDM",13160,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2791,1674.6,979.64,2791,{"$nulls":37},2232.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},979.64,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1021.79,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1395.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2118.37,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2232.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2232.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ATT TRUNK; D 10 SQ CM/<",3310014000,"CDM",14000,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2625,1575,921.38,2625,{"$nulls":37},2100,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},921.38,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},961.01,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1312.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2625,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1992.38,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2625,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2625,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2625,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2625,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2625,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2100,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2625,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2100,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ATT TRUNK; D 10.1-30 SQ",3310014001,"CDM",14001,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3528,2116.8,1238.33,3528,{"$nulls":37},2822.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1238.33,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1291.6,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1764,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3528,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2677.75,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3528,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3528,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3528,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3528,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3528,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2822.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3528,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2822.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ATT S/A/L DEFECT 10.1-30 SQCM",3310014021,"CDM",14021,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},4445,2667,1560.2,4445,{"$nulls":37},3556,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1560.2,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1627.31,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2222.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4445,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3373.76,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},4445,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4445,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4445,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},4445,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},4445,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3556,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4445,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3556,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ADJ TIS XFER FCE/GEN <10 SQCM",3310014040,"CDM",14040,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},4679,2807.4,1642.33,4679,{"$nulls":37},3743.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1642.33,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1712.98,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2339.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3551.36,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3743.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3743.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ATT FCMNAGHF 10.1-30SQCM",3310014041,"CDM",14041,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},4445,2667,1560.2,4445,{"$nulls":37},3556,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1560.2,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1627.31,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2222.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4445,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3373.76,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},4445,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4445,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4445,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},4445,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},4445,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3556,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4445,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3556,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ADJ TIS XFER LID/LIP <10 SQCM",3310014060,"CDM",14060,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},4679,2807.4,1642.33,4679,{"$nulls":37},3743.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1642.33,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1712.98,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2339.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3551.36,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3743.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3743.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SKIN TIS REARR 30-60 CM",3310014301,"CDM",14301,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3150,1890,1105.65,3150,{"$nulls":37},2520,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1105.65,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1153.21,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1575,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3150,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2390.85,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3150,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3150,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3150,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3150,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3150,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2520,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3150,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2520,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SKIN SLT GRFT TRNK/ARM/LEG",3310015100,"CDM",15100,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},4066.65,2439.99,1427.39,4066.65,{"$nulls":37},3253.32,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1427.39,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1488.8,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2033.32,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4066.65,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3086.59,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},4066.65,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4066.65,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4066.65,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},4066.65,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},4066.65,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3253.32,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4066.65,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3253.32,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["FULL GRFT SCLP/EXTRM <20 SQCM",3310015220,"CDM",15220,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3159,1895.4,1108.81,3159,{"$nulls":37},2527.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1108.81,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1156.51,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1579.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3159,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2397.68,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3159,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3159,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3159,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3159,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3159,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2527.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3159,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2527.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SKIN FULL GRFT FACE/GENIT/HF =",3310015240,"CDM",15240,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2100,1260,737.1,2100,{"$nulls":37},1680,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},737.1,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},768.81,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1050,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2100,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1593.9,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2100,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2100,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2100,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2100,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2100,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1680,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2100,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1680,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["FULL GRFT LID/LIP < 20 SQCM",3310015260,"CDM",15260,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},4679,2807.4,1642.33,4679,{"$nulls":37},3743.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1642.33,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1712.98,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2339.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3551.36,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3743.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3743.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["DLAY/SCT FLAP EYE NOSE EAR LIP",3310015630,"CDM",15630,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},4599,2759.4,1614.25,4599,{"$nulls":37},3679.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1614.25,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1683.69,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2299.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4599,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3490.64,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},4599,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4599,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4599,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},4599,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},4599,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3679.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4599,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3679.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["BELPHAROPL LL;W EXT FATPAD",3310015821,"CDM",15821,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},4445,2667,1560.2,4445,{"$nulls":37},3556,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1560.2,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1627.31,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2222.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4445,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3373.76,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},4445,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4445,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4445,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},4445,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},4445,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3556,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4445,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3556,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["BLEPHAROPLASTY UPR W/EXCSS SKN",3310015823,"CDM",15823,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},10033,6019.8,3521.58,10033,{"$nulls":37},8026.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},3521.58,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3673.08,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5016.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},10033,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7615.05,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},10033,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",10033,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",10033,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},10033,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},10033,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},8026.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},10033,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",8026.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["RHYTIDECTOMY FROWN LINES",3310015826,"CDM",15826,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7674,4604.4,2693.57,7674,{"$nulls":37},6139.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2693.57,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2809.45,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3837,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7674,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5824.57,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7674,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7674,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7674,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7674,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7674,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6139.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7674,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6139.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ABDOMINOPLASTY, W/LIPECTOMY",3310015830,"CDM",15830,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7132,4279.2,2503.33,7132,{"$nulls":37},5705.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2503.33,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2611.03,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3566,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5413.19,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5705.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5705.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXCISE EXC SKIN/SUBQ OTH AREA",3310015839,"CDM",15839,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},6354,3812.4,2230.25,6354,{"$nulls":37},5083.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2230.25,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2326.2,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3177,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6354,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4822.69,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},6354,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6354,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6354,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},6354,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},6354,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5083.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6354,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5083.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ABDOMINOPLASTY W/UMBIL TRANS",3310015847,"CDM",15847,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7132,4279.2,2503.33,7132,{"$nulls":37},5705.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2503.33,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2611.03,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3566,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5413.19,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5705.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5705.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REM SUTURE W ANES SAME SURGEON",3310015850,"CDM",15850,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},1470,882,515.97,1470,{"$nulls":37},1176,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},515.97,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},538.17,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},735,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1470,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1115.73,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1470,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1470,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1470,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},1470,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1470,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1176,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1470,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1176,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REMOVE STICHES AND/OR STAPLES",3310015851,"CDM",15851,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},5178,3106.8,1817.48,5178,{"$nulls":37},4142.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1817.48,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1895.67,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2589,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5178,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3930.1,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},5178,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5178,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5178,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},5178,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},5178,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4142.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5178,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4142.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["DESTRUCT B9 LESION 1 THRU 14",3310017110,"CDM",17110,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},501,300.6,175.85,501,{"$nulls":37},400.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},175.85,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},183.42,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},250.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},501,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",380.26,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},501,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",501,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",501,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},501,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},501,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},400.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},501,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",400.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["DESTRUCT LESION 15 OR MORE",3310017111,"CDM",17111,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},387,232.2,135.84,387,{"$nulls":37},309.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},135.84,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},141.68,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},193.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},387,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",293.73,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},387,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",387,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",387,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},387,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},387,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},309.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},387,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",309.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["INCISION OF BREAST LESION",3310019020,"CDM",19020,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2791,1674.6,979.64,2791,{"$nulls":37},2232.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},979.64,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1021.79,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1395.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2118.37,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2232.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2791,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2232.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["OPEN INCIS BREAST BX",3310019101,"CDM",19101,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3938,2362.8,1382.24,3938,{"$nulls":37},3150.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1382.24,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1441.7,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1969,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3938,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2988.94,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3938,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3938,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3938,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3938,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3938,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3150.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3938,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3150.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC BREAST LESION WO/NDLE LOC",3310019120,"CDM",19120,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},4679,2807.4,1642.33,4679,{"$nulls":37},3743.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1642.33,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1712.98,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2339.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3551.36,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3743.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3743.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REMOVAL OF BREAST TISSUE",3310019300,"CDM",19300,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},6405,3843,2248.15,6405,{"$nulls":37},5124,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2248.15,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2344.87,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3202.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6405,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4861.4,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},6405,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6405,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6405,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},6405,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},6405,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5124,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6405,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5124,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["MASTECTOMY PARTIAL (LUMPEC)",3310019301,"CDM",19301,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},5575,3345,1956.82,5575,{"$nulls":37},4460,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1956.82,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2041.01,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2787.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5575,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4231.42,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},5575,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5575,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5575,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},5575,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},5575,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4460,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5575,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4460,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REDUCTION MAMMAPLASTY",3310019318,"CDM",19318,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},12396,7437.6,4351,12396,{"$nulls":37},9916.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},4351,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4538.18,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6198,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},12396,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",9408.56,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},12396,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",12396,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",12396,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},12396,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},12396,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},9916.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},12396,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",9916.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["BREAST RECONSTRUCTION",3310019370,"CDM",19370,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},10895,6537,3824.14,10895,{"$nulls":37},8716,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},3824.14,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3988.66,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5447.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},10895,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",8269.3,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},10895,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",10895,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",10895,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},10895,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},10895,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},8716,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},10895,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",8716,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXPL P WND; EXTREM",3310020103,"CDM",20103,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},1050,630,368.55,1050,{"$nulls":37},840,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},368.55,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},384.4,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},525,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1050,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",796.95,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1050,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1050,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1050,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},1050,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1050,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},840,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1050,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",840,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["DEEP MUSCLE BIOPSY",3310020205,"CDM",20205,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},6589,3953.4,2312.74,6589,{"$nulls":37},5271.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2312.74,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2412.23,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3294.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6589,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5001.05,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},6589,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6589,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6589,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},6589,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},6589,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5271.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6589,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5271.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["BONE BIOPSY OPEN DEEP",3310020245,"CDM",20245,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},5100,3060,1790.1,5100,{"$nulls":37},4080,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1790.1,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1867.11,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2550,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5100,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3870.9,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},5100,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5100,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5100,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},5100,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},5100,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4080,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5100,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4080,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REMOV FGN BODY MUSCL/TEND DEEP",3310020525,"CDM",20525,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3192,1915.2,1120.39,3192,{"$nulls":37},2553.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1120.39,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1168.59,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1596,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2422.73,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2553.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2553.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CARPAL TUNNEL THERAPEUTIC INJ",3310020526,"CDM",20526,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},800,480,280.8,800,{"$nulls":37},640,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},280.8,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},292.88,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},400,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},800,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",607.2,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},800,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",800,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",800,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},800,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},800,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},640,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},800,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",640,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["INJ SGL TENDON SHTH/LIGAMENT",3310020550,"CDM",20550,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},243,145.8,85.29,243,{"$nulls":37},194.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},85.29,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},88.96,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},121.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},243,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",184.44,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},243,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",243,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",243,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},243,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},243,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},194.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},243,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",194.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["INJ TENDON ORIGIN/INSERTION",3310020551,"CDM",20551,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},1889,1133.4,663.04,1889,{"$nulls":37},1511.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},663.04,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},691.56,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},944.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1889,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1433.75,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1889,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1889,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1889,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},1889,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1889,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1511.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1889,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1511.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["TRIGGER POINT INJECTION",3310020552,"CDM",20552,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2078,1246.8,729.38,2078,{"$nulls":37},1662.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},729.38,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},760.76,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1039,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1577.2,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1662.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1662.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["DRAIN/INJECT SM JOINT/BURSA",3310020600,"CDM",20600,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2597,1558.2,911.55,2597,{"$nulls":37},2077.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},911.55,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},950.76,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1298.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2597,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1971.12,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2597,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2597,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2597,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2597,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2597,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2077.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2597,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2077.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["DRAIN/INJ INT JOINT/BURSA UNI",3310020605,"CDM",20605,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},660,396,231.66,660,{"$nulls":37},528,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},231.66,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},241.63,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},330,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},660,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",500.94,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},660,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",660,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",660,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},660,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},660,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},528,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},660,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",528,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["DRAIN/INJECT MAJ JOINT/BURSA",3310020610,"CDM",20610,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2078,1246.8,729.38,2078,{"$nulls":37},1662.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},729.38,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},760.76,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1039,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1577.2,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1662.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1662.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["DRN/INJ MAJ JOINT/BURSA W/US",3310020611,"CDM",20611,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},529,317.4,185.68,529,{"$nulls":37},423.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},185.68,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},193.67,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},264.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},529,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",401.51,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},529,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",529,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",529,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},529,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},529,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},423.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},529,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",423.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["INS WIRE/PIN W SK TRACT",3310020650,"CDM",20650,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},4493,2695.8,1577.04,4493,{"$nulls":37},3594.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1577.04,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1644.89,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2246.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4493,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3410.19,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},4493,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4493,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4493,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},4493,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},4493,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3594.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4493,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3594.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REMOVAL OF SUPPORT IMPLANT",3310020670,"CDM",20670,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3255,1953,1142.5,3255,{"$nulls":37},2604,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1142.5,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1191.66,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1627.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3255,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2470.54,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3255,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3255,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3255,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3255,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3255,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2604,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3255,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2604,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REMOVE HARDWARE DEEP",3310020680,"CDM",20680,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},4975,2985,1746.22,4975,{"$nulls":37},3980,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1746.22,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1821.35,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2487.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4975,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3776.02,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},4975,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4975,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4975,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},4975,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},4975,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3980,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4975,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3980,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["APP UNIPLANE EXT FIXATION SYS",3310020690,"CDM",20690,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},25195,15117,8843.44,25195,{"$nulls":37},20156,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},8843.44,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},9223.89,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},12597.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},25195,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",19123,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},25195,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",25195,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",25195,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},25195,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},25195,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},20156,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},25195,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",20156,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REM EXT FIX SYS W ANESTH",3310020694,"CDM",20694,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3045,1827,1068.79,3045,{"$nulls":37},2436,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1068.79,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1114.77,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1522.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3045,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2311.16,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3045,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3045,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3045,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3045,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3045,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2436,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3045,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2436,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["BONE GRFT; MINOR/SM",3310020900,"CDM",20900,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2730,1638,958.23,2730,{"$nulls":37},2184,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},958.23,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},999.45,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1365,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2730,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2072.07,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2730,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2730,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2730,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2730,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2730,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2184,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2730,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2184,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["BONE GRAFT ANY DONOR AREA",3310020902,"CDM",20902,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},20449,12269.4,7177.6,20449,{"$nulls":37},16359.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},7177.6,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7486.38,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},10224.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},20449,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",15520.79,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},20449,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",20449,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",20449,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},20449,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},20449,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},16359.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},20449,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",16359.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["TENDON GRAFT",3310020924,"CDM",20924,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7845,4707,2753.6,7845,{"$nulls":37},6276,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2753.6,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2872.05,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3922.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7845,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5954.36,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7845,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7845,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7845,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7845,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7845,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6276,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7845,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6276,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["IMP MANIP OTHERWISE NOT LISTED",3310020999,"CDM",20999,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7265,4359,2550.02,7265,{"$nulls":37},5812,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2550.02,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2659.72,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3632.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7265,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5514.14,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7265,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7265,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7265,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7265,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7265,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5812,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7265,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5812,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXCISEION FACE LESION SC <2 CM",3310021011,"CDM",21011,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3971,2382.6,1393.82,3971,{"$nulls":37},3176.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1393.82,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1453.78,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1985.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3971,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3013.99,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3971,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3971,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3971,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3971,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3971,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3176.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3971,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3176.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC SUBCUT FACE/SCALP <2 CM",3310021012,"CDM",21012,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3192,1915.2,1120.39,3192,{"$nulls":37},2553.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1120.39,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1168.59,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1596,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2422.73,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2553.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2553.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC FACE TUM DEEP 2CM />",3310021014,"CDM",21014,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2363,1417.8,829.41,2363,{"$nulls":37},1890.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},829.41,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},865.09,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1181.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2363,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1793.52,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2363,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2363,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2363,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2363,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2363,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1890.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2363,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1890.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["NEEDLE INSUFFLATION C2201",3310021234,"CDM",null,null,270,"RC",null,null,"facility","outpatient",{"$nulls":3},67.05,40.23,23.53,67.05,{"$nulls":37},53.64,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},23.53,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},24.55,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},33.52,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},67.05,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",50.89,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},67.05,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",67.05,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",67.05,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},67.05,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},67.05,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},53.64,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},67.05,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",53.64,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["GRAFT; EAR CARTILAGE",3310021235,"CDM",21235,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},11766,7059.6,4129.87,11766,{"$nulls":37},9412.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},4129.87,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4307.53,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5883,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},11766,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",8930.39,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},11766,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",11766,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",11766,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},11766,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},11766,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},9412.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},11766,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",9412.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["NAS/SIN ENDO W/MAX ANSTRO UNI",3310021256,"CDM",31256,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7296,4377.6,2560.9,7296,{"$nulls":37},5836.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2560.9,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2671.07,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3648,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7296,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5537.66,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7296,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7296,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7296,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7296,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7296,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5836.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7296,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5836.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CLSD NASAL FRAC TRTMNT W/STAB",3310021320,"CDM",21320,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2988,1792.8,1048.79,2988,{"$nulls":37},2390.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1048.79,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1093.91,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1494,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2988,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2267.89,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2988,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2988,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2988,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2988,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2988,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2390.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2988,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2390.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CL TX NASAL SEPTAL FX",3310021337,"CDM",21337,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3618,2170.8,1269.92,3618,{"$nulls":37},2894.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1269.92,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1324.55,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1809,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3618,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2746.06,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3618,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3618,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3618,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3618,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3618,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2894.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3618,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2894.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["OP TX DEPR ZYGOMATIC ARCH FX",3310021356,"CDM",21356,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3675,2205,1289.92,3675,{"$nulls":37},2940,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1289.92,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1345.42,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1837.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3675,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2789.32,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3675,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3675,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3675,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3675,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3675,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2940,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3675,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2940,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["I&D DEEP ABSC SFT TISS NK/THOR",3310021501,"CDM",21501,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},6123,3673.8,2149.17,6123,{"$nulls":37},4898.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2149.17,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2241.63,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3061.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6123,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4647.36,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},6123,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6123,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6123,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},6123,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},6123,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4898.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6123,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4898.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["PLUG MARLEX MESH MED 0112760",3310021521,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},661.5,396.9,232.19,661.5,{"$nulls":37},529.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},232.19,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},242.18,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},330.75,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},661.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",502.08,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},661.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",661.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",661.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},661.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},661.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},529.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},661.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",529.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC NECK MASS  3CM OR > SUBCUT",3310021552,"CDM",21552,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},4391,2634.6,1541.24,4391,{"$nulls":37},3512.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1541.24,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1607.55,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2195.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4391,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3332.77,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},4391,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4391,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4391,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},4391,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},4391,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3512.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4391,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3512.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC 5CM OR> NCK SFT TISS/SUBFS",3310021554,"CDM",21554,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},4940,2964,1733.94,4940,{"$nulls":37},3952,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1733.94,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1808.53,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2470,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4940,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3749.46,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},4940,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4940,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4940,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},4940,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},4940,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3952,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4940,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3952,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC TMR NCK/SFT TISS SUB <3CM",3310021555,"CDM",21555,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},4679,2807.4,1642.33,4679,{"$nulls":37},3743.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1642.33,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1712.98,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2339.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3551.36,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3743.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3743.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXT NECK TUM DEEP <5 CM",3310021556,"CDM",21556,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},4410,2646,1547.91,4410,{"$nulls":37},3528,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1547.91,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1614.5,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2205,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4410,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3347.19,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},4410,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4410,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4410,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},4410,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},4410,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3528,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4410,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3528,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC BACK LES SC < 3 CM",3310021930,"CDM",21930,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},4679,2807.4,1642.33,4679,{"$nulls":37},3743.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1642.33,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1712.98,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2339.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3551.36,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3743.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3743.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC TMR BCK/SFT TISS SUB 3CM>",3310021931,"CDM",21931,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},5851,3510.6,2053.7,5851,{"$nulls":37},4680.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2053.7,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2142.05,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2925.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5851,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4440.91,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},5851,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5851,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5851,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},5851,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},5851,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4680.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5851,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4680.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC BACK TUM DEEP < 5 CM",3310021932,"CDM",21932,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},4462,2677.2,1566.16,4462,{"$nulls":37},3569.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1566.16,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1633.54,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2231,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4462,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3386.66,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},4462,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4462,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4462,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},4462,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},4462,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3569.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4462,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3569.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC BACK TUM DEEP 5 CM/>",3310021933,"CDM",21933,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},4590,2754,1611.09,4590,{"$nulls":37},3672,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1611.09,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1680.4,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2295,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4590,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3483.81,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},4590,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4590,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4590,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},4590,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},4590,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3672,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4590,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3672,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["MESH PROLENE 6X6 0112720",3310022337,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},495,297,173.74,495,{"$nulls":37},396,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},173.74,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},181.22,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},247.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},495,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",375.7,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},495,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",495,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",495,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},495,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},495,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},396,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},495,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",396,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["POUCH ENDO RETREIVER CD001",3310022363,"CDM",null,null,270,"RC",null,null,"facility","outpatient",{"$nulls":3},205.47,123.28,72.12,205.47,{"$nulls":37},164.38,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},72.12,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},75.22,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},102.74,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},205.47,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",155.95,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},205.47,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",205.47,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",205.47,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},205.47,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},205.47,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},164.38,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},205.47,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",164.38,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["APPLIER HEMACLIP 5MM EL5ML",3310022471,"CDM",null,null,272,"RC",null,null,"facility","outpatient",{"$nulls":3},673.05,403.83,236.24,673.05,{"$nulls":37},538.44,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},236.24,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},246.4,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},336.52,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},673.05,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",510.84,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},673.05,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",673.05,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",673.05,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},673.05,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},673.05,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},538.44,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},673.05,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",538.44,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["INSERT SPACER IN SPINE SGL LVL",3310022869,"CDM",22869,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},37619,22571.4,13204.27,37619,{"$nulls":37},30095.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},13204.27,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},13772.32,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},18809.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},37619,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",28552.82,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},37619,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",37619,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",37619,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},37619,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},37619,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},30095.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},37619,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",30095.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC TUMOR SFT TIS ABDWALL <5CM",3310022900,"CDM",22900,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},6354,3812.4,2230.25,6354,{"$nulls":37},5083.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2230.25,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2326.2,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3177,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6354,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4822.69,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},6354,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6354,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6354,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},6354,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},6354,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5083.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6354,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5083.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC ABD LES SC 3 CM/>",3310022903,"CDM",22903,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3308,1984.8,1161.11,3308,{"$nulls":37},2646.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1161.11,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1211.06,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1654,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3308,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2510.77,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3308,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3308,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3308,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3308,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3308,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2646.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3308,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2646.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["DEB SUBQ TISSUE ADDON=<20SQ CM",3310022904,"CDM",11045,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},550,330,193.05,550,{"$nulls":37},440,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},193.05,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},201.36,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},275,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},550,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",417.45,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},550,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",550,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",550,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},550,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},550,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},440,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},550,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",440,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["I&D SHOULDER DEEP ABS/HEMATOMA",3310023030,"CDM",23030,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2078,1246.8,729.38,2078,{"$nulls":37},1662.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},729.38,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},760.76,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1039,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1577.2,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1662.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1662.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ARTHROTOMY GHJ FOR INFECTION",3310023040,"CDM",23040,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},5788,3472.8,2031.59,5788,{"$nulls":37},4630.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2031.59,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2118.99,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2894,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5788,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4393.09,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},5788,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5788,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5788,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},5788,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},5788,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4630.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5788,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4630.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC TMR SHLDR/SFT TIS SUB <3CM",3310023071,"CDM",23071,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},4381,2628.6,1537.73,4381,{"$nulls":37},3504.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1537.73,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1603.88,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2190.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4381,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3325.18,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},4381,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4381,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4381,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},4381,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},4381,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3504.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4381,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3504.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC SHOULDER LES SC < 3 CM",3310023075,"CDM",23075,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2536,1521.6,890.14,2536,{"$nulls":37},2028.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},890.14,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},928.43,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1268,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2536,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1924.82,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2536,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2536,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2536,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2536,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2536,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2028.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2536,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2028.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ARTHROTOMY GLHML JT W JT EXPL",3310023107,"CDM",23107,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},16797,10078.2,5895.75,16797,{"$nulls":37},13437.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},5895.75,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6149.38,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},8398.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},16797,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",12748.92,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},16797,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",16797,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",16797,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},16797,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},16797,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},13437.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},16797,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",13437.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CLAVICULECTOMY; PARTIAL",3310023120,"CDM",23120,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7132,4279.2,2503.33,7132,{"$nulls":37},5705.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2503.33,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2611.03,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3566,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5413.19,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5705.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5705.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ACROMIOPL/ACROMIONECT PARTIAL",3310023130,"CDM",23130,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},4631,2778.6,1625.48,4631,{"$nulls":37},3704.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1625.48,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1695.41,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2315.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4631,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3514.93,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},4631,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4631,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4631,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},4631,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},4631,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3704.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4631,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3704.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC BNCYST/BTMR PROX HUMERUS",3310023150,"CDM",23150,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7920,4752,2779.92,7920,{"$nulls":37},6336,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2779.92,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2899.51,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3960,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6011.28,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6336,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6336,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["PARTIAL EXCISION BONE SCAPULA",3310023182,"CDM",23182,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},19191,11514.6,6736.04,19191,{"$nulls":37},15352.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},6736.04,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7025.83,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},9595.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},19191,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",14565.97,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},19191,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",19191,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",19191,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},19191,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},19191,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},15352.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},19191,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",15352.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["OSTECTOMY OF SCAPULA PARTIAL",3310023190,"CDM",23190,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7132,4279.2,2503.33,7132,{"$nulls":37},5705.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2503.33,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2611.03,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3566,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5413.19,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5705.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5705.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REM FB SHOULDER; SQ",3310023330,"CDM",23330,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},1544,926.4,541.94,1544,{"$nulls":37},1235.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},541.94,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},565.26,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},772,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1544,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1171.9,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1544,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1544,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1544,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},1544,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1544,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1235.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1544,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1235.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SHOULDER PROSTHESIS REMOVAL",3310023334,"CDM",23334,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3360,2016,1179.36,3360,{"$nulls":37},2688,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1179.36,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1230.1,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1680,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3360,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2550.24,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3360,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3360,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3360,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3360,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3360,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2688,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3360,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2688,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["MUSCLE TRANSF UARM/SHLDR SGL",3310023395,"CDM",23395,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},15889,9533.4,5577.04,15889,{"$nulls":37},12711.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},5577.04,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5816.96,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},7944.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},15889,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",12059.75,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},15889,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",15889,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",15889,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},15889,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},15889,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},12711.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},15889,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",12711.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["INCISION OF TENDON, MUSCLE",3310023405,"CDM",23405,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3899,2339.4,1368.55,3899,{"$nulls":37},3119.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1368.55,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1427.42,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1949.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3899,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2959.34,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3899,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3899,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3899,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3899,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3899,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3119.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3899,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3119.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REPAIR ROTATOR CUFF; ACUTE",3310023410,"CDM",23410,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7814,4688.4,2742.71,7814,{"$nulls":37},6251.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2742.71,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2860.71,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3907,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7814,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5930.83,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7814,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7814,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7814,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7814,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7814,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6251.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7814,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6251.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REPAIR ROTATOR CUFF; CHRONIC",3310023412,"CDM",23412,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7814,4688.4,2742.71,7814,{"$nulls":37},6251.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2742.71,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2860.71,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3907,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7814,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5930.83,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7814,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7814,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7814,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7814,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7814,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6251.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7814,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6251.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["RELEASE OF SHOULDER LIGAMENT",3310023415,"CDM",23415,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7539,4523.4,2646.19,7539,{"$nulls":37},6031.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2646.19,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2760.03,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3769.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5722.1,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6031.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6031.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["RECNST COMP SHLDER W/ACROMIO",3310023420,"CDM",23420,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7539,4523.4,2646.19,7539,{"$nulls":37},6031.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2646.19,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2760.03,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3769.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5722.1,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6031.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6031.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REPAIR BICEPS TENDON",3310023430,"CDM",23430,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7539,4523.4,2646.19,7539,{"$nulls":37},6031.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2646.19,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2760.03,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3769.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5722.1,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6031.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6031.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["TENDON TRANSFER-BICEPS",3310023440,"CDM",23440,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7539,4523.4,2646.19,7539,{"$nulls":37},6031.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2646.19,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2760.03,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3769.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5722.1,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6031.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6031.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CAPULORRAPHY ANT, BANKART",3310023455,"CDM",23455,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7539,4523.4,2646.19,7539,{"$nulls":37},6031.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2646.19,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2760.03,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3769.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5722.1,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6031.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6031.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CAPSULORRHAPHY ANT W BONE BLK",3310023460,"CDM",23460,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},16797,10078.2,5895.75,16797,{"$nulls":37},13437.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},5895.75,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6149.38,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},8398.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},16797,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",12748.92,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},16797,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",16797,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",16797,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},16797,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},16797,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},13437.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},16797,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",13437.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CAPSULORRHAPHY ANT; W CPT",3310023462,"CDM",23462,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},9372,5623.2,3289.57,9372,{"$nulls":37},7497.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},3289.57,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3431.09,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4686,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},9372,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7113.35,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},9372,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",9372,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",9372,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},9372,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},9372,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},7497.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},9372,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7497.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CAPSULORRHAPHY GHJ MULTDIR UNS",3310023466,"CDM",23466,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},14872.41,8923.45,5220.22,14872.41,{"$nulls":37},11897.93,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},5220.22,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5444.79,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},7436.2,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},14872.41,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",11288.16,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},14872.41,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",14872.41,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",14872.41,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},14872.41,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},14872.41,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},11897.93,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},14872.41,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",11897.93,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ORIF CLAV FRACT W/WO FIX",3310023515,"CDM",23515,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7200,4320,2527.2,7200,{"$nulls":37},5760,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2527.2,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2635.92,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3600,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7200,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5464.8,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7200,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7200,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7200,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7200,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7200,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5760,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7200,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5760,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["OP TX ACLAV DISLOC ACUT/CHRNIC",3310023550,"CDM",23550,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},15889,9533.4,5577.04,15889,{"$nulls":37},12711.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},5577.04,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5816.96,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},7944.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},15889,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",12059.75,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},15889,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",15889,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",15889,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},15889,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},15889,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},12711.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},15889,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",12711.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["OP TX ACLAV DISLOC W GRAFT",3310023552,"CDM",23552,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},8269,4961.4,2902.42,8269,{"$nulls":37},6615.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2902.42,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3027.28,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4134.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},8269,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6276.17,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},8269,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",8269,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",8269,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},8269,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},8269,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6615.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},8269,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6615.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REPAIR SCAPULA FRACTURE",3310023585,"CDM",23585,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},4157,2494.2,1459.11,4157,{"$nulls":37},3325.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1459.11,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1521.88,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2078.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4157,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3155.16,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},4157,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4157,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4157,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},4157,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},4157,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3325.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4157,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3325.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["OPEN TX PROXIMAL HUMERAL FRACT",3310023615,"CDM",23615,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},16400,9840,5756.4,16400,{"$nulls":37},13120,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},5756.4,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6004.04,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},8200,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},16400,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",12447.6,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},16400,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",16400,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",16400,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},16400,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},16400,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},13120,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},16400,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",13120,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ORIF HUMERAL TUBEROSITY",3310023630,"CDM",23630,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},16400,9840,5756.4,16400,{"$nulls":37},13120,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},5756.4,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6004.04,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},8200,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},16400,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",12447.6,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},16400,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",16400,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",16400,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},16400,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},16400,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},13120,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},16400,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",13120,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CLS TX SHLDR DIS W/MAN WO ANES",3310023650,"CDM",23650,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},564,338.4,197.96,564,{"$nulls":37},451.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},197.96,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},206.48,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},282,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},564,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",428.08,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},564,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",564,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",564,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},564,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},564,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},451.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},564,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",451.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CLSD TX SHOULDER DISLC W/MANIP",3310023655,"CDM",23655,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3814,2288.4,1338.71,3814,{"$nulls":37},3051.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1338.71,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1396.31,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1907,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3814,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2894.83,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3814,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3814,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3814,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3814,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3814,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3051.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3814,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3051.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["MANIP SHLDER JNT W/ANESTHESIA",3310023700,"CDM",23700,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2698,1618.8,947,2698,{"$nulls":37},2158.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},947,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},987.74,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1349,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2698,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2047.78,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2698,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2698,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2698,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2698,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2698,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2158.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2698,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2158.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["UNLISTED PROCEDURE SHOULDER",3310023929,"CDM",23929,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3308,1984.8,1161.11,3308,{"$nulls":37},2646.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1161.11,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1211.06,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1654,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3308,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2510.77,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3308,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3308,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3308,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3308,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3308,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2646.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3308,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2646.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["I&D UPR ARM /ELBW; DEEP ABS",3310023930,"CDM",23930,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2078,1246.8,729.38,2078,{"$nulls":37},1662.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},729.38,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},760.76,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1039,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1577.2,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1662.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1662.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["I&D UPPER ARM/ELBOW; BURSA",3310023931,"CDM",23931,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},1654,992.4,580.55,1654,{"$nulls":37},1323.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},580.55,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},605.53,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},827,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1654,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1255.39,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1654,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1654,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1654,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},1654,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1654,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1323.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1654,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1323.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ARTHROTOMY, ELBOW",3310024000,"CDM",24000,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3945,2367,1384.7,3945,{"$nulls":37},3156,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1384.7,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1444.26,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1972.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2994.26,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3156,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3156,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ARTH ELBOW CAPSULAR RELEASE",3310024006,"CDM",24006,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7920,4752,2779.92,7920,{"$nulls":37},6336,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2779.92,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2899.51,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3960,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6011.28,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6336,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6336,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC ARM/ELBOW LES SC 3 CM/>",3310024071,"CDM",24071,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},5851,3510.6,2053.7,5851,{"$nulls":37},4680.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2053.7,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2142.05,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2925.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5851,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4440.91,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},5851,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5851,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5851,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},5851,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},5851,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4680.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5851,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4680.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC TUMOR ARM/ELBOW DEEP 5CM/>",3310024073,"CDM",24073,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},5100.55,3060.33,1790.29,5100.55,{"$nulls":37},4080.44,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1790.29,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1867.31,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2550.28,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5100.55,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3871.32,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},5100.55,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5100.55,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5100.55,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},5100.55,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},5100.55,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4080.44,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5100.55,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4080.44,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC ARM/ELBOW LES SC < 3 CM",3310024075,"CDM",24075,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2205,1323,773.96,2205,{"$nulls":37},1764,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},773.96,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},807.25,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1102.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2205,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1673.6,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2205,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2205,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2205,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2205,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2205,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1764,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2205,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1764,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC TMR ARM/ELB SFT TISS 5CM>",3310024076,"CDM",24076,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3051,1830.6,1070.9,3051,{"$nulls":37},2440.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1070.9,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1116.97,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1525.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3051,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2315.71,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3051,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3051,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3051,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3051,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3051,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2440.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3051,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2440.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ELBOW JOINT EXPLORATION",3310024101,"CDM",24101,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7497,4498.2,2631.45,7497,{"$nulls":37},5997.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2631.45,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2744.65,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3748.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5690.22,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5997.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5997.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC OLECRANON BURSA",3310024105,"CDM",24105,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},4993,2995.8,1752.54,4993,{"$nulls":37},3994.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1752.54,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1827.94,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2496.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4993,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3789.69,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},4993,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4993,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4993,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},4993,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},4993,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3994.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4993,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3994.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC CYST/TUMOR - RADIUS",3310024120,"CDM",24120,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},4993,2995.8,1752.54,4993,{"$nulls":37},3994.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1752.54,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1827.94,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2496.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4993,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3789.69,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},4993,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4993,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4993,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},4993,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},4993,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3994.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4993,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3994.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["PART EXC OLECRANON PROCESS BN",3310024147,"CDM",24147,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7497,4498.2,2631.45,7497,{"$nulls":37},5997.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2631.45,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2744.65,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3748.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5690.22,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5997.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5997.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["DEEP REM FB FROM UA/ELBOW",3310024201,"CDM",24201,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3900,2340,1368.9,3900,{"$nulls":37},3120,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1368.9,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1427.79,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1950,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3900,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2960.1,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3900,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3900,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3900,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3900,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3900,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3120,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3900,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3120,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["RECONSTR ELBOW ML W GRFT",3310024246,"CDM",24346,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},34431,20658.6,12085.28,34431,{"$nulls":37},27544.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},12085.28,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},12605.19,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},17215.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},34431,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",26133.13,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},34431,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",34431,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",34431,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},34431,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},34431,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},27544.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},34431,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",27544.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REPAIR UA/ELBOW TENDON/MUSCLE",3310024341,"CDM",24341,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},6340,3804,2225.34,6340,{"$nulls":37},5072,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2225.34,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2321.07,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3170,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6340,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4812.06,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},6340,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6340,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6340,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},6340,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},6340,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5072,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6340,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5072,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REPR RUPT TENDON W/WO GRAFT",3310024342,"CDM",24342,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7132,4279.2,2503.33,7132,{"$nulls":37},5705.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2503.33,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2611.03,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3566,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5413.19,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5705.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5705.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["RPR LAT COLL LIGAMENT ELBOW",3310024343,"CDM",24343,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7920,4752,2779.92,7920,{"$nulls":37},6336,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2779.92,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2899.51,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3960,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6011.28,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6336,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6336,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["RECONSTR ELBOW W TEND GRFT",3310024344,"CDM",24344,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},17307,10384.2,6074.76,17307,{"$nulls":37},13845.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},6074.76,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6336.09,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},8653.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},17307,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",13136.01,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},17307,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",17307,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",17307,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},17307,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},17307,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},13845.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},17307,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",13845.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REPR ELBOW MCL W LOCAL TISSUE",3310024345,"CDM",24345,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},18126,10875.6,6362.23,18126,{"$nulls":37},14500.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},6362.23,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6635.93,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},9063,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},18126,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",13757.63,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},18126,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",18126,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",18126,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},18126,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},18126,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},14500.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},18126,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",14500.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REPAIR ELBOW PERC",3310024357,"CDM",24357,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3360,2016,1179.36,3360,{"$nulls":37},2688,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1179.36,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1230.1,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1680,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3360,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2550.24,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3360,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3360,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3360,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3360,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3360,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2688,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3360,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2688,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REPAIR ELBOW W/DEB OPEN",3310024358,"CDM",24358,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7132,4279.2,2503.33,7132,{"$nulls":37},5705.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2503.33,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2611.03,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3566,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5413.19,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5705.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5705.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["TENOTOMY ELBOW DEBRIDE NIRSCHL",3310024359,"CDM",24359,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7132,4279.2,2503.33,7132,{"$nulls":37},5705.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2503.33,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2611.03,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3566,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5413.19,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5705.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5705.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["PLUG MARLEX MESH LG 0112770",3310024452,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},658.35,395.01,231.08,658.35,{"$nulls":37},526.68,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},231.08,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},241.02,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},329.18,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},658.35,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",499.69,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},658.35,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",658.35,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",658.35,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},658.35,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},658.35,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},526.68,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},658.35,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",526.68,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["TIP SCISSOR 38CM CB010",3310024453,"CDM",null,null,272,"RC",null,null,"facility","outpatient",{"$nulls":3},228.46,137.08,80.19,228.46,{"$nulls":37},182.77,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},80.19,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},83.64,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},114.23,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},228.46,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",173.4,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},228.46,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",228.46,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",228.46,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},228.46,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},228.46,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},182.77,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},228.46,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",182.77,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["WIRE GUIDE 45x6\" WS-1106ST",3310024470,"CDM",null,null,272,"RC",null,null,"facility","outpatient",{"$nulls":3},238.5,143.1,83.71,238.5,{"$nulls":37},190.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},83.71,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},87.31,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},119.25,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},238.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",181.02,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},238.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",238.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",238.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},238.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},238.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},190.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},238.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",190.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["TROCAR BLDLS 11MM CTR33",3310024497,"CDM",null,null,272,"RC",null,null,"facility","outpatient",{"$nulls":3},297.69,178.62,104.49,297.69,{"$nulls":37},238.15,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},104.49,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},108.98,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},148.84,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},297.69,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",225.95,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},297.69,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",297.69,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",297.69,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},297.69,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},297.69,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},238.15,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},297.69,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",238.15,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CLTX HUM SHFT FRACTURE W MAN",3310024505,"CDM",24505,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2927,1756.2,1027.38,2927,{"$nulls":37},2341.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1027.38,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1071.57,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1463.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2927,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2221.59,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2927,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2927,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2927,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2927,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2927,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2341.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2927,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2341.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["OP TX HUMS SHFT FX W PLT/SCREW",3310024515,"CDM",24515,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},34431,20658.6,12085.28,34431,{"$nulls":37},27544.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},12085.28,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},12605.19,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},17215.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},34431,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",26133.13,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},34431,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",34431,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",34431,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},34431,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},34431,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},27544.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},34431,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",27544.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["TREAT HUMERUS FX WITH EXTN",3310024546,"CDM",24546,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},46135,27681,16193.38,46135,{"$nulls":37},36908,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},16193.38,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},16890.02,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},23067.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},46135,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",35016.47,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},46135,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",46135,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",46135,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},46135,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},46135,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},36908,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},46135,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",36908,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["TREAT HUMERUS EPICONDYLAR FRAC",3310024575,"CDM",24575,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7770,4662,2727.27,7770,{"$nulls":37},6216,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2727.27,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2844.6,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3885,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7770,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5897.43,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7770,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7770,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7770,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7770,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7770,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6216,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7770,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6216,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["TREAT HUMERUS CONDYLAR FX",3310024579,"CDM",24579,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},34431,20658.6,12085.28,34431,{"$nulls":37},27544.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},12085.28,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},12605.19,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},17215.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},34431,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",26133.13,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},34431,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",34431,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",34431,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},34431,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},34431,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},27544.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},34431,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",27544.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["OP TX ELBOW PA FX/DISLOCATION",3310024586,"CDM",24586,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},34431,20658.6,12085.28,34431,{"$nulls":37},27544.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},12085.28,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},12605.19,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},17215.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},34431,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",26133.13,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},34431,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",34431,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",34431,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},34431,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},34431,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},27544.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},34431,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",27544.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["TREAT ELBOW FRACTURE",3310024635,"CDM",24635,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},17307,10384.2,6074.76,17307,{"$nulls":37},13845.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},6074.76,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6336.09,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},8653.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},17307,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",13136.01,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},17307,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",17307,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",17307,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},17307,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},17307,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},13845.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},17307,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",13845.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CL TX RADIAL HD/NCK FX W MANIP",3310024655,"CDM",24655,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3726,2235.6,1307.83,3726,{"$nulls":37},2980.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1307.83,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1364.09,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1863,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3726,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2828.03,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3726,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3726,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3726,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3726,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3726,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2980.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3726,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2980.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["OPEN TX RAD HD/NK FX PROSTH",3310024666,"CDM",24666,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},34431,20658.6,12085.28,34431,{"$nulls":37},27544.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},12085.28,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},12605.19,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},17215.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},34431,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",26133.13,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},34431,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",34431,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",34431,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},34431,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},34431,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},27544.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},34431,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",27544.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["OPN TX ULNAR FRAC PROX END",3310024685,"CDM",24685,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},6300,3780,2211.3,6300,{"$nulls":37},5040,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2211.3,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2306.43,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3150,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6300,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4781.7,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},6300,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6300,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6300,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},6300,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},6300,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5040,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6300,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5040,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["I&D EXTENSOR TNDN SHEATH WRIST",3310025000,"CDM",25000,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},4679,2807.4,1642.33,4679,{"$nulls":37},3743.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1642.33,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1712.98,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2339.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3551.36,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3743.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3743.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["DCMPRN FASCT F/ARM&WRST WO DBD",3310025020,"CDM",25020,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3814,2288.4,1338.71,3814,{"$nulls":37},3051.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1338.71,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1396.31,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1907,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3814,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2894.83,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3814,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3814,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3814,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3814,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3814,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3051.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3814,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3051.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC FOREARM LES SC 3 CM/>",3310025071,"CDM",25071,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3469,2081.4,1217.62,3469,{"$nulls":37},2775.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1217.62,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1270,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1734.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3469,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2632.97,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3469,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3469,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3469,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3469,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3469,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2775.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3469,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2775.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC FOREARM TUM DEEP 3 CM/>",3310025073,"CDM",25073,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},4760,2856,1670.76,4760,{"$nulls":37},3808,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1670.76,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1742.64,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2380,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4760,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3612.84,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},4760,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4760,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4760,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},4760,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},4760,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3808,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4760,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3808,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC FOREARM LES SC < 3CM",3310025075,"CDM",25075,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3522,2113.2,1236.22,3522,{"$nulls":37},2817.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1236.22,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1289.4,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1761,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3522,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2673.2,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3522,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3522,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3522,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3522,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3522,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2817.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3522,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2817.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC FOREARM TUM DEEP <3 CM",3310025076,"CDM",25076,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3902,2341.2,1369.6,3902,{"$nulls":37},3121.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1369.6,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1428.52,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1951,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3902,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2961.62,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3902,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3902,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3902,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3902,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3902,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3121.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3902,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3121.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REMOVE  GANGLION-WRIST",3310025111,"CDM",25111,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},5519,3311.4,1937.17,5519,{"$nulls":37},4415.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1937.17,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2020.51,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2759.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5519,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4188.92,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},5519,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5519,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5519,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},5519,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},5519,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4415.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5519,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4415.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["RAD EXC WRIST BURSA/FARM TEND",3310025115,"CDM",25115,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2757,1654.2,967.71,2757,{"$nulls":37},2205.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},967.71,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1009.34,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1378.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2757,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2092.56,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2757,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2757,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2757,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2757,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2757,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2205.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2757,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2205.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["PIN BALL JURGAN .045\" W045-YL",3310025153,"CDM",null,null,272,"RC",null,null,"facility","outpatient",{"$nulls":3},40.33,24.2,14.16,40.33,{"$nulls":37},32.26,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},14.16,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},14.76,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},20.16,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},40.33,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",30.61,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},40.33,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",40.33,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",40.33,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},40.33,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},40.33,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},32.26,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},40.33,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",32.26,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXCISION DISTAL ULAN PAR/CMPLT",3310025240,"CDM",25240,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},5949,3569.4,2088.1,5949,{"$nulls":37},4759.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2088.1,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2177.93,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2974.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5949,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4515.29,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},5949,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5949,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5949,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},5949,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},5949,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4759.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5949,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4759.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["DEEP FB REM-FOREARM/WRIST",3310025248,"CDM",25248,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},6948,4168.8,2438.75,6948,{"$nulls":37},5558.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2438.75,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2543.66,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3474,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6948,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5273.53,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},6948,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6948,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6948,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},6948,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},6948,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5558.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6948,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5558.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REPR TNDN/MSCL ARM PRIM SGL EA",3310025260,"CDM",25260,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7845,4707,2753.6,7845,{"$nulls":37},6276,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2753.6,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2872.05,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3922.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7845,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5954.36,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7845,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7845,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7845,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7845,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7845,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6276,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7845,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6276,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REP T/M EXTENSOR FA/W; EACH",3310025270,"CDM",25270,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3143,1885.8,1103.19,3143,{"$nulls":37},2514.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1103.19,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1150.65,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1571.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3143,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2385.54,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3143,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3143,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3143,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3143,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3143,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2514.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3143,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2514.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["TRANSPLANT FOREARM TENDON",3310025310,"CDM",25310,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},6453,3871.8,2265,6453,{"$nulls":37},5162.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2265,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2362.44,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3226.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6453,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4897.83,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},6453,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6453,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6453,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},6453,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},6453,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5162.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6453,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5162.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["TEND TRANS FLX/EXT F/W W GRAFT",3310025312,"CDM",25312,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7920,4752,2779.92,7920,{"$nulls":37},6336,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2779.92,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2899.51,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3960,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6011.28,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6336,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6336,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["OPEN REPAIR WRIST JOINT",3310025320,"CDM",25320,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},18126,10875.6,6362.23,18126,{"$nulls":37},14500.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},6362.23,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6635.93,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},9063,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},18126,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",13757.63,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},18126,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",18126,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",18126,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},18126,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},18126,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},14500.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},18126,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",14500.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REPAIR NONUNION RADIUS/ULNA",3310025400,"CDM",25400,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},14872.41,8923.45,5220.22,14872.41,{"$nulls":37},11897.93,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},5220.22,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5444.79,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},7436.2,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},14872.41,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",11288.16,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},14872.41,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",14872.41,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",14872.41,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},14872.41,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},14872.41,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},11897.93,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},14872.41,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",11897.93,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ARTHROPLAS PROST REPLACE TRAPE",3310025445,"CDM",25445,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7132,4279.2,2503.33,7132,{"$nulls":37},5705.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2503.33,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2611.03,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3566,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5413.19,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5705.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5705.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ARTHROPLASTY BASAL JNT LRTI",3310025447,"CDM",25447,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},4721,2832.6,1657.07,4721,{"$nulls":37},3776.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1657.07,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1728.36,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2360.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4721,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3583.24,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},4721,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4721,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4721,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},4721,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},4721,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3776.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4721,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3776.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REVJ ARTHRP WREMOVAL IMP WRIST",3310025449,"CDM",25449,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},19844,11906.4,6965.24,19844,{"$nulls":37},15875.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},6965.24,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7264.89,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},9922,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},19844,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",15061.6,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},19844,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",19844,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",19844,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},19844,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},19844,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},15875.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},19844,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",15875.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["OPEN TX RADIAL SHAFT FRACTURE",3310025515,"CDM",25515,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},16168,9700.8,5674.97,16168,{"$nulls":37},12934.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},5674.97,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5919.1,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},8084,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},16168,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",12271.51,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},16168,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",16168,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",16168,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},16168,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},16168,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},12934.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},16168,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",12934.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["OPN RDLSHFT FX CLSD RD/UL JT D",3310025525,"CDM",25525,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7455,4473,2616.7,7455,{"$nulls":37},5964,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2616.7,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2729.28,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3727.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7455,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5658.34,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7455,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7455,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7455,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7455,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7455,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5964,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7455,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5964,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["TREAT FRACTURE OF ULNA",3310025545,"CDM",25545,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},5292,3175.2,1857.49,5292,{"$nulls":37},4233.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1857.49,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1937.4,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2646,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5292,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4016.63,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},5292,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5292,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5292,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},5292,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},5292,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4233.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5292,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4233.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CL TX RADIAL & ULNA FX W MANIP",3310025565,"CDM",25565,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},993,595.8,348.54,993,{"$nulls":37},794.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},348.54,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},363.54,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},496.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},993,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",753.69,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},993,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",993,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",993,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},993,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},993,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},794.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},993,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",794.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["OPEN TX RADIAL & ULNAR SHFT FX",3310025575,"CDM",25575,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},13446,8067.6,4719.55,13446,{"$nulls":37},10756.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},4719.55,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4922.58,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6723,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},13446,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",10205.51,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},13446,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",13446,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",13446,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},13446,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},13446,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},10756.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},13446,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",10756.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CLSD REDUC DSTL RADIUS W/MANIP",3310025605,"CDM",25605,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3192,1915.2,1120.39,3192,{"$nulls":37},2553.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1120.39,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1168.59,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1596,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2422.73,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2553.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3192,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2553.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["TREAT FX RAD EXTRA-ARTICUL",3310025607,"CDM",25607,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7132,4279.2,2503.33,7132,{"$nulls":37},5705.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2503.33,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2611.03,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3566,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5413.19,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5705.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5705.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["TX FX RAD INTRA ARTIC; 2 FRAGS",3310025608,"CDM",25608,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},14873,8923.8,5220.42,14873,{"$nulls":37},11898.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},5220.42,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5445.01,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},7436.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},14873,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",11288.61,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},14873,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",14873,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",14873,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},14873,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},14873,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},11898.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},14873,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",11898.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ORIF DSTL RADIUS W/3 FRAGMENTS",3310025609,"CDM",25609,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},14873,8923.8,5220.42,14873,{"$nulls":37},11898.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},5220.42,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5445.01,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},7436.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},14873,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",11288.61,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},14873,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",14873,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",14873,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},14873,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},14873,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},11898.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},14873,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",11898.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CLOSED TX WRIST FX WO MANIP",3310025622,"CDM",25622,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},621,372.6,217.97,621,{"$nulls":37},496.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},217.97,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},227.35,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},310.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},621,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",471.34,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},621,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",621,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",621,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},621,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},621,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},496.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},621,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",496.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["OPEN TX ULNAR STYLOID FX",3310025652,"CDM",25652,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},16797,10078.2,5895.75,16797,{"$nulls":37},13437.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},5895.75,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6149.38,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},8398.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},16797,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",12748.92,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},16797,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",16797,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",16797,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},16797,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},16797,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},13437.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},16797,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",13437.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ARTHRODESIS WRIST W SLDNG GRFT",3310025805,"CDM",25805,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},13169,7901.4,4622.32,13169,{"$nulls":37},10535.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},4622.32,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4821.17,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6584.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},13169,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",9995.27,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},13169,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",13169,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",13169,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},13169,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},13169,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},10535.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},13169,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",10535.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ARTHRODESIS WRST LIM W/AUTOGRF",3310025825,"CDM",25825,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},17307,10384.2,6074.76,17307,{"$nulls":37},13845.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},6074.76,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6336.09,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},8653.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},17307,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",13136.01,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},17307,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",17307,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",17307,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},17307,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},17307,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},13845.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},17307,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",13845.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["DRAIN FINGER ABSCESS COMP",3310026011,"CDM",26011,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2078,1246.8,729.38,2078,{"$nulls":37},1662.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},729.38,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},760.76,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1039,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1577.2,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1662.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1662.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["DR TENDON SHEATH 1 DIG/ & PALM",3310026020,"CDM",26020,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3198,1918.8,1122.5,3198,{"$nulls":37},2558.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1122.5,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1170.79,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1599,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3198,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2427.28,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3198,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3198,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3198,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3198,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3198,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2558.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3198,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2558.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["INCISION BONE CORTEX HAND/FNGR",3310026034,"CDM",26034,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},4304,2582.4,1510.7,4304,{"$nulls":37},3443.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1510.7,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1575.69,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2152,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4304,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3266.74,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},4304,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4304,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4304,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},4304,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},4304,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3443.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4304,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3443.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["FASCIOTOMY PALMAR OPEN PARTIAL",3310026045,"CDM",26045,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7754,4652.4,2721.65,7754,{"$nulls":37},6203.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2721.65,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2838.74,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3877,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7754,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5885.29,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7754,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7754,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7754,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7754,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7754,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6203.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7754,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6203.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["TENDON SHEATH INCISION",3310026055,"CDM",26055,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},4492,2695.2,1576.69,4492,{"$nulls":37},3593.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1576.69,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1644.52,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2246,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4492,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3409.43,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},4492,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4492,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4492,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},4492,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},4492,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3593.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4492,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3593.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC TMR/VAS MAL HND/FGR 1.5CM>",3310026111,"CDM",26111,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},5292,3175.2,1857.49,5292,{"$nulls":37},4233.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1857.49,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1937.4,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2646,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5292,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4016.63,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},5292,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5292,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5292,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},5292,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},5292,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4233.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5292,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4233.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC HAND TUM DEEP 1.5 CM/>",3310026113,"CDM",26113,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3902,2341.2,1369.6,3902,{"$nulls":37},3121.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1369.6,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1428.52,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1951,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3902,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2961.62,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3902,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3902,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3902,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3902,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3902,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3121.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3902,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3121.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC MAS/TUMR HND/FGR/SUB <1.5",3310026115,"CDM",26115,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3051,1830.6,1070.9,3051,{"$nulls":37},2440.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1070.9,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1116.97,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1525.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3051,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2315.71,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3051,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3051,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3051,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3051,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3051,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2440.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3051,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2440.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC HAND TUM DEEP < 1.5 CM",3310026116,"CDM",26116,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2934,1760.4,1029.83,2934,{"$nulls":37},2347.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1029.83,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1074.14,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1467,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2934,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2226.91,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2934,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2934,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2934,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2934,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2934,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2347.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2934,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2347.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["FASCIECTOMY PALM ONLY",3310026121,"CDM",26121,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3780,2268,1326.78,3780,{"$nulls":37},3024,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1326.78,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1383.86,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1890,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3780,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2869.02,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3780,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3780,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3780,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3780,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3780,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3024,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3780,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3024,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["PALM W SGL DIGIT RELEASE",3310026123,"CDM",26123,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3945,2367,1384.7,3945,{"$nulls":37},3156,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1384.7,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1444.26,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1972.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2994.26,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3156,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3156,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["PALM RELEASE W EA ADDTL DIGIT",3310026125,"CDM",26125,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2757,1654.2,967.71,2757,{"$nulls":37},2205.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},967.71,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1009.34,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1378.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2757,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2092.56,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2757,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2757,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2757,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2757,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2757,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2205.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2757,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2205.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SYNOVECTOMY TNDN SHTH RADICAL",3310026145,"CDM",26145,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3357,2014.2,1178.31,3357,{"$nulls":37},2685.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1178.31,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1229,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1678.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3357,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2547.96,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3357,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3357,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3357,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3357,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3357,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2685.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3357,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2685.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC MASS TNDN SHEATH HND/FGR",3310026160,"CDM",26160,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3357,2014.2,1178.31,3357,{"$nulls":37},2685.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1178.31,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1229,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1678.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3357,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2547.96,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3357,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3357,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3357,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3357,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3357,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2685.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3357,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2685.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXCISE CYST TUMOR METACARPAL",3310026200,"CDM",26200,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3921,2352.6,1376.27,3921,{"$nulls":37},3136.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1376.27,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1435.48,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1960.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3921,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2976.04,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3921,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3921,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3921,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3921,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3921,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3136.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3921,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3136.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC CYST/TUMOR FINGER PHALANX",3310026210,"CDM",26210,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3308,1984.8,1161.11,3308,{"$nulls":37},2646.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1161.11,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1211.06,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1654,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3308,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2510.77,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3308,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3308,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3308,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3308,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3308,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2646.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3308,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2646.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["PARTIAL EXCISION MCP BONE",3310026230,"CDM",26230,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7920,4752,2779.92,7920,{"$nulls":37},6336,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2779.92,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2899.51,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3960,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6011.28,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6336,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6336,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["PARTL EX PROX/MDL PHALANX FGR",3310026235,"CDM",26235,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3726,2235.6,1307.83,3726,{"$nulls":37},2980.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1307.83,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1364.09,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1863,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3726,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2828.03,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3726,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3726,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3726,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3726,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3726,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2980.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3726,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2980.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["PAR EXC BONE DISTAL PHALANX",3310026236,"CDM",26236,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3826,2295.6,1342.93,3826,{"$nulls":37},3060.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1342.93,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1400.7,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1913,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3826,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2903.93,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3826,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3826,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3826,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3826,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3826,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3060.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3826,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3060.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REPAR FLX TND FLX Z2 W/O GRFT",3310026356,"CDM",26356,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3945,2367,1384.7,3945,{"$nulls":37},3156,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1384.7,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1444.26,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1972.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2994.26,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3156,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3156,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["RPR/ADV FLX TDN ZONE2 WO GFT",3310026357,"CDM",26357,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},8930,5358,3134.43,8930,{"$nulls":37},7144,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},3134.43,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3269.27,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4465,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},8930,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6777.87,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},8930,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",8930,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",8930,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},8930,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},8930,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},7144,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},8930,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7144,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REP ET HAND; WO FG EA TENDON",3310026410,"CDM",26410,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2690,1614,944.19,2690,{"$nulls":37},2152,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},944.19,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},984.81,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1345,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2690,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2041.71,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2690,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2690,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2690,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2690,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2690,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2152,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2690,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2152,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXTENSOR TENDON REPAIR EACH",3310026418,"CDM",26418,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3253,1951.8,1141.8,3253,{"$nulls":37},2602.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1141.8,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1190.92,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1626.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3253,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2469.03,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3253,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3253,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3253,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3253,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3253,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2602.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3253,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2602.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CLSD TREAT DISTAL EXT INSERT",3310026432,"CDM",26432,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3810,2286,1337.31,3810,{"$nulls":37},3048,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1337.31,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1394.84,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1905,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3810,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2891.79,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3810,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3810,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3810,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3810,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3810,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3048,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3810,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3048,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["RPR EXT TEND DIST INS WO GRAFT",3310026433,"CDM",26433,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7754,4652.4,2721.65,7754,{"$nulls":37},6203.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2721.65,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2838.74,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3877,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7754,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5885.29,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7754,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7754,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7754,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7754,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7754,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6203.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7754,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6203.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CMC TENDON TRF/TRANSPLANT",3310026480,"CDM",26480,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3255,1953,1142.5,3255,{"$nulls":37},2604,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1142.5,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1191.66,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1627.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3255,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2470.54,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3255,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3255,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3255,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3255,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3255,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2604,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3255,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2604,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CMP TENDON TRANF/TRANSPL W GRA",3310026483,"CDM",26483,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3087,1852.2,1083.54,3087,{"$nulls":37},2469.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1083.54,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1130.15,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1543.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3087,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2343.03,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3087,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3087,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3087,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3087,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3087,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2469.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3087,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2469.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REP MCP/IP JNT COLLAT LIGAMENT",3310026540,"CDM",26540,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3570,2142,1253.07,3570,{"$nulls":37},2856,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1253.07,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1306.98,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1785,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3570,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2709.63,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3570,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3570,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3570,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3570,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3570,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2856,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3570,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2856,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CL TX MC FX WMANIP EACH BONE",3310026605,"CDM",26605,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},639,383.4,224.29,639,{"$nulls":37},511.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},224.29,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},233.94,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},319.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},639,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",485,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},639,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",639,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",639,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},639,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},639,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},511.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},639,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",511.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["PERC SK FIXATION MC FX EA BONE",3310026608,"CDM",26608,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3308,1984.8,1161.11,3308,{"$nulls":37},2646.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1161.11,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1211.06,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1654,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3308,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2510.77,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3308,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3308,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3308,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3308,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3308,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2646.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3308,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2646.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["TREAT METACARPAL FRACTURE",3310026615,"CDM",26615,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},5458,3274.8,1915.76,5458,{"$nulls":37},4366.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1915.76,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1998.17,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2729,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5458,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4142.62,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},5458,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5458,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5458,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},5458,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},5458,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4366.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5458,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4366.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["OPN TX CARPOMETACARPAL THUMB",3310026665,"CDM",26665,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},5238,3142.8,1838.54,5238,{"$nulls":37},4190.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1838.54,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1917.63,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2619,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5238,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3975.64,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},5238,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5238,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5238,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},5238,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},5238,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4190.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5238,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4190.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["OPEN TX CARPOMETACARPAL DISLOC",3310026685,"CDM",26685,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7588,4552.8,2663.39,7588,{"$nulls":37},6070.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2663.39,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2777.97,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3794,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5759.29,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6070.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6070.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CLOSED TX OF PHLNGL SHAFT FX",3310026725,"CDM",26725,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},553,331.8,194.1,553,{"$nulls":37},442.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},194.1,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},202.45,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},276.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},553,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",419.73,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},553,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",553,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",553,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},553,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},553,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},442.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},553,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",442.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["PERC SK FIX UNST PHAL SHFT FX",3310026727,"CDM",26727,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3990,2394,1400.49,3990,{"$nulls":37},3192,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1400.49,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1460.74,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1995,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3990,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3028.41,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3990,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3990,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3990,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3990,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3990,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3192,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3990,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3192,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["OPEN TX PHALANG FRACT PRX/MID",3310026735,"CDM",26735,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3425,2055,1202.18,3425,{"$nulls":37},2740,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1202.18,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1253.89,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1712.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3425,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2599.57,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3425,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3425,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3425,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3425,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3425,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2740,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3425,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2740,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["OPEN TX ARTIC FRACT MCP/IP JNT",3310026746,"CDM",26746,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3675,2205,1289.92,3675,{"$nulls":37},2940,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1289.92,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1345.42,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1837.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3675,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2789.32,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3675,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3675,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3675,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3675,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3675,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2940,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3675,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2940,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["PERC SKTL FIX PHALANG FX",3310026756,"CDM",26756,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2835,1701,995.08,2835,{"$nulls":37},2268,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},995.08,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1037.89,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1417.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2835,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2151.76,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2835,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2835,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2835,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2835,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2835,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2268,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2835,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2268,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["OPEN TX DISTAL PHLANG FRACT EA",3310026765,"CDM",26765,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3150,1890,1105.65,3150,{"$nulls":37},2520,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1105.65,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1153.21,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1575,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3150,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2390.85,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3150,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3150,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3150,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3150,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3150,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2520,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3150,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2520,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["PERC SK FIX IPJNT DISL SGL MAN",3310026776,"CDM",26776,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2625,1575,921.38,2625,{"$nulls":37},2100,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},921.38,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},961.01,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1312.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2625,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1992.38,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2625,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2625,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2625,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2625,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2625,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2100,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2625,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2100,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ARTHRODESIS METACARP JOINT",3310026850,"CDM",26850,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},19191,11514.6,6736.04,19191,{"$nulls":37},15352.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},6736.04,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7025.83,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},9595.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},19191,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",14565.97,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},19191,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",19191,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",19191,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},19191,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},19191,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},15352.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},19191,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",15352.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ARTHROD IP JOINT WWO FIXATION",3310026860,"CDM",26860,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7497,4498.2,2631.45,7497,{"$nulls":37},5997.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2631.45,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2744.65,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3748.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5690.22,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5997.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5997.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ARTHROD IP JOINT EA ADD IP JNT",3310026861,"CDM",26861,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},299,179.4,104.95,299,{"$nulls":37},239.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},104.95,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},109.46,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},149.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},299,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",226.94,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},299,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",299,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",299,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},299,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},299,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},239.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},299,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",239.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ARTHRODESIS IPHLJT WWO INT FIX",3310026862,"CDM",26862,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7588,4552.8,2663.39,7588,{"$nulls":37},6070.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2663.39,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2777.97,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3794,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5759.29,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6070.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6070.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["AMP F/TH 1/2 JT/PLX W DIR CLSR",3310026951,"CDM",26951,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7588,4552.8,2663.39,7588,{"$nulls":37},6070.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2663.39,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2777.97,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3794,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5759.29,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6070.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6070.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["AMP FNGR/THUMB VY CLOSURE",3310026952,"CDM",26952,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3945,2367,1384.7,3945,{"$nulls":37},3156,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1384.7,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1444.26,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1972.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2994.26,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3156,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3156,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["FASCIOTOMY HIP OR THIGH",3310027025,"CDM",27025,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},16797,10078.2,5895.75,16797,{"$nulls":37},13437.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},5895.75,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6149.38,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},8398.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},16797,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",12748.92,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},16797,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",16797,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",16797,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},16797,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},16797,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},13437.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},16797,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",13437.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC HIP PELVIS LES SC 3 CM/>",3310027043,"CDM",27043,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3528,2116.8,1238.33,3528,{"$nulls":37},2822.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1238.33,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1291.6,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1764,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3528,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2677.75,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3528,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3528,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3528,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3528,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3528,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2822.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3528,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2822.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC TUMR SUBCUT HIP/PLVS/GROIN",3310027047,"CDM",27047,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3051,1830.6,1070.9,3051,{"$nulls":37},2440.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1070.9,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1116.97,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1525.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3051,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2315.71,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3051,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3051,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3051,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3051,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3051,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2440.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3051,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2440.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REMOVE GROWTH FROM HIP",3310027048,"CDM",27048,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7750,4650,2720.25,7750,{"$nulls":37},6200,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2720.25,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2837.27,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3875,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7750,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5882.25,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7750,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7750,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7750,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7750,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7750,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6200,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7750,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6200,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC TROCHANTERIC BURSA/CALCIFI",3310027062,"CDM",27062,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7920,4752,2779.92,7920,{"$nulls":37},6336,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2779.92,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2899.51,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3960,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6011.28,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6336,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6336,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["INJECT SACROILIAC JOINT",3310027096,"CDM",27096,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},1050,630,368.55,1050,{"$nulls":37},840,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},368.55,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},384.4,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},525,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1050,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",796.95,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1050,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1050,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1050,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},1050,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1050,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},840,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1050,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",840,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SCREW CORT 2.7X18 202-818",3310027133,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},247.23,148.34,86.78,247.23,{"$nulls":37},197.78,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},86.78,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},90.51,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},123.62,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},247.23,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",187.65,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},247.23,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",247.23,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",247.23,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},247.23,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},247.23,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},197.78,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},247.23,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",197.78,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SCREW CORT 2.7X16 202-816",3310027134,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},247.23,148.34,86.78,247.23,{"$nulls":37},197.78,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},86.78,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},90.51,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},123.62,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},247.23,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",187.65,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},247.23,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",247.23,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",247.23,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},247.23,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},247.23,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},197.78,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},247.23,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",197.78,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["DEEP I&D THIGH/KNEE",3310027301,"CDM",27301,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3528,2116.8,1238.33,3528,{"$nulls":37},2822.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1238.33,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1291.6,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1764,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3528,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2677.75,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3528,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3528,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3528,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3528,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3528,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2822.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3528,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2822.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["FASCIOTOMY ILIOTIBIAL OPEN",3310027305,"CDM",27305,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},5787,3472.2,2031.24,5787,{"$nulls":37},4629.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2031.24,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2118.62,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2893.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5787,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4392.33,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},5787,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5787,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5787,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},5787,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},5787,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4629.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5787,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4629.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["DEEP SFT TISS BX THIGH/KNEE",3310027324,"CDM",27324,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2835,1701,995.08,2835,{"$nulls":37},2268,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},995.08,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1037.89,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1417.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2835,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2151.76,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2835,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2835,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2835,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2835,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2835,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2268,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2835,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2268,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC THIGH/KNEE LES SC < 3 CM",3310027327,"CDM",27327,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2757,1654.2,967.71,2757,{"$nulls":37},2205.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},967.71,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1009.34,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1378.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2757,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2092.56,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2757,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2757,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2757,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2757,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2757,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2205.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2757,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2205.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC THIGH/KNEE TUMOR >5CM",3310027328,"CDM",27328,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3675,2205,1289.92,3675,{"$nulls":37},2940,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1289.92,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1345.42,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1837.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3675,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2789.32,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3675,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3675,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3675,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3675,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3675,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2940,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3675,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2940,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ARTHROTOMY KNEE W/LOOSE BODIES",3310027331,"CDM",27331,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},8965,5379,3146.71,8965,{"$nulls":37},7172,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},3146.71,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3282.09,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4482.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},8965,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6804.44,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},8965,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",8965,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",8965,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},8965,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},8965,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},7172,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},8965,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7172,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ARTH KNEE W/MENISC; MED/LAT",3310027332,"CDM",27332,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},8965,5379,3146.71,8965,{"$nulls":37},7172,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},3146.71,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3282.09,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4482.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},8965,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6804.44,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},8965,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",8965,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",8965,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},8965,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},8965,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},7172,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},8965,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7172,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC THIGH/KNEE LES SC 3 CM/>",3310027337,"CDM",27337,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},6447,3868.2,2262.9,6447,{"$nulls":37},5157.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2262.9,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2360.25,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3223.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6447,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4893.27,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},6447,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6447,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6447,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},6447,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},6447,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5157.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6447,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5157.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC THIGH/KNEE TUM DEP 5CM UNI",3310027339,"CDM",27339,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},6121,3672.6,2148.47,6121,{"$nulls":37},4896.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2148.47,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2240.9,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3060.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6121,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4645.84,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},6121,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6121,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6121,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},6121,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},6121,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4896.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6121,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4896.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXCISION PREPATELLAR BURSA",3310027340,"CDM",27340,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3570,2142,1253.07,3570,{"$nulls":37},2856,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1253.07,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1306.98,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1785,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3570,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2709.63,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3570,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3570,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3570,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3570,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3570,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2856,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3570,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2856,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC SYNOVIAL CYST POPLIT SPACE",3310027345,"CDM",27345,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3150,1890,1105.65,3150,{"$nulls":37},2520,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1105.65,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1153.21,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1575,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3150,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2390.85,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3150,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3150,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3150,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3150,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3150,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2520,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3150,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2520,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC LESION MENIS/CAPSULE KNEE",3310027347,"CDM",27347,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},4840,2904,1698.84,4840,{"$nulls":37},3872,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1698.84,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1771.92,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2420,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4840,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3673.56,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},4840,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4840,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4840,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},4840,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},4840,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3872,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4840,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3872,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REMOVAL OF KNEECAP",3310027350,"CDM",27350,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},6945,4167,2437.69,6945,{"$nulls":37},5556,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2437.69,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2542.56,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3472.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5271.26,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},6945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},6945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},6945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5556,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5556,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC FEMUR BONE CYST/TUMOR",3310027355,"CDM",27355,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3780,2268,1326.78,3780,{"$nulls":37},3024,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1326.78,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1383.86,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1890,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3780,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2869.02,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3780,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3780,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3780,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3780,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3780,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3024,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3780,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3024,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["PART EXC BONE FEMUR PROX TIBIA",3310027360,"CDM",27360,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7920,4752,2779.92,7920,{"$nulls":37},6336,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2779.92,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2899.51,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3960,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6011.28,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6336,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6336,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["FRGN BDY REMOVE KNE/THGH DEEP",3310027372,"CDM",27372,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},6255,3753,2195.5,6255,{"$nulls":37},5004,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2195.5,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2289.96,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3127.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6255,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4747.54,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},6255,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6255,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6255,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},6255,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},6255,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5004,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6255,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5004,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REPAIR KNEECAP TENDON",3310027380,"CDM",27380,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},8965,5379,3146.71,8965,{"$nulls":37},7172,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},3146.71,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3282.09,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4482.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},8965,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6804.44,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},8965,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",8965,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",8965,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},8965,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},8965,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},7172,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},8965,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7172,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["RECNSTR INFRAPATELAR TENDON LT",3310027381,"CDM",27381,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},17307,10384.2,6074.76,17307,{"$nulls":37},13845.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},6074.76,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6336.09,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},8653.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},17307,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",13136.01,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},17307,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",17307,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",17307,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},17307,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},17307,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},13845.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},17307,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",13845.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SUTURE QUAD/HAMSTRING MSCL RUP",3310027385,"CDM",27385,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},8965,5379,3146.71,8965,{"$nulls":37},7172,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},3146.71,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3282.09,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4482.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},8965,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6804.44,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},8965,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",8965,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",8965,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},8965,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},8965,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},7172,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},8965,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7172,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["RECNSTR QUAD/HMST MSCL RUPT LT",3310027386,"CDM",27386,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},17307,10384.2,6074.76,17307,{"$nulls":37},13845.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},6074.76,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6336.09,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},8653.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},17307,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",13136.01,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},17307,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",17307,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",17307,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},17307,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},17307,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},13845.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},17307,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",13845.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["RPR PRIM LIG/CAP KNEE COLLAT",3310027405,"CDM",27405,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},11522,6913.2,4044.22,11522,{"$nulls":37},9217.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},4044.22,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4218.2,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5761,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},11522,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",8745.2,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},11522,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",11522,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",11522,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},11522,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},11522,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},9217.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},11522,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",9217.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["AUTOCHONDROCYTE IMPLANT KNEE",3310027412,"CDM",27412,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},17305,10383,6074.05,17305,{"$nulls":37},13844,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},6074.05,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6335.36,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},8652.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},17305,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",13134.5,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},17305,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",17305,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",17305,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},17305,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},17305,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},13844,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},17305,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",13844,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["OPEN OSTECHNDRAL KNEE ALLOGRFT",3310027415,"CDM",27415,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},28689,17213.4,10069.84,28689,{"$nulls":37},22951.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},10069.84,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},10503.04,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},14344.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},28689,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",21774.95,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},28689,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",28689,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",28689,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},28689,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},28689,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},22951.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},28689,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",22951.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ANTERIOR TIBIAL TUBERCLEPLASTY",3310027418,"CDM",27418,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},6220,3732,2183.22,6220,{"$nulls":37},4976,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2183.22,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2277.14,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3110,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6220,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4720.98,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},6220,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6220,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6220,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},6220,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},6220,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4976,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6220,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4976,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["RECONSTRUCT DISLOC PATELLA",3310027420,"CDM",27420,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},8400,5040,2948.4,8400,{"$nulls":37},6720,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2948.4,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3075.24,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4200,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},8400,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6375.6,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},8400,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",8400,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",8400,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},8400,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},8400,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6720,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},8400,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6720,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["RECON DISLO PATELLA W MSCL ADV",3310027422,"CDM",27422,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},5775,3465,2027.02,5775,{"$nulls":37},4620,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2027.02,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2114.23,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2887.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5775,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4383.23,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},5775,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5775,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5775,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},5775,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},5775,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4620,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5775,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4620,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["OPEN LATERAL RETINA RELEASE",3310027425,"CDM",27425,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7497,4498.2,2631.45,7497,{"$nulls":37},5997.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2631.45,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2744.65,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3748.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5690.22,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5997.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5997.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["LIGAMENTOUS RECON KNEE X-ARTIC",3310027427,"CDM",27427,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},6718,4030.8,2358.02,6718,{"$nulls":37},5374.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2358.02,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2459.46,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3359,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6718,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5098.96,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},6718,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6718,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6718,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},6718,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},6718,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5374.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6718,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5374.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["LIGAMENT AUG KNEE; INTRA-ARTIC",3310027428,"CDM",27428,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},30392,18235.2,10667.59,30392,{"$nulls":37},24313.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},10667.59,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},11126.51,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},15196,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},30392,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",23067.53,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},30392,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",30392,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",30392,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},30392,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},30392,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},24313.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},30392,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",24313.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["LIGAMENT ALIGN KNEE; IA & EA",3310027429,"CDM",27429,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},8253,4951.8,2896.8,8253,{"$nulls":37},6602.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2896.8,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3021.42,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4126.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},8253,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6264.03,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},8253,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",8253,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",8253,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},8253,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},8253,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6602.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},8253,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6602.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["POST CAPSULAR RELEASE KNEE",3310027435,"CDM",27435,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7497,4498.2,2631.45,7497,{"$nulls":37},5997.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2631.45,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2744.65,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3748.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5690.22,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5997.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5997.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["KNEE REALIGNMENT",3310027455,"CDM",27455,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},17151,10290.6,6020,17151,{"$nulls":37},13720.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},6020,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6278.98,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},8575.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},17151,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",13017.61,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},17151,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",17151,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",17151,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},17151,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},17151,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},13720.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},17151,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",13720.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CL TX FEMUR FX OR EPIPHYS SEP",3310027510,"CDM",27510,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3726,2235.6,1307.83,3726,{"$nulls":37},2980.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1307.83,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1364.09,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1863,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3726,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2828.03,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3726,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3726,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3726,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3726,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3726,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2980.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3726,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2980.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["OP TX PATEL FX W IF &/REP",3310027524,"CDM",27524,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},12389,7433.4,4348.54,12389,{"$nulls":37},9911.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},4348.54,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4535.61,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6194.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},12389,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",9403.25,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},12389,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",12389,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",12389,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},12389,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},12389,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},9911.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},12389,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",9911.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CLOSED TX OF TIBIAL FRACTURE",3310027532,"CDM",27532,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7588,4552.8,2663.39,7588,{"$nulls":37},6070.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2663.39,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2777.97,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3794,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5759.29,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6070.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6070.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SCREW CORT 2.7X14 202-814",3310027541,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},292.46,175.47,102.65,292.46,{"$nulls":37},233.97,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},102.65,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},107.07,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},146.23,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},292.46,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",221.98,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},292.46,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",292.46,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",292.46,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},292.46,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},292.46,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},233.97,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},292.46,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",233.97,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SCREW CORT 2.7X20 202.820",3310027542,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},247.23,148.34,86.78,247.23,{"$nulls":37},197.78,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},86.78,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},90.51,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},123.62,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},247.23,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",187.65,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},247.23,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",247.23,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",247.23,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},247.23,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},247.23,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},197.78,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},247.23,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",197.78,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["KNEE MANIP JOINT W/ANESTHESIA",3310027570,"CDM",27570,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2078,1246.8,729.38,2078,{"$nulls":37},1662.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},729.38,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},760.76,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1039,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1577.2,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1662.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1662.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["UNLISTED PROCEDURE FEMUR/KNEE",3310027599,"CDM",27599,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7920,4752,2779.92,7920,{"$nulls":37},6336,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2779.92,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2899.51,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3960,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6011.28,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6336,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6336,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["DECOMPRESSION FASCIOTOMY LEG",3310027600,"CDM",27600,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},9252,5551.2,3247.45,9252,{"$nulls":37},7401.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},3247.45,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3387.16,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4626,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},9252,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7022.27,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},9252,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",9252,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",9252,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},9252,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},9252,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},7401.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},9252,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7401.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["DF LEG ANT/LAT & P COMPARTM",3310027602,"CDM",27602,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7919,4751.4,2779.57,7919,{"$nulls":37},6335.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2779.57,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2899.15,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3959.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7919,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6010.52,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7919,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7919,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7919,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7919,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7919,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6335.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7919,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6335.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["UNL PROC OF LEG OR ANKLE",3310027605,"CDM",27899,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3673,2203.8,1289.22,3673,{"$nulls":37},2938.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1289.22,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1344.69,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1836.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3673,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2787.81,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3673,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3673,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3673,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3673,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3673,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2938.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3673,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2938.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["TENOTOMY PRQ ACHILLES TENDON",3310027606,"CDM",27606,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7588,4552.8,2663.39,7588,{"$nulls":37},6070.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2663.39,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2777.97,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3794,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5759.29,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6070.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6070.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC LEG/ANKLE TUM < 3 CM",3310027618,"CDM",27618,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2934,1760.4,1029.83,2934,{"$nulls":37},2347.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1029.83,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1074.14,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1467,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2934,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2226.91,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2934,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2934,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2934,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2934,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2934,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2347.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2934,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2347.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC LEG/ANKLE TUM DEEP <5 CM",3310027619,"CDM",27619,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3418,2050.8,1199.72,3418,{"$nulls":37},2734.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1199.72,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1251.33,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1709,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3418,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2594.26,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3418,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3418,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3418,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3418,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3418,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2734.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3418,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2734.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ARTHROTOMY ANKLE W SYNOVECTOMY",3310027625,"CDM",27625,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7442,4465.2,2612.14,7442,{"$nulls":37},5953.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2612.14,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2724.52,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3721,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7442,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5648.48,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7442,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7442,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7442,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7442,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7442,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5953.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7442,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5953.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC LESN TNDN SHTH KNE/ANK CYS",3310027630,"CDM",27630,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3470,2082,1217.97,3470,{"$nulls":37},2776,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1217.97,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1270.37,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1735,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3470,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2633.73,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3470,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3470,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3470,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3470,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3470,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2776,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3470,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2776,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC LEG/ANKLE LES SC 3 CM/>",3310027632,"CDM",27632,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3360,2016,1179.36,3360,{"$nulls":37},2688,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1179.36,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1230.1,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1680,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3360,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2550.24,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3360,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3360,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3360,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3360,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3360,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2688,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3360,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2688,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC LEG/ANKLE TUMOR DEP 5 CM/>",3310027634,"CDM",27634,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},6709,4025.4,2354.86,6709,{"$nulls":37},5367.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2354.86,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2456.16,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3354.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6709,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5092.13,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},6709,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6709,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6709,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},6709,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},6709,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5367.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6709,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5367.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC/CUR BNGN CYST/TMR TIB/FIB",3310027635,"CDM",27635,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3899,2339.4,1368.55,3899,{"$nulls":37},3119.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1368.55,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1427.42,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1949.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3899,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2959.34,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3899,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3899,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3899,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3899,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3899,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3119.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3899,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3119.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REPAIR ACHILLES TENDON",3310027650,"CDM",27650,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7132,4279.2,2503.33,7132,{"$nulls":37},5705.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2503.33,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2611.03,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3566,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5413.19,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5705.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5705.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["PRIM REPR RUPT ACHILLES W/GRAF",3310027652,"CDM",27652,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},5985,3591,2100.73,5985,{"$nulls":37},4788,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2100.73,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2191.11,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2992.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5985,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4542.62,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},5985,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5985,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5985,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},5985,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},5985,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4788,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5985,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4788,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SECONDARY REPR RUPT ACHIL TEND",3310027654,"CDM",27654,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},15889,9533.4,5577.04,15889,{"$nulls":37},12711.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},5577.04,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5816.96,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},7944.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},15889,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",12059.75,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},15889,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",15889,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",15889,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},15889,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},15889,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},12711.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},15889,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",12711.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REPAIR PERONEAL BREVIS TENDON",3310027658,"CDM",27658,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3945,2367,1384.7,3945,{"$nulls":37},3156,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1384.7,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1444.26,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1972.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2994.26,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3156,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3156,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["RPR FLX TDN LEG SECONARY EA",3310027659,"CDM",27659,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},19191,11514.6,6736.04,19191,{"$nulls":37},15352.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},6736.04,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7025.83,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},9595.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},19191,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",14565.97,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},19191,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",19191,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",19191,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},19191,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},19191,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},15352.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},19191,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",15352.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REPAIR OF LEG TENDON, EACH",3310027664,"CDM",27664,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3945,2367,1384.7,3945,{"$nulls":37},3156,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1384.7,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1444.26,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1972.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2994.26,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3156,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3156,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["RPR DISL PERONL TEN W FIB INC",3310027676,"CDM",27676,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},16168,9700.8,5674.97,16168,{"$nulls":37},12934.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},5674.97,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5919.1,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},8084,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},16168,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",12271.51,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},16168,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",16168,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",16168,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},16168,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},16168,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},12934.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},16168,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",12934.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["TENOLYSIS FLX/XTN TDN LG/ANKLE",3310027680,"CDM",27680,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7588,4552.8,2663.39,7588,{"$nulls":37},6070.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2663.39,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2777.97,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3794,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5759.29,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6070.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6070.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["LNGTH/SHRT SGL TENDON LEG/ANK",3310027685,"CDM",27685,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7588,4552.8,2663.39,7588,{"$nulls":37},6070.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2663.39,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2777.97,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3794,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5759.29,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6070.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6070.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["TX/TPLANT SGL TNDN SUPERFICIAL",3310027690,"CDM",27690,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},5264,3158.4,1847.66,5264,{"$nulls":37},4211.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1847.66,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1927.15,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2632,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5264,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3995.38,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},5264,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5264,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5264,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},5264,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},5264,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4211.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5264,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4211.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["DEEP TRANSF/PL SGL LLEG TENDON",3310027691,"CDM",27691,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},18126,10875.6,6362.23,18126,{"$nulls":37},14500.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},6362.23,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6635.93,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},9063,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},18126,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",13757.63,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},18126,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",18126,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",18126,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},18126,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},18126,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},14500.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},18126,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",14500.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["RPR PRI DISRPTD LIG ANKLE COLL",3310027695,"CDM",27695,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},17151,10290.6,6020,17151,{"$nulls":37},13720.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},6020,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6278.98,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},8575.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},17151,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",13017.61,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},17151,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",17151,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",17151,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},17151,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},17151,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},13720.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},17151,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",13720.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["RPR SEC DISRPTD LIG ANKLE CTRL",3310027698,"CDM",27698,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},15889,9533.4,5577.04,15889,{"$nulls":37},12711.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},5577.04,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5816.96,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},7944.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},15889,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",12059.75,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},15889,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",15889,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",15889,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},15889,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},15889,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},12711.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},15889,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",12711.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["OSTEOTOMY FIBULA",3310027707,"CDM",27707,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},8930,5358,3134.43,8930,{"$nulls":37},7144,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},3134.43,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3269.27,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4465,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},8930,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6777.87,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},8930,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",8930,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",8930,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},8930,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},8930,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},7144,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},8930,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7144,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["RPR NON/MAL TIBIA W/O GRAFT",3310027720,"CDM",27720,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},17151,10290.6,6020,17151,{"$nulls":37},13720.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},6020,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6278.98,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},8575.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},17151,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",13017.61,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},17151,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",17151,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",17151,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},17151,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},17151,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},13720.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},17151,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",13720.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["RPR NON/MAL TIB W/ILIA OR GRFT",3310027724,"CDM",27724,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},33763,20257.8,11850.81,33763,{"$nulls":37},27010.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},11850.81,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},12360.63,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},16881.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},33763,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",25626.12,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},33763,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",33763,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",33763,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},33763,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},33763,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},27010.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},33763,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",27010.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CLOS TREAT TIB SHFT FX W/MANIP",3310027752,"CDM",27752,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2078,1246.8,729.38,2078,{"$nulls":37},1662.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},729.38,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},760.76,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1039,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1577.2,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1662.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1662.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ORIF MEDIAL MALLEOLUS FRACT",3310027766,"CDM",27766,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},12564,7538.4,4409.96,12564,{"$nulls":37},10051.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},4409.96,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4599.68,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6282,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},12564,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",9536.08,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},12564,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",12564,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",12564,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},12564,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},12564,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},10051.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},12564,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",10051.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["OPTX POSTERIOR ANKLE FX",3310027769,"CDM",27769,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},18126,10875.6,6362.23,18126,{"$nulls":37},14500.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},6362.23,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6635.93,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},9063,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},18126,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",13757.63,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},18126,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",18126,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",18126,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},18126,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},18126,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},14500.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},18126,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",14500.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["OPEN TX OF FIBULA FRACTURE",3310027784,"CDM",27784,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},16168,9700.8,5674.97,16168,{"$nulls":37},12934.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},5674.97,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5919.1,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},8084,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},16168,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",12271.51,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},16168,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",16168,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",16168,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},16168,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},16168,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},12934.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},16168,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",12934.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["OPEN TX DISTAL FIB FX LAT MALL",3310027792,"CDM",27792,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},12393.68,7436.21,4350.18,12393.68,{"$nulls":37},9914.94,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},4350.18,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4537.33,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6196.84,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},12393.68,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",9406.8,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},12393.68,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",12393.68,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",12393.68,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},12393.68,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},12393.68,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},9914.94,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},12393.68,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",9914.94,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ORIF ANKLE FX W/WO FIXATION",3310027814,"CDM",27814,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},6997,4198.2,2455.95,6997,{"$nulls":37},5597.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2455.95,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2561.6,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3498.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6997,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5310.72,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},6997,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6997,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6997,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},6997,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},6997,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5597.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6997,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5597.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["OPEN TX ANKLE FX WO FIX PST LP",3310027822,"CDM",27822,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},16168,9700.8,5674.97,16168,{"$nulls":37},12934.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},5674.97,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5919.1,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},8084,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},16168,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",12271.51,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},16168,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",16168,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",16168,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},16168,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},16168,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},12934.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},16168,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",12934.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["OPN TX FRCTRE DISTL TIBIA ONLY",3310027827,"CDM",27827,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7875,4725,2764.12,7875,{"$nulls":37},6300,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2764.12,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2883.04,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3937.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7875,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5977.12,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7875,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7875,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7875,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7875,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7875,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6300,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7875,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6300,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["OPEN TX LOWER LEG JNT W FIXATI",3310027829,"CDM",27829,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},12393.68,7436.21,4350.18,12393.68,{"$nulls":37},9914.94,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},4350.18,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4537.33,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6196.84,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},12393.68,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",9406.8,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},12393.68,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",12393.68,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",12393.68,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},12393.68,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},12393.68,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},9914.94,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},12393.68,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",9914.94,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["FASCIOTOMY FOOT AND/OR TOE",3310028008,"CDM",28008,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7754,4652.4,2721.65,7754,{"$nulls":37},6203.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2721.65,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2838.74,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3877,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7754,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5885.29,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7754,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7754,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7754,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7754,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7754,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6203.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7754,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6203.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXPLORATION OF A TOE JOINT",3310028024,"CDM",28024,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3465,2079,1216.21,3465,{"$nulls":37},2772,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1216.21,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1268.54,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1732.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3465,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2629.94,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3465,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3465,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3465,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3465,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3465,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2772,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3465,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2772,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["TARSAL TUNNEL RLSE TIBIAL NERV",3310028035,"CDM",28035,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},4454,2672.4,1563.35,4454,{"$nulls":37},3563.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1563.35,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1630.61,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2227,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4454,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3380.59,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},4454,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4454,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4454,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},4454,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},4454,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3563.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4454,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3563.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC SFT TISS FT/TOE 1.5CM> SUB",3310028039,"CDM",28039,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},4670,2802,1639.17,4670,{"$nulls":37},3736,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1639.17,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1709.69,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2335,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4670,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3544.53,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},4670,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4670,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4670,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},4670,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},4670,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3736,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4670,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3736,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXCISE TUMOR SFT TISSUE FT/TOE",3310028041,"CDM",28041,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},6354,3812.4,2230.25,6354,{"$nulls":37},5083.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2230.25,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2326.2,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3177,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6354,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4822.69,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},6354,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6354,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6354,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},6354,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},6354,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5083.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6354,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5083.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC FOOT/TOE TUM SC < 1.5 CM",3310028043,"CDM",28043,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2078,1246.8,729.38,2078,{"$nulls":37},1662.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},729.38,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},760.76,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1039,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1577.2,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1662.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1662.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC FOOT/TOE TUM DEEP <1.5 CM",3310028045,"CDM",28045,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},6589,3953.4,2312.74,6589,{"$nulls":37},5271.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2312.74,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2412.23,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3294.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6589,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5001.05,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},6589,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6589,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6589,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},6589,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},6589,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5271.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6589,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5271.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["FASCIECTOMY PLANTAR; PARTIAL",3310028060,"CDM",28060,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3709,2225.4,1301.86,3709,{"$nulls":37},2967.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1301.86,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1357.86,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1854.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3709,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2815.13,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3709,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3709,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3709,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3709,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3709,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2967.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3709,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2967.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["RADICAL REMOV FT PLNTR FASCIA",3310028062,"CDM",28062,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7497,4498.2,2631.45,7497,{"$nulls":37},5997.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2631.45,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2744.65,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3748.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5690.22,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5997.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5997.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC NEUROMA, SINGLE EA",3310028080,"CDM",28080,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7019,4211.4,2463.67,7019,{"$nulls":37},5615.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2463.67,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2569.66,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3509.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7019,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5327.42,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7019,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7019,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7019,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7019,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7019,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5615.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7019,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5615.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC FOOT CYST/GANGLION",3310028090,"CDM",28090,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7019,4211.4,2463.67,7019,{"$nulls":37},5615.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2463.67,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2569.66,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3509.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7019,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5327.42,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7019,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7019,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7019,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7019,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7019,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5615.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7019,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5615.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REMOVE TOE TENDON OR GROWTH",3310028092,"CDM",28092,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},4304,2582.4,1510.7,4304,{"$nulls":37},3443.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1510.7,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1575.69,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2152,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4304,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3266.74,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},4304,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4304,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4304,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},4304,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},4304,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3443.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4304,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3443.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC HEEL TALUS/CALCN CYST/TUMR",3310028100,"CDM",28100,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7497,4498.2,2631.45,7497,{"$nulls":37},5997.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2631.45,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2744.65,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3748.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5690.22,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5997.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5997.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC/CURETTAGE CYST/TUMOR",3310028103,"CDM",28103,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},17151,10290.6,6020,17151,{"$nulls":37},13720.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},6020,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6278.98,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},8575.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},17151,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",13017.61,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},17151,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",17151,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",17151,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},17151,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},17151,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},13720.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},17151,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",13720.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC TAR/METATRAS CYST/TUMOR",3310028104,"CDM",28104,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7497,4498.2,2631.45,7497,{"$nulls":37},5997.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2631.45,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2744.65,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3748.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5690.22,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5997.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5997.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC BC/BT FOOT PHALANGE",3310028108,"CDM",28108,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2890,1734,1014.39,2890,{"$nulls":37},2312,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1014.39,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1058.03,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1445,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2890,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2193.51,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2890,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2890,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2890,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2890,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2890,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2312,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2890,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2312,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["PRTL EXC 5TH METATRSL HEAD",3310028110,"CDM",28110,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3308,1984.8,1161.11,3308,{"$nulls":37},2646.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1161.11,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1211.06,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1654,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3308,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2510.77,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3308,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3308,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3308,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3308,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3308,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2646.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3308,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2646.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["COMPL EXC OTHR METATRSL HEAD",3310028112,"CDM",28112,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3465,2079,1216.21,3465,{"$nulls":37},2772,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1216.21,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1268.54,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1732.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3465,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2629.94,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3465,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3465,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3465,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3465,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3465,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2772,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3465,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2772,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["COMP EXC 5TH METATRSL HEAD",3310028113,"CDM",28113,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7497,4498.2,2631.45,7497,{"$nulls":37},5997.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2631.45,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2744.65,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3748.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5690.22,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5997.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5997.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["COMP EXC ALL METATRSL HDS",3310028114,"CDM",28114,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7497,4498.2,2631.45,7497,{"$nulls":37},5997.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2631.45,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2744.65,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3748.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5690.22,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5997.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5997.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["OSTECTOMY EXC TARSAL CONDITION",3310028116,"CDM",28116,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3465,2079,1216.21,3465,{"$nulls":37},2772,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1216.21,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1268.54,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1732.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3465,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2629.94,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3465,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3465,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3465,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3465,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3465,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2772,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3465,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2772,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["OSTECTOMY-CALCANEUS FOR SPUR",3310028119,"CDM",28119,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3945,2367,1384.7,3945,{"$nulls":37},3156,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1384.7,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1444.26,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1972.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2994.26,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3156,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3156,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["PARTL EXC ANKLE OR HEEL BONE",3310028120,"CDM",28120,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3945,2367,1384.7,3945,{"$nulls":37},3156,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1384.7,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1444.26,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1972.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2994.26,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3156,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3156,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXC TARSEL/META BONE PART",3310028122,"CDM",28122,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3465,2079,1216.21,3465,{"$nulls":37},2772,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1216.21,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1268.54,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1732.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3465,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2629.94,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3465,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3465,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3465,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3465,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3465,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2772,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3465,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2772,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["PART EXC BONE PHALANX TOE",3310028124,"CDM",28124,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},1197,718.2,420.15,1197,{"$nulls":37},957.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},420.15,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},438.22,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},598.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1197,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",908.52,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1197,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1197,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1197,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},1197,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1197,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},957.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1197,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",957.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["RESECT PHALANG BS SGL TOE EA",3310028126,"CDM",28126,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7920,4752,2779.92,7920,{"$nulls":37},6336,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2779.92,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2899.51,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3960,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6011.28,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6336,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7920,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6336,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["RESECT HD OF TOE PHALANX",3310028153,"CDM",28153,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},8189,4913.4,2874.34,8189,{"$nulls":37},6551.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2874.34,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2997.99,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4094.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},8189,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6215.45,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},8189,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",8189,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",8189,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},8189,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},8189,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6551.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},8189,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6551.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["INTRPHALANG TOE JNT EXC EA SGL",3310028160,"CDM",28160,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},6945,4167,2437.69,6945,{"$nulls":37},5556,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2437.69,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2542.56,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3472.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5271.26,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},6945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},6945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},6945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5556,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5556,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REMOVAL OF FOOT FOREIGN BODY",3310028190,"CDM",28190,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2019,1211.4,708.67,2019,{"$nulls":37},1615.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},708.67,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},739.16,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1009.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2019,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1532.42,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2019,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2019,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2019,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2019,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2019,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1615.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2019,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1615.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REMOVAL OF FOOT FOREIGN BODY",3310028192,"CDM",28192,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3051,1830.6,1070.9,3051,{"$nulls":37},2440.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1070.9,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1116.97,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1525.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3051,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2315.71,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3051,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3051,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3051,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3051,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3051,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2440.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3051,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2440.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REPR FOOT FLEXOR TENDON EA",3310028200,"CDM",28200,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},5372,3223.2,1885.57,5372,{"$nulls":37},4297.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1885.57,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1966.69,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2686,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5372,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4077.35,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},5372,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5372,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5372,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},5372,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},5372,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4297.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5372,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4297.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["2' RPR FOOT FLEX TEND W/GRAFT",3310028202,"CDM",28202,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},5372,3223.2,1885.57,5372,{"$nulls":37},4297.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1885.57,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1966.69,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2686,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5372,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4077.35,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},5372,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5372,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5372,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},5372,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},5372,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4297.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5372,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4297.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REPR FOOT EXTENSOR TENDON EA",3310028208,"CDM",28208,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2536,1521.6,890.14,2536,{"$nulls":37},2028.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},890.14,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},928.43,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1268,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2536,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1924.82,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2536,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2536,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2536,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2536,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2536,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2028.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2536,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2028.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["2\" REPR TENDON EXTNR FOOT W/GR",3310028210,"CDM",28210,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},12393.68,7436.21,4350.18,12393.68,{"$nulls":37},9914.94,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},4350.18,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4537.33,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6196.84,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},12393.68,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",9406.8,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},12393.68,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",12393.68,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",12393.68,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},12393.68,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},12393.68,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},9914.94,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},12393.68,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",9914.94,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["OP INC FOOT/TOE EXT TENDON",3310028234,"CDM",28234,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3468,2080.8,1217.27,3468,{"$nulls":37},2774.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1217.27,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1269.63,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1734,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3468,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2632.21,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3468,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3468,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3468,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3468,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3468,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2774.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3468,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2774.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ADV POST TIB TEN W EXC NAV BNE",3310028238,"CDM",28238,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},15889,9533.4,5577.04,15889,{"$nulls":37},12711.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},5577.04,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5816.96,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},7944.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},15889,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",12059.75,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},15889,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",15889,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",15889,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},15889,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},15889,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},12711.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},15889,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",12711.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["MTP JNT CAPSULOTOMY EA SGL JNT",3310028270,"CDM",28270,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2316,1389.6,812.92,2316,{"$nulls":37},1852.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},812.92,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},847.89,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1158,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2316,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1757.84,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2316,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2316,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2316,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2316,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2316,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1852.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2316,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1852.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CAPSUL INTERMED JNT SLG EA JNT",3310028272,"CDM",28272,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3921,2352.6,1376.27,3921,{"$nulls":37},3136.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1376.27,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1435.48,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1960.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3921,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2976.04,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3921,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3921,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3921,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3921,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3921,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3136.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3921,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3136.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["TOE WEBBING OP",3310028280,"CDM",28280,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},5785,3471,2030.54,5785,{"$nulls":37},4628,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2030.54,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2117.89,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2892.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5785,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4390.81,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},5785,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5785,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5785,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},5785,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},5785,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4628,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5785,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4628,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CORRECTION, HAMMERTOE",3310028285,"CDM",28285,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},5372,3223.2,1885.57,5372,{"$nulls":37},4297.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1885.57,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1966.69,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2686,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5372,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4077.35,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},5372,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5372,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5372,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},5372,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},5372,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4297.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5372,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4297.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["COCK-UP 5TH TOE W PLSTC CLOSE",3310028286,"CDM",28286,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3826,2295.6,1342.93,3826,{"$nulls":37},3060.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1342.93,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1400.7,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1913,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3826,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2903.93,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3826,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3826,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3826,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3826,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3826,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3060.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3826,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3060.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["OSTC PRTL EXSTC/CDYLC MET HEAD",3310028288,"CDM",28288,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7754,4652.4,2721.65,7754,{"$nulls":37},6203.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2721.65,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2838.74,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3877,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7754,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5885.29,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7754,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7754,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7754,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7754,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7754,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6203.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7754,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6203.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["HALLUX RIG CORR W/CHEILEC UNI",3310028289,"CDM",28289,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},4679,2807.4,1642.33,4679,{"$nulls":37},3743.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1642.33,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1712.98,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2339.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3551.36,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3743.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3743.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CORRJ HALUX RIGDUS W/IMPLT",3310028291,"CDM",28291,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},12388,7432.8,4348.19,12388,{"$nulls":37},9910.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},4348.19,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4535.25,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6194,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},12388,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",9402.49,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},12388,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",12388,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",12388,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},12388,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},12388,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},9910.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},12388,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",9910.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CORR BUNIN KELER/MCBRIDE/MAYO",3310028292,"CDM",28292,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},5785,3471,2030.54,5785,{"$nulls":37},4628,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2030.54,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2117.89,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2892.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5785,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4390.81,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},5785,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5785,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5785,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},5785,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},5785,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4628,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5785,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4628,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CORR BUNIN, RESECT W/MET OSTEO",3310028296,"CDM",28296,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},4679,2807.4,1642.33,4679,{"$nulls":37},3743.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1642.33,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1712.98,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2339.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3551.36,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3743.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3743.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CORRECTION HALLUX VALGUS",3310028297,"CDM",28297,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},15889,9533.4,5577.04,15889,{"$nulls":37},12711.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},5577.04,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5816.96,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},7944.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},15889,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",12059.75,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},15889,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",15889,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",15889,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},15889,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},15889,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},12711.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},15889,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",12711.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["BUNIO; BY PHALYNX OSTEOTOMY",3310028298,"CDM",28298,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},12388,7432.8,4348.19,12388,{"$nulls":37},9910.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},4348.19,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4535.25,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6194,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},12388,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",9402.49,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},12388,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",12388,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",12388,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},12388,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},12388,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},9910.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},12388,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",9910.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["DBL OST BUNION CORRECT",3310028299,"CDM",28299,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},4962,2977.2,1741.66,4962,{"$nulls":37},3969.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1741.66,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1816.59,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2481,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4962,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3766.16,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},4962,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4962,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4962,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},4962,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},4962,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3969.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4962,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3969.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["OSTEOTOMY; CALCANEUS",3310028300,"CDM",28300,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7200,4320,2527.2,7200,{"$nulls":37},5760,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2527.2,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2635.92,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3600,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7200,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5464.8,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7200,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7200,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7200,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7200,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7200,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5760,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7200,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5760,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["OSTEOT WWO LGTH COOR 1ST MET",3310028306,"CDM",28306,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},16797,10078.2,5895.75,16797,{"$nulls":37},13437.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},5895.75,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6149.38,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},8398.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},16797,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",12748.92,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},16797,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",16797,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",16797,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},16797,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},16797,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},13437.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},16797,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",13437.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["OSTEOTOMY META OTHER THAN 1ST",3310028308,"CDM",28308,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},4679,2807.4,1642.33,4679,{"$nulls":37},3743.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1642.33,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1712.98,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2339.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3551.36,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3743.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4679,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3743.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SHORTEN; PROX PHALYNX 1ST TOE",3310028310,"CDM",28310,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2316,1389.6,812.92,2316,{"$nulls":37},1852.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},812.92,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},847.89,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1158,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2316,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1757.84,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2316,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2316,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2316,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2316,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2316,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1852.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2316,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1852.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REPAIR DEFORMITY OF TOE",3310028313,"CDM",28313,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},5026,3015.6,1764.13,5026,{"$nulls":37},4020.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1764.13,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1840.02,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2513,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5026,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3814.73,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},5026,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5026,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5026,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},5026,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},5026,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4020.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5026,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4020.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SESAMOIDECTOMY FIRST TOE",3310028315,"CDM",28315,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7588,4552.8,2663.39,7588,{"$nulls":37},6070.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2663.39,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2777.97,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3794,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5759.29,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6070.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6070.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["RPR NU/MU METATARSAL WWO GRAFT",3310028322,"CDM",28322,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},17307,10384.2,6074.76,17307,{"$nulls":37},13845.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},6074.76,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6336.09,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},8653.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},17307,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",13136.01,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},17307,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",17307,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",17307,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},17307,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},17307,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},13845.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},17307,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",13845.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["T-PUTTY 5CC DBX 038050",3310028381,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},4107.6,2464.56,1441.77,4107.6,{"$nulls":37},3286.08,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1441.77,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1503.79,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2053.8,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4107.6,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3117.67,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},4107.6,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4107.6,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4107.6,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},4107.6,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},4107.6,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3286.08,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4107.6,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3286.08,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SCREW CORT 2X18 201.818",3310028383,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},301.5,180.9,105.83,301.5,{"$nulls":37},241.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},105.83,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},110.38,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},150.75,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},301.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",228.84,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},301.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",301.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",301.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},301.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},301.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},241.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},301.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",241.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SCREW CORT 2x16 201.816",3310028434,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},301.5,180.9,105.83,301.5,{"$nulls":37},241.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},105.83,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},110.38,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},150.75,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},301.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",228.84,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},301.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",301.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",301.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},301.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},301.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},241.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},301.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",241.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SCREW SYN CORT 2X12 201.812",3310028461,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},283.41,170.05,99.48,283.41,{"$nulls":37},226.73,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},99.48,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},103.76,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},141.71,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},283.41,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",215.11,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},283.41,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",283.41,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",283.41,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},283.41,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},283.41,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},226.73,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},283.41,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",226.73,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SCREW CORT 2X14 201.814",3310028462,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},247.23,148.34,86.78,247.23,{"$nulls":37},197.78,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},86.78,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},90.51,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},123.62,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},247.23,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",187.65,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},247.23,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",247.23,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",247.23,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},247.23,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},247.23,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},197.78,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},247.23,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",197.78,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CLSD TX METATARSAL FX WO MANIP",3310028470,"CDM",28470,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},564,338.4,197.96,564,{"$nulls":37},451.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},197.96,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},206.48,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},282,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},564,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",428.08,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},564,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",564,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",564,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},564,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},564,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},451.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},564,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",451.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ORIF METATARSAL FRACTURE",3310028485,"CDM",28485,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7132,4279.2,2503.33,7132,{"$nulls":37},5705.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2503.33,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2611.03,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3566,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5413.19,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5705.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5705.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["TX BIG TOE FRACTURE",3310028505,"CDM",28505,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},5103,3061.8,1791.15,5103,{"$nulls":37},4082.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1791.15,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1868.21,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2551.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5103,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3873.18,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},5103,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5103,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5103,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},5103,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},5103,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4082.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5103,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4082.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["TREATMENT OF TOE FRACTURE",3310028515,"CDM",28515,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},450,270,157.95,450,{"$nulls":37},360,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},157.95,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},164.74,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},225,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},450,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",341.55,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},450,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",450,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",450,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},450,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},450,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},360,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},450,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",360,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["TREAT TOE FRACTURE",3310028525,"CDM",28525,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7497,4498.2,2631.45,7497,{"$nulls":37},5997.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2631.45,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2744.65,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3748.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5690.22,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5997.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7497,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5997.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SURGICAL REPAIR FT DISLOCATION",3310028615,"CDM",28615,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},20449,12269.4,7177.6,20449,{"$nulls":37},16359.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},7177.6,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7486.38,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},10224.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},20449,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",15520.79,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},20449,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",20449,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",20449,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},20449,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},20449,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},16359.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},20449,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",16359.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ORIF TARSAL BONE FRACT",3310028645,"CDM",28645,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},4520,2712,1586.52,4520,{"$nulls":37},3616,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1586.52,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1654.77,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2260,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4520,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3430.68,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},4520,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4520,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4520,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},4520,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},4520,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3616,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4520,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3616,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ORIF INTERPHAL JOINT DISLOC",3310028675,"CDM",28675,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},6130,3678,2151.63,6130,{"$nulls":37},4904,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2151.63,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2244.19,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3065,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6130,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4652.67,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},6130,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6130,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6130,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},6130,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},6130,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4904,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6130,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4904,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ARTHROD MT/TMT MULTI/TRANS",3310028730,"CDM",28730,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},27234,16340.4,9559.13,27234,{"$nulls":37},21787.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},9559.13,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},9970.37,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},13617,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},27234,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",20670.61,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},27234,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",27234,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",27234,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},27234,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},27234,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},21787.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},27234,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",21787.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["FUSION OF FOOT BONES",3310028740,"CDM",28740,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},5400,3240,1895.4,5400,{"$nulls":37},4320,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1895.4,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1976.94,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2700,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5400,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4098.6,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},5400,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5400,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5400,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},5400,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},5400,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4320,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5400,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4320,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ARTHRODESIS GRT TOE; MTP JOINT",3310028750,"CDM",28750,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7200,4320,2527.2,7200,{"$nulls":37},5760,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2527.2,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2635.92,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3600,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7200,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5464.8,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7200,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7200,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7200,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7200,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7200,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5760,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7200,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5760,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ARTHRODESIS GTOE INTERPHAL JNT",3310028755,"CDM",28755,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3945,2367,1384.7,3945,{"$nulls":37},3156,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1384.7,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1444.26,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1972.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2994.26,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3156,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3945,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3156,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["AMPUTATE METATARSAL W TOE SNGL",3310028810,"CDM",28810,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7442,4465.2,2612.14,7442,{"$nulls":37},5953.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2612.14,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2724.52,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3721,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7442,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5648.48,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7442,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7442,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7442,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7442,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7442,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5953.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7442,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5953.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["AMPUTATION TOE MTP JOINT",3310028820,"CDM",28820,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7588,4552.8,2663.39,7588,{"$nulls":37},6070.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2663.39,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2777.97,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3794,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5759.29,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6070.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7588,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6070.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["AMPUTATE TOE; IP JOINT",3310028825,"CDM",28825,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3826,2295.6,1342.93,3826,{"$nulls":37},3060.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1342.93,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1400.7,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1913,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3826,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2903.93,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3826,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3826,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3826,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3826,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3826,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3060.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3826,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3060.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["UNL TENDON PROCEDURE FOOT/TOE",3310028899,"CDM",28899,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7754,4652.4,2721.65,7754,{"$nulls":37},6203.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2721.65,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2838.74,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3877,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7754,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5885.29,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7754,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7754,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7754,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7754,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7754,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6203.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7754,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6203.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SCREW PEG FL THRD 2.5X12 FP-12",3310029220,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},438.75,263.25,154,438.75,{"$nulls":37},351,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},154,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},160.63,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},219.38,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},438.75,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",333.01,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},438.75,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",438.75,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",438.75,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},438.75,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},438.75,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},351,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},438.75,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",351,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SCREW PEG FL THRD 2.5X16 FP-16",3310029244,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},438.75,263.25,154,438.75,{"$nulls":37},351,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},154,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},160.63,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},219.38,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},438.75,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",333.01,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},438.75,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",438.75,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",438.75,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},438.75,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},438.75,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},351,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},438.75,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",351,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SCREW PEG FL THRD 2.5X18 FP-18",3310029268,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},438.75,263.25,154,438.75,{"$nulls":37},351,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},154,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},160.63,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},219.38,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},438.75,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",333.01,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},438.75,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",438.75,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",438.75,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},438.75,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},438.75,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},351,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},438.75,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",351,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["PLATE DISTAL RADIUS PL-DR50L",3310029680,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},3732,2239.2,1309.93,3732,{"$nulls":37},2985.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1309.93,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1366.29,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1866,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3732,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2832.59,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3732,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3732,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3732,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3732,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3732,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2985.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3732,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2985.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REMOVE FULL ARM OR LEG CAST",3310029705,"CDM",29705,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},277,166.2,97.23,277,{"$nulls":37},221.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},97.23,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},101.41,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},138.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},277,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",210.24,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},277,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",277,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",277,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},277,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},277,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},221.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},277,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",221.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SHOULDER ARTHROSCOPY DX",3310029805,"CDM",29805,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},3859,2315.4,1354.51,3859,{"$nulls":37},3087.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1354.51,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1412.78,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1929.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3859,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2928.98,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3859,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3859,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3859,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3859,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3859,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3087.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3859,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3087.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ARTHROSCOPIC CAPSULORRHAPHY",3310029806,"CDM",29806,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},8014,4808.4,2812.91,8014,{"$nulls":37},6411.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2812.91,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2933.93,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4007,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},8014,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6082.63,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},8014,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",8014,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",8014,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},8014,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},8014,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6411.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},8014,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6411.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ARTHROSCOPIC LABRAL REPAIR",3310029807,"CDM",29807,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7539,4523.4,2646.19,7539,{"$nulls":37},6031.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2646.19,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2760.03,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3769.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5722.1,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6031.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6031.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ARTHROSCOPY SHLDR; W REM FB/LB",3310029819,"CDM",29819,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},5250,3150,1842.75,5250,{"$nulls":37},4200,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1842.75,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1922.02,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2625,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5250,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3984.75,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},5250,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5250,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5250,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},5250,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},5250,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4200,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5250,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4200,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ARTHRO SHLDR SURG PART SYNOVEC",3310029820,"CDM",29820,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},6718,4030.8,2358.02,6718,{"$nulls":37},5374.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2358.02,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2459.46,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3359,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6718,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5098.96,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},6718,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6718,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6718,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},6718,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},6718,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5374.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6718,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5374.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ARTHRO SHLDR SURG COMP SYNOVEC",3310029821,"CDM",29821,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},6718,4030.8,2358.02,6718,{"$nulls":37},5374.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2358.02,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2459.46,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3359,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6718,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5098.96,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},6718,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6718,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6718,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},6718,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},6718,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5374.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6718,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5374.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ARTHRO SHLDR SURG DEBRIDE LIM",3310029822,"CDM",29822,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7539,4523.4,2646.19,7539,{"$nulls":37},6031.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2646.19,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2760.03,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3769.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5722.1,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6031.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6031.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ARTHRO SHLDR SURG DEBRIDE EXT",3310029823,"CDM",29823,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},6770,4062,2376.27,6770,{"$nulls":37},5416,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2376.27,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2478.5,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3385,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6770,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5138.43,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},6770,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6770,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6770,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},6770,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},6770,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5416,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6770,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5416,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["DISTAL CLAVICULECTOMY",3310029824,"CDM",29824,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7539,4523.4,2646.19,7539,{"$nulls":37},6031.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2646.19,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2760.03,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3769.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5722.1,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6031.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6031.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ARTH SHLDR SRG W/LYS W/WO MANI",3310029825,"CDM",29825,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7539,4523.4,2646.19,7539,{"$nulls":37},6031.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2646.19,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2760.03,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3769.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5722.1,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6031.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6031.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ARTH SHLDR SRG DECOMP W/RELEAS",3310029826,"CDM",29826,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7539,4523.4,2646.19,7539,{"$nulls":37},6031.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2646.19,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2760.03,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3769.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5722.1,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6031.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6031.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ARTH SHLDR SRG W/ RCUF REPAIR",3310029827,"CDM",29827,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7688,4612.8,2698.49,7688,{"$nulls":37},6150.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2698.49,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2814.58,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3844,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7688,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5835.19,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7688,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7688,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7688,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7688,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7688,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6150.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7688,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6150.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ARTH SHLDR SRG BICEP TENODESIS",3310029828,"CDM",29828,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7539,4523.4,2646.19,7539,{"$nulls":37},6031.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2646.19,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2760.03,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3769.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5722.1,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6031.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7539,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6031.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ARTHROSCOPY ELBOW DIAGNOSTIC",3310029830,"CDM",29830,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},5067,3040.2,1778.52,5067,{"$nulls":37},4053.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1778.52,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1855.03,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2533.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5067,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3845.85,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},5067,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5067,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5067,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},5067,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},5067,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4053.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5067,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4053.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ARTHRO ELBOW; REM LOOSE BODIES",3310029834,"CDM",29834,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},4095,2457,1437.34,4095,{"$nulls":37},3276,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1437.34,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1499.18,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2047.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4095,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3108.1,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},4095,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4095,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4095,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},4095,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},4095,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3276,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4095,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3276,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ARTH ELBW SURG W/PART SYNOVEC",3310029835,"CDM",29835,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},6718,4030.8,2358.02,6718,{"$nulls":37},5374.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2358.02,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2459.46,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3359,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6718,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5098.96,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},6718,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6718,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6718,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},6718,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},6718,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5374.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6718,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5374.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ARTH ELBW SURG W/DEBRIDE LIMIT",3310029837,"CDM",29837,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},7132,4279.2,2503.33,7132,{"$nulls":37},5705.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2503.33,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2611.03,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3566,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5413.19,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5705.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7132,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5705.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ARTHROSCOPY ELBOW; EXT DEBRID",3310029838,"CDM",29838,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},5788,3472.8,2031.59,5788,{"$nulls":37},4630.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2031.59,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2118.99,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2894,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5788,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4393.09,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},5788,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5788,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5788,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},5788,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},5788,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4630.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5788,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4630.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ARTH WRIST SURG W/JNT DEBRIDE",3310029846,"CDM",29846,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},6566,3939.6,2304.67,6566,{"$nulls":37},5252.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2304.67,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2403.81,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3283,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6566,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4983.59,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},6566,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6566,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6566,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},6566,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},6566,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5252.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6566,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5252.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ARTH WRST W/RLS TRNSV CARP LIG",3310029848,"CDM",29848,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},6566,3939.6,2304.67,6566,{"$nulls":37},5252.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2304.67,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2403.81,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3283,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6566,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4983.59,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},6566,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6566,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6566,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},6566,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},6566,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5252.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6566,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5252.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["OSTEOCHONDR ALGRF KNEE W/SCOPE",3310029867,"CDM",29867,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},22685,13611,7962.44,22685,{"$nulls":37},18148,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},7962.44,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},8304.98,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},11342.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},22685,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",17217.92,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},22685,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",22685,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",22685,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},22685,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},22685,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},18148,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},22685,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",18148,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SCREW INTERFERENCE AR-4030C-10",3310038556,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},1239,743.4,434.89,1239,{"$nulls":37},991.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},434.89,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},453.6,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},619.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1239,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",940.4,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1239,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1239,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1239,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},1239,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1239,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},991.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1239,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",991.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["COLONOSCOPY FLEX W BLEED CNTRL",3310045382,"CDM",45382,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2839,1703.4,996.49,2839,{"$nulls":37},2271.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},996.49,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1039.36,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1419.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2839,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2154.8,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2839,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2839,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2839,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2839,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2839,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2271.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2839,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2271.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REP INCOMPL CIRCUMCIS",3310054163,"CDM",54163,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2835,1701,995.08,2835,{"$nulls":37},2268,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},995.08,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1037.89,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1417.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2835,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2151.76,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2835,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2835,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2835,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2835,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2835,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2268,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2835,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2268,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REMOVE VITREOUS ANT APPR; PART",3310067005,"CDM",67005,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2646,1587.6,928.75,2646,{"$nulls":37},2116.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},928.75,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},968.7,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1323,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2646,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2008.31,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2646,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2646,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2646,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2646,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2646,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2116.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2646,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2116.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["2ND OBS INITIAL HOUR",3110120100,"CDM",99218,"CPT",762,"RC",null,null,"facility","inpatient",{"$nulls":3},285,171,86.07,233.7,{"$nulls":37},233.7,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},100.04,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",142.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",142.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},104.34,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},142.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},216.32,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},86.07,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},228,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["KIT NEEDLE GUIDE",3160021818,"CDM",null,null,272,"RC",null,null,"facility","inpatient",{"$nulls":3},156.41,93.85,47.24,128.26,{"$nulls":37},128.26,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},54.9,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",78.2,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",78.2,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},57.26,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},78.2,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},118.72,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},47.24,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},125.13,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ROOM RATE PSYCH UNIT",3210100124,"CDM",null,null,124,"RC",null,null,"facility","inpatient",{"$nulls":3},961,576.6,290.22,788.02,{"$nulls":37},788.02,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},337.31,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",480.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",480.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},351.82,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},480.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},729.4,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},290.22,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},768.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["DISECTOR ENDOSCOPY",3300021313,"CDM",null,null,270,"RC",null,null,"facility","inpatient",{"$nulls":3},394.35,236.61,119.09,323.37,{"$nulls":37},323.37,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},138.42,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",197.18,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",197.18,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},144.37,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},197.18,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},299.31,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},119.09,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},315.48,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SCREW 4.5x65m 215.065",3300022669,"CDM",null,null,278,"RC",null,null,"facility","inpatient",{"$nulls":3},196,117.6,59.19,160.72,{"$nulls":37},160.72,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},68.8,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",98,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",98,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},71.76,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},98,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},148.76,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},59.19,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},156.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["BIT DRILL 2.4M 310.530",3300024042,"CDM",null,null,272,"RC",null,null,"facility","inpatient",{"$nulls":3},413,247.8,124.73,338.66,{"$nulls":37},338.66,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},144.96,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",206.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",206.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},151.2,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},206.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},313.47,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},124.73,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},330.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CLIPS HEMOLOCK M/L 544230",3300024450,"CDM",null,null,272,"RC",null,null,"facility","inpatient",{"$nulls":3},322.14,193.28,97.29,264.15,{"$nulls":37},264.15,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},113.07,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",161.07,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",161.07,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},117.94,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},161.07,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},244.5,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},97.29,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},257.71,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["WIRE DANEK METRX GUIDE 955-519",3300026318,"CDM",null,null,272,"RC",null,null,"facility","inpatient",{"$nulls":3},266,159.6,80.33,218.12,{"$nulls":37},218.12,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},93.37,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",133,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",133,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},97.38,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},133,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},201.89,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},80.33,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},212.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CATHETER 3FRX80 FOGARTY A4F03",3300026516,"CDM",null,null,272,"RC",null,null,"facility","inpatient",{"$nulls":3},309.15,185.49,93.36,253.5,{"$nulls":37},253.5,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},108.51,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",154.57,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",154.57,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},113.18,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},154.57,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},234.64,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},93.36,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},247.32,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["PLATE 3.5X137 8HOLE 223.601",3300027270,"CDM",null,null,278,"RC",null,null,"facility","inpatient",{"$nulls":3},2170,1302,655.34,1779.4,{"$nulls":37},1779.4,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},761.67,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1085,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1085,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},794.44,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1085,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1647.03,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},655.34,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1736,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["PLATE 4.5x206m 224.611",3300027288,"CDM",null,null,278,"RC",null,null,"facility","inpatient",{"$nulls":3},1338,802.8,404.08,1097.16,{"$nulls":37},1097.16,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},469.64,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",669,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",669,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},489.84,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},669,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1015.54,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},404.08,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1070.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SCREW 5.0M STAR 100 04.005.590",3300027756,"CDM",null,null,278,"RC",null,null,"facility","inpatient",{"$nulls":3},627.69,376.61,189.56,514.71,{"$nulls":37},514.71,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},220.32,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",313.85,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",313.85,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},229.8,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},313.85,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},476.42,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},189.56,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},502.15,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["NAIL TIBIAL 10X360M 1822-1036S",3300028187,"CDM","C1713","CPT",278,"RC",null,null,"facility","inpatient",{"$nulls":3},3347.47,2008.48,1010.94,2744.93,{"$nulls":37},2744.93,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1174.96,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1673.74,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1673.74,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1225.51,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1673.74,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2540.73,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},1010.94,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2677.98,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["NAIL HUM STRY 7X270 1830-0727S",3300028702,"CDM",null,null,278,"RC",null,null,"facility","inpatient",{"$nulls":3},2668.75,1601.25,805.96,2188.38,{"$nulls":37},2188.38,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},936.73,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1334.38,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1334.38,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},977.03,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1334.38,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2025.58,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},805.96,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2135,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SLEEVE POROUS REVI 1294-54-120",3300029009,"CDM",null,null,278,"RC",null,null,"facility","inpatient",{"$nulls":3},3683.9,2210.34,1112.54,3020.8,{"$nulls":37},3020.8,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1293.05,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1841.95,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1841.95,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1348.68,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1841.95,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2796.08,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},1112.54,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2947.12,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["HIP ACETABULR SHELL 6202-62-20",3300029456,"CDM",null,null,278,"RC",null,null,"facility","inpatient",{"$nulls":3},7338,4402.8,2216.08,6017.16,{"$nulls":37},6017.16,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2575.64,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3669,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3669,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2686.44,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3669,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},5569.54,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},2216.08,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},5870.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["MESH PARIETEX 15X10 PCO1510OS",3300029827,"CDM",null,null,278,"RC",null,null,"facility","inpatient",{"$nulls":3},2338.77,1403.26,706.31,1917.79,{"$nulls":37},1917.79,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},820.91,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1169.38,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1169.38,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},856.22,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1169.38,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1775.13,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},706.31,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1871.02,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["HIP UNIVERSAL HEAD UH1-42-26",3300030523,"CDM",null,null,278,"RC",null,null,"facility","inpatient",{"$nulls":3},2955.22,1773.14,892.48,2423.28,{"$nulls":37},2423.28,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1037.28,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1477.61,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1477.61,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1081.91,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1477.61,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2243.01,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},892.48,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2364.18,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["NAIL GAM3 R 10x360m 3425-0360S",3300030922,"CDM",null,null,278,"RC",null,null,"facility","inpatient",{"$nulls":3},4561.6,2736.96,1377.6,3740.51,{"$nulls":37},3740.51,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1601.12,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2280.8,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2280.8,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1670,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2280.8,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3462.25,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},1377.6,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3649.28,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["BURR EGG 4.0MM 5820-015-040",3300031317,"CDM",null,null,272,"RC",null,null,"facility","inpatient",{"$nulls":3},764.1,458.46,230.76,626.56,{"$nulls":37},626.56,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},268.2,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",382.05,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",382.05,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},279.74,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},382.05,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},579.95,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},230.76,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},611.28,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["GAMMA3 NAIL KIT LT 3525-0360S",3300031513,"CDM",null,null,278,"RC",null,null,"facility","inpatient",{"$nulls":3},3970.72,2382.43,1199.16,3255.99,{"$nulls":37},3255.99,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1393.72,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1985.36,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1985.36,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1453.68,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1985.36,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3013.78,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},1199.16,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3176.58,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["PLATE 6/HOLE LOCK 8162-04-006",3300031689,"CDM",null,null,278,"RC",null,null,"facility","inpatient",{"$nulls":3},855,513,258.21,701.1,{"$nulls":37},701.1,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},300.1,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",427.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",427.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},313.02,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},427.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},648.95,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},258.21,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},684,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["BIT DRILL 2.3MM 702741",3300031796,"CDM",null,null,272,"RC",null,null,"facility","inpatient",{"$nulls":3},397.6,238.56,120.08,326.03,{"$nulls":37},326.03,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},139.56,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",198.8,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",198.8,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},145.56,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},198.8,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},301.78,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},120.08,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},318.08,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["PLATE PRE-BENT ADV 22-10712",3300031985,"CDM",null,null,278,"RC",null,null,"facility","inpatient",{"$nulls":3},760.08,456.05,229.54,623.27,{"$nulls":37},623.27,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},266.79,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",380.04,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",380.04,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},278.27,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},380.04,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},576.9,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},229.54,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},608.06,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SCREW CAN 7.3MX32MX55M 209.855",3300033250,"CDM",null,null,278,"RC",null,null,"facility","inpatient",{"$nulls":3},1371,822.6,414.04,1124.22,{"$nulls":37},1124.22,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},481.22,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",685.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",685.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},501.92,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},685.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1040.59,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},414.04,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1096.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["MESH C-QUR 3.54x3.54CM 31505",3300033271,"CDM",null,null,278,"RC",null,null,"facility","inpatient",{"$nulls":3},812.25,487.35,245.3,666.04,{"$nulls":37},666.04,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},285.1,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",406.12,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",406.12,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},297.36,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},406.12,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},616.5,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},245.3,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},649.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["BALLOON COYOTE H74939186301010",3300033461,"CDM","C1725","CPT",272,"RC",null,null,"facility","inpatient",{"$nulls":3},750,450,226.5,615,{"$nulls":37},615,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},263.25,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",375,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",375,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},274.58,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},375,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},569.25,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},226.5,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},600,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SCREW CORTICAL 8161-35-026",3300033763,"CDM",null,null,278,"RC",null,null,"facility","inpatient",{"$nulls":3},563.5,338.1,170.18,462.07,{"$nulls":37},462.07,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},197.79,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",281.75,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",281.75,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},206.3,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},281.75,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},427.7,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},170.18,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},450.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SCREW LOCKING 3.5x28m 412.110",3300033783,"CDM",null,null,278,"RC",null,null,"facility","inpatient",{"$nulls":3},552.23,331.34,166.77,452.83,{"$nulls":37},452.83,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},193.83,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",276.12,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",276.12,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},202.17,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},276.12,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},419.14,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},166.77,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},441.78,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["PLATE LEFORT MAXILLA 5511710",3300033950,"CDM",null,null,278,"RC",null,null,"facility","inpatient",{"$nulls":3},1254.27,752.56,378.79,1028.5,{"$nulls":37},1028.5,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},440.25,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",627.14,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",627.14,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},459.19,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},627.14,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},951.99,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},378.79,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1003.42,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["INSERT BEARING X3 5532-G-311",3300034237,"CDM",null,null,278,"RC",null,null,"facility","inpatient",{"$nulls":3},6735,4041,2033.97,5522.7,{"$nulls":37},5522.7,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2363.98,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3367.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3367.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2465.68,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3367.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},5111.86,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},2033.97,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},5388,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["GRAFT HERNIA 10x10  G23764",3300034292,"CDM",null,null,278,"RC",null,null,"facility","inpatient",{"$nulls":3},4200,2520,1268.4,3444,{"$nulls":37},3444,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1474.2,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2100,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2100,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1537.62,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2100,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3187.8,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},1268.4,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3360,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["HIP ACETABULAR CUP PT-106062",3300034516,"CDM",null,null,278,"RC",null,null,"facility","inpatient",{"$nulls":3},4900,2940,1479.8,4018,{"$nulls":37},4018,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1719.9,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2450,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2450,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1793.89,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2450,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3719.1,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},1479.8,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3920,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["PLATE DISTAL 6 HOLE 40-20906",3300035712,"CDM","C1713","CPT",278,"RC",null,null,"facility","inpatient",{"$nulls":3},4557.06,2734.24,1376.23,3736.79,{"$nulls":37},3736.79,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1599.53,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2278.53,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2278.53,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1668.34,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2278.53,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3458.81,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},1376.23,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3645.65,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SCREW L/P TM SS  AR-8835-30",3300035901,"CDM",null,null,278,"RC",null,null,"facility","inpatient",{"$nulls":3},135.08,81.05,40.79,110.77,{"$nulls":37},110.77,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},47.41,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",67.54,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",67.54,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},49.45,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},67.54,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},102.53,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},40.79,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},108.06,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SCREW BONE PT 26m 53-27126E",3300035982,"CDM",null,null,278,"RC",null,null,"facility","inpatient",{"$nulls":3},394.9,236.94,119.26,323.82,{"$nulls":37},323.82,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},138.61,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",197.45,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",197.45,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},144.57,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},197.45,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},299.73,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},119.26,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},315.92,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["POST TAPER 12m 8156-0032-A",3300036175,"CDM",null,null,278,"RC",null,null,"facility","inpatient",{"$nulls":3},1802.5,1081.5,544.36,1478.05,{"$nulls":37},1478.05,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},632.68,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",901.25,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",901.25,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},659.9,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},901.25,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1368.1,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},544.36,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1442,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["BALLOON 6X1500X150 39032-60151",3300036267,"CDM",null,null,272,"RC",null,null,"facility","inpatient",{"$nulls":3},1640,984,495.28,1344.8,{"$nulls":37},1344.8,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},575.64,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",820,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",820,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},600.4,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},820,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1244.76,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},495.28,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1312,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["BREAST INSPIRA SRM-445",3300036464,"CDM",null,null,278,"RC",null,null,"facility","inpatient",{"$nulls":3},3307.5,1984.5,998.86,2712.15,{"$nulls":37},2712.15,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1160.93,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1653.75,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1653.75,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1210.88,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1653.75,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2510.39,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},998.86,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2646,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["INSERT TIBIAL 1961-92-144",3300036644,"CDM",null,null,278,"RC",null,null,"facility","inpatient",{"$nulls":3},2800,1680,845.6,2296,{"$nulls":37},2296,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},982.8,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1400,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1400,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1025.08,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1400,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2125.2,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},845.6,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2240,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SCREW CORTICAL 4.5X65MM 661765",3300036755,"CDM",null,null,278,"RC",null,null,"facility","inpatient",{"$nulls":3},135.8,81.48,41.01,111.36,{"$nulls":37},111.36,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},47.67,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",67.9,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",67.9,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},49.72,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},67.9,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},103.07,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},41.01,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},108.64,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["HIP ACETBULR LINER 1221-32-150",3300037052,"CDM",null,null,278,"RC",null,null,"facility","inpatient",{"$nulls":3},3073,1843.8,928.05,2519.86,{"$nulls":37},2519.86,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1078.62,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1536.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1536.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1125.03,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1536.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2332.41,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},928.05,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2458.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["TIBIAL INSERT CR 1516-30-506",3300037472,"CDM",null,null,278,"RC",null,null,"facility","inpatient",{"$nulls":3},2800,1680,845.6,2296,{"$nulls":37},2296,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},982.8,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1400,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1400,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1025.08,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1400,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2125.2,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},845.6,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2240,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["DRILL BIT TAPERED 03.037.021",3300037665,"CDM",null,null,272,"RC",null,null,"facility","inpatient",{"$nulls":3},2588.57,1553.14,781.75,2122.63,{"$nulls":37},2122.63,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},908.59,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1294.29,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1294.29,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},947.68,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1294.29,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1964.72,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},781.75,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2070.86,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["TRUNK EXCLUDER AAA RLT261414",3300037805,"CDM",null,null,278,"RC",null,null,"facility","inpatient",{"$nulls":3},13367,8020.2,4036.83,10960.94,{"$nulls":37},10960.94,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},4691.82,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6683.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6683.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4893.66,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6683.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},10145.55,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},4036.83,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},10693.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["BIOCUE PLATELET CON 800-0811A",3300038071,"CDM",null,null,278,"RC",null,null,"facility","inpatient",{"$nulls":3},4976.4,2985.84,1502.87,4080.65,{"$nulls":37},4080.65,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1746.72,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2488.2,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2488.2,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1821.86,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2488.2,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3777.09,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},1502.87,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3981.12,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["TIBIAL INSERT SZ 5 1516-50-505",3300038248,"CDM",null,null,278,"RC",null,null,"facility","inpatient",{"$nulls":3},2800,1680,845.6,2296,{"$nulls":37},2296,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},982.8,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1400,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1400,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1025.08,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1400,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2125.2,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},845.6,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2240,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SCREW CORTICAL 3.5X44MM 338644",3300038275,"CDM",null,null,278,"RC",null,null,"facility","inpatient",{"$nulls":3},93.12,55.87,28.12,76.36,{"$nulls":37},76.36,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},32.69,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",46.56,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",46.56,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},34.09,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},46.56,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},70.68,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},28.12,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},74.5,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["DRILL 10MM CANNUL AR-1218-100",3300038555,"CDM",null,null,272,"RC",null,null,"facility","inpatient",{"$nulls":3},614.25,368.55,185.5,503.68,{"$nulls":37},503.68,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},215.6,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",307.12,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",307.12,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},224.88,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},307.12,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},466.22,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},185.5,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},491.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["OMEGA3 BARREL PLATE 597124S",3300038733,"CDM",null,null,278,"RC",null,null,"facility","inpatient",{"$nulls":3},1374,824.4,414.95,1126.68,{"$nulls":37},1126.68,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},482.27,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",687,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",687,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},503.02,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},687,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1042.87,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},414.95,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1099.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["QUICKSET KIT 5CC ABS-3005",3300038857,"CDM",null,null,278,"RC",null,null,"facility","inpatient",{"$nulls":3},3080,1848,930.16,2525.6,{"$nulls":37},2525.6,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1081.08,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1540,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1540,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1127.59,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1540,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2337.72,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},930.16,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2464,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["FLEX OSTEOTOME 12M 2709-04-020",3300039005,"CDM",null,null,278,"RC",null,null,"facility","inpatient",{"$nulls":3},2782.5,1669.5,840.32,2281.65,{"$nulls":37},2281.65,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},976.66,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1391.25,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1391.25,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1018.67,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1391.25,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2111.92,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},840.32,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2226,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["TIBIAL INSERT SZ 8 1516-50-808",3300039197,"CDM",null,null,278,"RC",null,null,"facility","inpatient",{"$nulls":3},2800,1680,845.6,2296,{"$nulls":37},2296,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},982.8,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1400,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1400,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1025.08,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1400,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2125.2,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},845.6,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2240,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["6-HOLE TUBULAR PLATE 7008-0106",3300039308,"CDM","C1713","CPT",278,"RC",null,null,"facility","inpatient",{"$nulls":3},885,531,267.27,725.7,{"$nulls":37},725.7,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},310.64,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",442.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",442.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},324,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},442.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},671.72,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},267.27,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},708,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["STEM EXTENSION 42-5603-135-16",3300039483,"CDM","C1776","CPT",278,"RC",null,null,"facility","inpatient",{"$nulls":3},9333.3,5599.98,2818.66,7653.31,{"$nulls":37},7653.31,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},3275.99,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4666.65,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4666.65,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3416.92,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4666.65,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7083.97,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},2818.66,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7466.64,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SHEATH SCOUT SH-01",3300039632,"CDM",null,null,279,"RC",null,null,"facility","inpatient",{"$nulls":3},140,84,42.28,114.8,{"$nulls":37},114.8,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},49.14,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",70,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",70,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},51.25,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},70,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},106.26,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},42.28,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},112,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["STENT-GRAFT 120M 28-L2-15-120U",3300039709,"CDM","C1876","CPT",278,"RC",null,null,"facility","inpatient",{"$nulls":3},7689,4613.4,2322.08,6304.98,{"$nulls":37},6304.98,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2698.84,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3844.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3844.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2814.94,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3844.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},5835.95,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},2322.08,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},6151.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CUP MULTI-HOLE 01-030-02-0862",3300039866,"CDM",null,null,278,"RC",null,null,"facility","inpatient",{"$nulls":3},960,576,289.92,787.2,{"$nulls":37},787.2,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},336.96,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",480,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",480,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},351.46,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},480,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},728.64,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},289.92,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},768,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["DISPOSABLES DX KIT AR-8991DS",3300039946,"CDM",null,null,272,"RC",null,null,"facility","inpatient",{"$nulls":3},825,495,249.15,676.5,{"$nulls":37},676.5,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},289.58,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",412.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",412.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},302.03,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},412.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},626.17,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},249.15,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},660,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["HUMERAL COMPONENT 8HM2-5854-A",3300040086,"CDM","C1776","CPT",278,"RC",null,null,"facility","inpatient",{"$nulls":3},8670,5202,2618.34,7109.4,{"$nulls":37},7109.4,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},3043.17,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4335,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4335,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3174.09,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4335,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},6580.53,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},2618.34,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},6936,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CENTRAL SCREW SHOULDER 115395",3300040226,"CDM",null,null,278,"RC",null,null,"facility","inpatient",{"$nulls":3},221.38,132.82,66.86,181.53,{"$nulls":37},181.53,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},77.7,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",110.69,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",110.69,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},81.05,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},110.69,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},168.03,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},66.86,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},177.1,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["IMN LOCKING SCREW",3300040410,"CDM",null,null,278,"RC",null,null,"facility","inpatient",{"$nulls":3},853.6,512.16,257.79,699.95,{"$nulls":37},699.95,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},299.61,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",426.8,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",426.8,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},312.5,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},426.8,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},647.88,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},257.79,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},682.88,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SCREW POLYAXIAL 07.02000.032",3300040427,"CDM",null,null,278,"RC",null,null,"facility","inpatient",{"$nulls":3},2275,1365,687.05,1865.5,{"$nulls":37},1865.5,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},798.52,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1137.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1137.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},832.88,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1137.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1726.72,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},687.05,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1820,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["VIVIGEN F - SM BL-1600-001",3300040568,"CDM",null,null,278,"RC",null,null,"facility","inpatient",{"$nulls":3},1855,1113,560.21,1521.1,{"$nulls":37},1521.1,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},651.1,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",927.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",927.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},679.12,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},927.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1407.94,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},560.21,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1484,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["DISPOSABLE KIT KNEE FIBERTAK",3300040757,"CDM",null,null,272,"RC",null,null,"facility","inpatient",{"$nulls":3},1029,617.4,310.76,843.78,{"$nulls":37},843.78,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},361.18,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",514.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",514.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},376.72,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},514.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},781.01,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},310.76,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},823.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["PLATE LCK  47-2232-060-01",3300040770,"CDM","C1713","CPT",278,"RC",null,null,"facility","inpatient",{"$nulls":3},1102.5,661.5,332.96,904.05,{"$nulls":37},904.05,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},386.98,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",551.25,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",551.25,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},403.63,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},551.25,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},836.8,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},332.96,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},882,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["PLATE SPINE 711-0238",3300040935,"CDM","C1713","CPT",278,"RC",null,null,"facility","inpatient",{"$nulls":3},3411.17,2046.7,1030.17,2797.16,{"$nulls":37},2797.16,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1197.32,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1705.58,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1705.58,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1248.83,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1705.58,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2589.08,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},1030.17,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2728.94,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SCRW 6.5X45MM AR-9096FT-65-045",3300041072,"CDM","C1713","CPT",272,"RC",null,null,"facility","inpatient",{"$nulls":3},1050,630,317.1,861,{"$nulls":37},861,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},368.55,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",525,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",525,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},384.4,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},525,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},796.95,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},317.1,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},840,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["OR TIME (676 TO 690 MINUTES)",3300060046,"CDM",null,null,360,"RC",null,null,"facility","inpatient",{"$nulls":3},59340,35604,17920.68,48658.8,{"$nulls":37},48658.8,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},20828.34,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",29670,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",29670,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},21724.37,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},29670,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},45039.06,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},17920.68,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},47472,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["NEEDLE SPEEDCINCH PEEK AR-4502",3310037677,"CDM",null,null,278,"RC",null,null,"facility","inpatient",{"$nulls":3},1185,711,357.87,971.7,{"$nulls":37},971.7,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},415.94,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",592.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",592.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},433.83,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},592.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},899.42,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},357.87,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},948,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["PLATE VARIAX 7-HOLE 629507",3310038242,"CDM",null,null,278,"RC",null,null,"facility","inpatient",{"$nulls":3},1001.04,600.62,302.31,820.85,{"$nulls":37},820.85,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},351.37,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",500.52,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",500.52,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},366.48,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},500.52,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},759.79,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},302.31,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},800.83,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SCREW BC IR 7X30 AR-4030C-07",3310038617,"CDM",null,null,278,"RC",null,null,"facility","inpatient",{"$nulls":3},885,531,267.27,725.7,{"$nulls":37},725.7,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},310.64,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",442.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",442.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},324,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},442.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},671.72,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},267.27,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},708,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CANN SCREW 4.0X20 AR-8840-20",3310039219,"CDM",null,null,278,"RC",null,null,"facility","inpatient",{"$nulls":3},135.08,81.05,40.79,110.77,{"$nulls":37},110.77,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},47.41,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",67.54,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",67.54,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},49.45,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},67.54,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},102.53,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},40.79,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},108.06,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ARTH SUR KNEE MENISCEC MED/LAT",3310298815,"CDM",29881,"CPT",361,"RC",null,null,"facility","inpatient",{"$nulls":3},9847,5908.2,2973.79,8074.54,{"$nulls":37},8074.54,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},3456.3,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4923.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4923.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3604.99,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4923.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7473.87,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},2973.79,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7877.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["RIGHT ANGLE BOLSTER M00582140",3320022319,"CDM",null,null,272,"RC",null,null,"facility","inpatient",{"$nulls":3},127.12,76.27,38.39,104.24,{"$nulls":37},104.24,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},44.62,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",63.56,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",63.56,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},46.54,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},63.56,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},96.48,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},38.39,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},101.7,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["G-TUBE 28FR M00582170",3320037043,"CDM",null,null,278,"RC",null,null,"facility","inpatient",{"$nulls":3},125.36,75.22,37.86,102.8,{"$nulls":37},102.8,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},44,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",62.68,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",62.68,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},45.89,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},62.68,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},95.15,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},37.86,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},100.29,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["DELIVERY,RECOVERY ADD 30 MIN",3352041063,"CDM",null,null,720,"RC",null,null,"facility","inpatient",{"$nulls":3},151,90.6,45.6,123.82,{"$nulls":37},123.82,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},53,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",75.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",75.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},55.28,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},75.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},114.61,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},45.6,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},120.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["PERITONEAL LAVAGE",3400049084,"CDM",49084,"CPT",450,"RC",null,null,"facility","inpatient",{"$nulls":3},1993.17,1195.9,601.94,1634.4,{"$nulls":37},1634.4,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},699.6,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",996.58,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",996.58,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},729.7,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},996.58,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1512.82,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},601.94,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1594.54,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["DESTROY LESIONS,2-14",3400450211,"CDM",17003,"CPT",450,"RC",null,null,"facility","inpatient",{"$nulls":3},60,36,18.12,49.2,{"$nulls":37},49.2,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},21.06,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",30,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",30,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},21.97,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},30,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},45.54,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},18.12,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},48,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["DRAINAGE OF NOSE LESION",3400450412,"CDM",30020,"CPT",450,"RC",null,null,"facility","inpatient",{"$nulls":3},146,87.6,44.09,119.72,{"$nulls":37},119.72,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},51.25,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",73,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",73,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},53.45,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},73,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},110.81,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},44.09,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},116.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["INSERT TEMP BLADDER CATH",3400450499,"CDM",51702,"CPT",450,"RC",null,null,"facility","inpatient",{"$nulls":3},121,72.6,36.54,99.22,{"$nulls":37},99.22,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},42.47,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",60.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",60.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},44.3,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},60.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},91.84,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},36.54,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},96.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SHORT RT ARM SPLINT,DYNAMIC",3400450646,"CDM",29126,"CPT",450,"RC",null,null,"facility","inpatient",{"$nulls":3},146,87.6,44.09,119.72,{"$nulls":37},119.72,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},51.25,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",73,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",73,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},53.45,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},73,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},110.81,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},44.09,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},116.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["LIVER PROFILE",4100045144,"CDM",80076,"CPT",300,"RC",null,null,"facility","inpatient",{"$nulls":3},98,58.8,29.6,80.36,{"$nulls":37},80.36,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},34.4,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",49,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",49,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},35.88,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},49,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},74.38,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},29.6,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},78.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["FICIN PANEL",4100045326,"CDM",86971,"CPT",302,"RC",null,null,"facility","inpatient",{"$nulls":3},119,71.4,35.94,97.58,{"$nulls":37},97.58,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},41.77,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",59.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",59.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},43.57,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},59.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},90.32,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},35.94,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},95.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["HEPATITIS PANEL,ACUTE",4100045353,"CDM",80074,"CPT",301,"RC",null,null,"facility","inpatient",{"$nulls":3},750,450,226.5,615,{"$nulls":37},615,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},263.25,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",375,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",375,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},274.58,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},375,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},569.25,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},226.5,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},600,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["FREE FATTY ACIDS",4100051292,"CDM",82725,"CPT",301,"RC",null,null,"facility","inpatient",{"$nulls":3},60,36,18.12,49.2,{"$nulls":37},49.2,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},21.06,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",30,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",30,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},21.97,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},30,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},45.54,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},18.12,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},48,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["PYRUVIC ACID PYRUVATE",4100058130,"CDM",84210,"CPT",301,"RC",null,null,"facility","inpatient",{"$nulls":3},182,109.2,54.96,149.24,{"$nulls":37},149.24,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},63.88,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",91,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",91,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},66.63,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},91,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},138.14,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},54.96,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},145.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["5-HIAA (RANDOM)",4100058286,"CDM",83497,"CPT",301,"RC",null,null,"facility","inpatient",{"$nulls":3},114,68.4,34.43,93.48,{"$nulls":37},93.48,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},40.01,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",57,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",57,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},41.74,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},57,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},86.53,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},34.43,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},91.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["MICROALBUMIN, URINE",4100058513,"CDM",82043,"CPT",301,"RC",null,null,"facility","inpatient",{"$nulls":3},78,46.8,23.56,63.96,{"$nulls":37},63.96,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},27.38,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",39,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",39,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},28.56,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},39,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},59.2,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},23.56,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},62.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["LEGIONELLA CULTURE SCREEN",4100075151,"CDM",87081,"CPT",306,"RC",null,null,"facility","inpatient",{"$nulls":3},845,507,255.19,692.9,{"$nulls":37},692.9,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},296.59,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",422.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",422.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},309.35,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},422.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},641.36,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},255.19,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},676,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CARDIO-IQ LP PLA2",4100079324,"CDM",83698,"CPT",301,"RC",null,null,"facility","inpatient",{"$nulls":3},150,90,45.3,123,{"$nulls":37},123,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},52.65,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",75,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",75,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},54.92,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},75,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},113.85,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},45.3,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},120,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["FISH-DNA PROBE(S) EACH",4100901366,"CDM",88368,"CPT",311,"RC",null,null,"facility","inpatient",{"$nulls":3},437,262.2,131.97,358.34,{"$nulls":37},358.34,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},153.39,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",218.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",218.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},159.99,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},218.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},331.68,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},131.97,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},349.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["FISH-DNA PROBE(S) EACH",4100902366,"CDM",88368,"CPT",311,"RC",null,null,"facility","inpatient",{"$nulls":3},437,262.2,131.97,358.34,{"$nulls":37},358.34,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},153.39,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",218.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",218.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},159.99,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},218.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},331.68,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},131.97,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},349.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["DIBUCAINE NUMBER",4100902825,"CDM",82638,"CPT",301,"RC",null,null,"facility","inpatient",{"$nulls":3},419,251.4,126.54,343.58,{"$nulls":37},343.58,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},147.07,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",209.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",209.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},153.4,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},209.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},318.02,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},126.54,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},335.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["IGG, SERUM",4100904815,"CDM",82784,"CPT",301,"RC",null,null,"facility","inpatient",{"$nulls":3},36,21.6,10.87,29.52,{"$nulls":37},29.52,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},12.64,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",18,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",18,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},13.18,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},18,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},27.32,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},10.87,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},28.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CREATINE EPOC",4100909253,"CDM",82565,"CPT",301,"RC",null,null,"facility","inpatient",{"$nulls":3},70,42,21.14,57.4,{"$nulls":37},57.4,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},24.57,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",35,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",35,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},25.63,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},35,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},53.13,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},21.14,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},56,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["IN-SITU HYBRIDIZATION AUTO",4110079211,"CDM",88367,"CPT",310,"RC",null,null,"facility","inpatient",{"$nulls":3},91,54.6,27.48,74.62,{"$nulls":37},74.62,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},31.94,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",45.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",45.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},33.32,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},45.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},69.07,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},27.48,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},72.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CHOLANGIOGRAM ADD SET SIN",4200090028,"CDM",74301,"CPT",320,"RC",null,null,"facility","inpatient",{"$nulls":3},524,314.4,158.25,429.68,{"$nulls":37},429.68,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},183.92,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",262,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",262,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},191.84,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},262,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},397.72,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},158.25,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},419.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CHEST W OBLIQUES",4200093233,"CDM",71048,"CPT",324,"RC",null,null,"facility","inpatient",{"$nulls":3},186,111.6,56.17,152.52,{"$nulls":37},152.52,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},65.29,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",93,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",93,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},68.09,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},93,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},141.17,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},56.17,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},148.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["INJECTION SACROILIAC JT LT",4200098073,"CDM",27096,"CPT",361,"RC",null,null,"facility","inpatient",{"$nulls":3},1050,630,317.1,861,{"$nulls":37},861,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},368.55,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",525,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",525,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},384.4,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},525,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},796.95,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},317.1,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},840,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ULTRASOUND UNLISTED",4220903111,"CDM",76999,"CPT",402,"RC",null,null,"facility","inpatient",{"$nulls":3},168,100.8,50.74,137.76,{"$nulls":37},137.76,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},58.97,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",84,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",84,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},61.5,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},84,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},127.51,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},50.74,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},134.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["FACE NECK ORBIT W CONT",4240093035,"CDM",70542,"CPT",610,"RC",null,null,"facility","inpatient",{"$nulls":3},4496,2697.6,1357.79,3686.72,{"$nulls":37},3686.72,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1578.1,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2248,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2248,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1645.99,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2248,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3412.46,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},1357.79,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3596.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CARDIAC WWO CONT MYO LIMITED",4240093052,"CDM",75561,"CPT",610,"RC",null,null,"facility","inpatient",{"$nulls":3},2555,1533,771.61,2095.1,{"$nulls":37},2095.1,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},896.8,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1277.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1277.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},935.39,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1277.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1939.24,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},771.61,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2044,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SCR MAMMO BI INCL CAD",4270095022,"CDM",77067,"CPT",403,"RC",null,null,"facility","inpatient",{"$nulls":3},225,135,67.95,184.5,{"$nulls":37},184.5,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},78.97,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",112.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",112.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},82.37,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},112.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},170.78,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},67.95,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},180,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["MAGSEED DEVICE 1ST BI",4270095081,"CDM",19283,"CPT",361,"RC",null,null,"facility","inpatient",{"$nulls":3},1879,1127.4,567.46,1540.78,{"$nulls":37},1540.78,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},659.53,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",939.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",939.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},687.9,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},939.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1426.16,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},567.46,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1503.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["MECH REM INTRALUM OBSTR SIN",4280017219,"CDM",75902,"CPT",320,"RC",null,null,"facility","inpatient",{"$nulls":3},340,204,102.68,278.8,{"$nulls":37},278.8,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},119.34,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",170,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",170,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},124.47,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},170,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},258.06,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},102.68,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},272,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["PORT MINI PROFLE  H965451090",4280024727,"CDM","C1788","CPT",272,"RC",null,null,"facility","inpatient",{"$nulls":3},750,450,226.5,615,{"$nulls":37},615,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},263.25,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",375,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",375,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},274.58,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},375,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},569.25,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},226.5,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},600,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["TRAY BIOPSY CUSTOM SAN23BSBUG",4280033417,"CDM",null,null,272,"RC",null,null,"facility","inpatient",{"$nulls":3},277.3,166.38,83.74,227.39,{"$nulls":37},227.39,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},97.33,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",138.65,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",138.65,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},101.52,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},138.65,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},210.47,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},83.74,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},221.84,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CATH INSERT 20G 8CM F220088PT",4280039244,"CDM",null,null,272,"RC",null,null,"facility","inpatient",{"$nulls":3},381.5,228.9,115.21,312.83,{"$nulls":37},312.83,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},133.91,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",190.75,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",190.75,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},139.67,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},190.75,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},289.56,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},115.21,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},305.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["DRAINAGE VISCERAL PERC",4280093442,"CDM",49405,"CPT",361,"RC",null,null,"facility","inpatient",{"$nulls":3},1726,1035.6,521.25,1415.32,{"$nulls":37},1415.32,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},605.83,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",863,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",863,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},631.89,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},863,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1310.03,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},521.25,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1380.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["PACE GENERATOR ADAPTA ADDR01",4290029559,"CDM","C2619","CPT",275,"RC",null,null,"facility","inpatient",{"$nulls":3},6100,3660,1842.2,5002,{"$nulls":37},5002,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2141.1,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3050,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3050,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2233.21,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3050,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},4629.9,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},1842.2,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},4880,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["PACE LEAD STYLET 52 CM 4091",4290031963,"CDM",null,null,272,"RC",null,null,"facility","inpatient",{"$nulls":3},340.2,204.12,102.74,278.96,{"$nulls":37},278.96,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},119.41,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",170.1,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",170.1,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},124.55,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},170.1,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},258.21,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},102.74,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},272.16,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["STENT DES 3.0X18W RSINT30018UX",4290034137,"CDM","C1875","CPT",278,"RC",null,null,"facility","inpatient",{"$nulls":3},2850,1710,860.7,2337,{"$nulls":37},2337,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1000.35,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1425,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1425,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1043.38,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1425,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2163.15,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},860.7,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2280,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["PACE ICD EVERA XT DR DDBB1D1",4290036217,"CDM","C1882","CPT",275,"RC",null,null,"facility","inpatient",{"$nulls":3},12350,7410,3729.7,10127,{"$nulls":37},10127,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},4334.85,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6175,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6175,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4521.34,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6175,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},9373.65,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},3729.7,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},9880,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CATH RX TRK 3.50X08 1012276-08",4290036846,"CDM",null,null,272,"RC",null,null,"facility","inpatient",{"$nulls":3},402.5,241.5,121.56,330.05,{"$nulls":37},330.05,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},141.28,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",201.25,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",201.25,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},147.36,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},201.25,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},305.5,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},121.56,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},322,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SEL CATH,ART-L EXT ABD/P 1 ORD",4290063060,"CDM",36245,"CPT",361,"RC",null,null,"facility","inpatient",{"$nulls":3},1254,752.4,378.71,1028.28,{"$nulls":37},1028.28,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},440.15,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",627,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",627,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},459.09,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},627,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},951.79,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},378.71,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1003.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["OXIMETRY CONTINUOUS",4300075010,"CDM",94761,"CPT",460,"RC",null,null,"facility","inpatient",{"$nulls":3},207,124.2,62.51,169.74,{"$nulls":37},169.74,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},72.66,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",103.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",103.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},75.78,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},103.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},157.11,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},62.51,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},165.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SEMATOSENSORY",4320077002,"CDM",95925,"CPT",920,"RC",null,null,"facility","inpatient",{"$nulls":3},939,563.4,283.58,769.98,{"$nulls":37},769.98,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},329.59,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",469.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",469.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},343.77,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},469.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},712.7,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},283.58,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},751.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["DEBROX OTIC",4400080284,"CDM",null,null,259,"RC",904747835,"NDC","facility","inpatient",15,"ML",null,6.63,3.98,2,5.44,{"$nulls":37},5.44,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2.33,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3.32,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3.32,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2.43,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3.32,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},5.03,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},2,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},5.3,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["FAMOTIDINE 20 MG TAB",4400080768,"CDM",null,null,259,"RC",904719361,"NDC","facility","inpatient",1,"UN",null,1.16,0.7,0.35,0.95,{"$nulls":37},0.95,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},0.41,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",0.58,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",0.58,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},0.42,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},0.58,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},0.88,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},0.35,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},0.93,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["XYLOCAINE 2% WITH EPI INJ",4400081123,"CDM",null,null,250,"RC",63323048327,"NDC","facility","inpatient",20,"ML",null,26.12,15.67,7.89,21.42,{"$nulls":37},21.42,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},9.17,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",13.06,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",13.06,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},9.56,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},13.06,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},19.83,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},7.89,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},20.9,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["BETAGAN .05%",4400081381,"CDM",null,null,250,"RC",24208050505,"NDC","facility","inpatient",5,"ML",null,7.9,4.74,2.39,6.48,{"$nulls":37},6.48,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2.77,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3.95,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3.95,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2.89,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3.95,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},6,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},2.39,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},6.32,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["METHYLPREDNISOLONE INJ 1000MG",4400081827,"CDM",null,null,636,"RC",43598013074,"NDC","facility","inpatient",1,"UN",null,45.4,27.24,13.71,37.23,{"$nulls":37},37.23,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},15.94,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",22.7,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",22.7,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},16.62,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},22.7,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},34.46,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},13.71,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},36.32,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EFFEXOR XR 37.5MG CAPSULES",4400082153,"CDM",null,null,259,"RC",68084069801,"NDC","facility","inpatient",1,"UN",null,1.87,1.12,0.56,1.53,{"$nulls":37},1.53,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},0.66,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",0.94,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",0.94,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},0.68,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},0.94,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1.42,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},0.56,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1.5,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["TOPROL XL 25MG",4400082305,"CDM",null,null,250,"RC",904632206,"NDC","facility","inpatient",1,"UN",null,1.58,0.95,0.48,1.3,{"$nulls":37},1.3,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},0.55,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",0.79,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",0.79,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},0.58,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},0.79,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1.2,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},0.48,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1.26,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["RABIES VACCINE L 3ML SYRINGE",4400082676,"CDM",90675,"CPT",636,"RC",50632001001,"NDC","facility","inpatient",1,"UN",null,988.26,592.96,298.45,810.37,{"$nulls":37},810.37,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},346.88,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",494.13,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",494.13,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},361.8,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},494.13,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},750.09,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},298.45,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},790.61,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["VALIUM 5MG INJ",4400082826,"CDM",null,null,250,"RC",409321312,"NDC","facility","inpatient",1,"ML",null,28.66,17.2,8.66,23.5,{"$nulls":37},23.5,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},10.06,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",14.33,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",14.33,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},10.49,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},14.33,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},21.75,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},8.66,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},22.93,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["DIFLUCAN 200MG,PREMIX",4400088038,"CDM",null,null,636,"RC",25021018466,"NDC","facility","inpatient",100,"ML",null,159.07,95.44,48.04,130.44,{"$nulls":37},130.44,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},55.83,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",79.54,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",79.54,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},58.24,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},79.54,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},120.73,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},48.04,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},127.26,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["AMPICILLIN/SULB INJ 1.5GM CHG",4400902046,"CDM",null,null,636,"RC",71288003192,"NDC","facility","inpatient",1,"UN",null,105.07,63.04,31.73,86.16,{"$nulls":37},86.16,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},36.88,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",52.54,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",52.54,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},38.47,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},52.54,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},79.75,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},31.73,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},84.06,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ST STNDRDZED COGNITVE TEST /HR",4600072117,"CDM",96125,"CPT",444,"RC",null,null,"facility","inpatient",{"$nulls":3},277,166.2,83.65,227.14,{"$nulls":37},227.14,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},97.23,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",138.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",138.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},101.41,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},138.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},210.24,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},83.65,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},221.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["K12 ST OTHER EACH 15 MIN",4600202404,"CDM",null,null,440,"RC",null,null,"facility","inpatient",{"$nulls":3},18.75,11.25,5.66,15.37,{"$nulls":37},15.37,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},6.58,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",9.38,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",9.38,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6.86,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},9.38,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},14.23,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},5.66,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},15,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["RITUXIMAB 500 MG INJ",4820081944,"CDM",null,null,636,"RC",50242005306,"NDC","facility","inpatient",50,"ML",null,16390.64,9834.38,4949.97,13440.32,{"$nulls":37},13440.32,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},5753.11,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",8195.32,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",8195.32,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6000.61,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},8195.32,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},12440.5,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},4949.97,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},13112.51,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["DARATUMUMAB 400 MG INJ",4820089023,"CDM",null,null,636,"RC",57894050520,"NDC","facility","inpatient",20,"ML",null,10770.9,6462.54,3252.81,8832.14,{"$nulls":37},8832.14,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},3780.59,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5385.45,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5385.45,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3943.23,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5385.45,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},8175.11,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},3252.81,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},8616.72,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["VINBLASTINE 1 MG INJ CHG",4820902072,"CDM",null,null,636,"RC",63323027810,"NDC","facility","inpatient",1,"ML",null,137.07,82.24,41.4,112.4,{"$nulls":37},112.4,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},48.11,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",68.54,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",68.54,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},50.18,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},68.54,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},104.04,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},41.4,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},109.66,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EXTREMITY STDY SGL LVL BIL MOD",4980061084,"CDM",93922,"CPT",921,"RC",null,null,"facility","inpatient",{"$nulls":3},787,472.2,237.67,645.34,{"$nulls":37},645.34,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},276.24,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",393.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",393.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},288.12,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},393.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},597.33,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},237.67,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},629.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["WOUND DEHISCENCE SIMPLE CLOSUR",4980061222,"CDM",12020,"CPT",761,"RC",null,null,"facility","inpatient",{"$nulls":3},373,223.8,112.65,305.86,{"$nulls":37},305.86,82,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},130.92,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",186.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",186.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},136.56,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},186.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},283.11,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":144},112.65,30.2,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},298.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["VALVE PNEUMOSTAT DRAIN 16100",3160020847,"CDM",null,null,272,"RC",null,null,"facility","outpatient",{"$nulls":3},369,221.4,129.52,369,{"$nulls":37},295.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},129.52,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},135.09,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},184.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},369,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",280.07,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},369,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",369,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",369,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},369,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},369,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},295.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},369,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",295.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ELECTRODE MENISCECTOMY 9735BA",3300021151,"CDM",null,null,272,"RC",null,null,"facility","outpatient",{"$nulls":3},241.55,144.93,84.78,241.55,{"$nulls":37},193.24,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},84.78,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},88.43,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},120.78,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},241.55,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",183.34,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},241.55,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",241.55,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",241.55,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},241.55,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},241.55,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},193.24,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},241.55,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",193.24,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ENDOLOOP VICRYL EJ10G",3300022618,"CDM",null,null,270,"RC",null,null,"facility","outpatient",{"$nulls":3},576.42,345.85,202.32,576.42,{"$nulls":37},461.14,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},202.32,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},211.03,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},288.21,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},576.42,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",437.5,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},576.42,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",576.42,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",576.42,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},576.42,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},576.42,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},461.14,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},576.42,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",461.14,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["BIT SYN DRILL 2.5MM 310.25",3300022903,"CDM",null,null,272,"RC",null,null,"facility","outpatient",{"$nulls":3},1394.82,836.89,489.58,1394.82,{"$nulls":37},1115.86,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},489.58,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},510.64,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},697.41,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1394.82,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1058.67,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1394.82,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1394.82,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1394.82,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},1394.82,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1394.82,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1115.86,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1394.82,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1115.86,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ROUND LONG DIAMOND BUR",3300024282,"CDM",null,null,270,"RC",null,null,"facility","outpatient",{"$nulls":3},480.02,288.01,168.49,480.02,{"$nulls":37},384.02,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},168.49,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},175.74,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},240.01,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},480.02,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",364.34,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},480.02,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",480.02,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",480.02,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},480.02,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},480.02,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},384.02,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},480.02,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",384.02,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["OSTEOTOME FLAT 6x1.5 2422-41",3300025109,"CDM",null,null,272,"RC",null,null,"facility","outpatient",{"$nulls":3},1002,601.2,351.7,1002,{"$nulls":37},801.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},351.7,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},366.83,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},501,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1002,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",760.52,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1002,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1002,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1002,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},1002,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1002,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},801.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1002,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",801.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["GRAFT VASC 6X40 IRST06040040L",3300026346,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},2789.5,1673.7,979.11,2789.5,{"$nulls":37},2231.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},979.11,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1021.24,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1394.75,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2789.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2117.23,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2789.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2789.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2789.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2789.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2789.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2231.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2789.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2231.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["STEM HIP #9 127' 6076-0935A",3300026738,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},1200,720,421.2,1200,{"$nulls":37},960,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},421.2,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},439.32,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},600,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1200,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",910.8,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1200,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1200,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1200,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},1200,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1200,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},960,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1200,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",960,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SCREW LOCK 5X65 212.222",3300027262,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},635.04,381.02,222.9,635.04,{"$nulls":37},508.03,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},222.9,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},232.49,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},317.52,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},635.04,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",482,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},635.04,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",635.04,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",635.04,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},635.04,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},635.04,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},508.03,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},635.04,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",508.03,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SCREW CANN 7.3X85M 222574",3300027342,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},678,406.8,237.98,678,{"$nulls":37},542.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},237.98,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},248.22,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},339,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},678,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",514.6,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},678,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",678,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",678,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},678,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},678,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},542.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},678,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",542.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SCREW 5M STAR 56M 04.005.546",3300027745,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},834,500.4,292.73,834,{"$nulls":37},667.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},292.73,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},305.33,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},417,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},834,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",633.01,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},834,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",834,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",834,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},834,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},834,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},667.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},834,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",667.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ROD GLO STR 80m 115.801",3300027949,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},600,360,210.6,600,{"$nulls":37},480,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},210.6,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},219.66,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},300,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},600,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",455.4,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},600,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",600,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",600,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},600,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},600,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},480,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},600,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",480,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["FIXATOR LO PROFILE 03.304.320S",3300028392,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},4774,2864.4,1675.67,4774,{"$nulls":37},3819.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1675.67,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1747.76,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2387,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4774,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3623.47,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},4774,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4774,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4774,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},4774,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},4774,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3819.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4774,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3819.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SCREW 4x16 04.613.616",3300028996,"CDM","C1713","CPT",278,"RC",null,null,"facility","outpatient",{"$nulls":3},350,210,122.85,350,{"$nulls":37},280,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},122.85,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},128.14,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},175,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},350,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",265.65,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},350,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",350,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",350,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},350,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},350,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},280,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},350,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",280,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SCREW CANCELLOUS 2.5X22 SP-22",3300029232,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},356.16,213.7,125.01,356.16,{"$nulls":37},284.93,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},125.01,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},130.39,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},178.08,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},356.16,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",270.33,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},356.16,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",356.16,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",356.16,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},356.16,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},356.16,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},284.93,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},356.16,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",284.93,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SCREW 5.0n STAR 62m 04.005.552",3300029774,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},627.69,376.61,220.32,627.69,{"$nulls":37},502.15,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},220.32,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},229.8,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},313.85,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},627.69,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",476.42,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},627.69,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",627.69,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",627.69,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},627.69,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},627.69,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},502.15,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},627.69,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",502.15,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["NAIL FIXAT 11X400 RT 456.420S",3300030417,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},3502.52,2101.51,1229.38,3502.52,{"$nulls":37},2802.02,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1229.38,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1282.27,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1751.26,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3502.52,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2658.41,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3502.52,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3502.52,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3502.52,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3502.52,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3502.52,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2802.02,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3502.52,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2802.02,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["GRAFT AAA ILIAC LEG G55219",3300030944,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},6170,3702,2165.67,6170,{"$nulls":37},4936,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2165.67,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2258.84,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3085,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6170,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4683.03,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},6170,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6170,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6170,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},6170,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},6170,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4936,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6170,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4936,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["BIT DRILL 2.8m DB2.8",3300031149,"CDM",null,null,272,"RC",null,null,"facility","outpatient",{"$nulls":3},469,281.4,164.62,469,{"$nulls":37},375.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},164.62,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},171.7,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},234.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},469,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",355.97,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},469,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",469,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",469,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},469,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},469,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},375.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},469,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",375.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["PINNACLE ALTRX 1221-36-154",3300031593,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},3241.8,1945.08,1137.87,3241.8,{"$nulls":37},2593.44,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1137.87,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1186.82,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1620.9,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3241.8,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2460.53,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3241.8,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3241.8,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3241.8,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3241.8,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3241.8,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2593.44,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3241.8,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2593.44,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SCREW LOCKING CO-T2328",3300031756,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},580.5,348.3,203.76,580.5,{"$nulls":37},464.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},203.76,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},212.52,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},290.25,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},580.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",440.6,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},580.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",580.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",580.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},580.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},580.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},464.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},580.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",464.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["MESH PHYSIO 15X20 PHY1520V",3300031783,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},2470,1482,866.97,2470,{"$nulls":37},1976,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},866.97,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},904.27,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1235,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2470,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1874.73,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2470,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2470,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2470,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2470,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2470,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1976,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2470,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1976,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["BIT DRILL 1.5x50x5 01-9192",3300032058,"CDM",null,null,272,"RC",null,null,"facility","outpatient",{"$nulls":3},332.5,199.5,116.71,332.5,{"$nulls":37},266,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},116.71,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},121.73,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},166.25,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},332.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",252.37,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},332.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",332.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",332.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},332.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},332.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},266,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},332.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",266,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SCREW LOCKING 04.210.116",3300033240,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},541.94,325.16,190.22,541.94,{"$nulls":37},433.55,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},190.22,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},198.4,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},270.97,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},541.94,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",411.33,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},541.94,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",541.94,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",541.94,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},541.94,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},541.94,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},433.55,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},541.94,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",433.55,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["KNEE AUGMENTATION 8m 96-0868",3300033344,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},2544.85,1526.91,893.24,2544.85,{"$nulls":37},2035.88,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},893.24,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},931.67,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1272.42,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2544.85,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1931.54,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2544.85,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2544.85,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2544.85,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2544.85,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2544.85,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2035.88,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2544.85,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2035.88,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SCREW LOCKING 3.5x28 30-0265",3300033564,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},511,306.6,179.36,511,{"$nulls":37},408.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},179.36,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},187.08,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},255.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},511,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",387.85,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},511,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",511,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",511,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},511,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},511,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},408.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},511,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",408.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["BUTTON SUTURE  AR-8922",3300033756,"CDM",null,null,272,"RC",null,null,"facility","outpatient",{"$nulls":3},367.5,220.5,128.99,367.5,{"$nulls":37},294,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},128.99,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},134.54,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},183.75,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},367.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",278.93,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},367.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",367.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",367.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},367.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},367.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},294,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},367.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",294,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["LINER ACETABULAR 1218-32-652",3300033841,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},5845.4,3507.24,2051.74,5845.4,{"$nulls":37},4676.32,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2051.74,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2140,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2922.7,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5845.4,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4436.66,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},5845.4,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5845.4,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5845.4,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},5845.4,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},5845.4,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4676.32,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5845.4,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4676.32,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["PLATE LEFORT 5m 50-282-05",3300034013,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},711,426.6,249.56,711,{"$nulls":37},568.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},249.56,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},260.3,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},355.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},711,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",539.65,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},711,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",711,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",711,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},711,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},711,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},568.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},711,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",568.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REAMER LO-PROFILE AR-1405LP-50",3300034268,"CDM",null,null,272,"RC",null,null,"facility","outpatient",{"$nulls":3},819,491.4,287.47,819,{"$nulls":37},655.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},287.47,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},299.84,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},409.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},819,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",621.62,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},819,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",819,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",819,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},819,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},819,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},655.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},819,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",655.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SIDEPLATE OMEGA+ 3362-1-303",3300034328,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},2556.4,1533.84,897.3,2556.4,{"$nulls":37},2045.12,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},897.3,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},935.9,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1278.2,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2556.4,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1940.31,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2556.4,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2556.4,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2556.4,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2556.4,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2556.4,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2045.12,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2556.4,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2045.12,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SCREW 46mm 04.005.436S",3300034508,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},879.06,527.44,308.55,879.06,{"$nulls":37},703.25,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},308.55,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},321.82,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},439.53,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},879.06,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",667.21,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},879.06,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",879.06,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",879.06,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},879.06,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},879.06,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},703.25,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},879.06,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",703.25,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SLING SUPRIS RETRO 93-4450",3300035612,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},3136.88,1882.12,1101.04,3136.88,{"$nulls":37},2509.5,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1101.04,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1148.41,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1568.44,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3136.88,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2380.89,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3136.88,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3136.88,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3136.88,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3136.88,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3136.88,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2509.5,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3136.88,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2509.5,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["VARIAX BONE SCREW  40-35016",3300035816,"CDM","C1713","CPT",278,"RC",null,null,"facility","outpatient",{"$nulls":3},212.8,127.68,74.69,212.8,{"$nulls":37},170.24,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},74.69,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},77.91,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},106.4,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},212.8,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",161.52,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},212.8,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",212.8,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",212.8,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},212.8,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},212.8,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},170.24,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},212.8,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",170.24,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["STENT ZIV 125-6-80PTX G34313",3300035974,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},2000,1200,702,2000,{"$nulls":37},1600,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},702,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},732.2,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1000,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2000,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1518,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2000,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2000,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2000,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2000,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2000,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1600,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2000,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1600,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["FIXATOR TIBIA EXT 4922-9-941S",3300036240,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},8892.36,5335.42,3121.22,8892.36,{"$nulls":37},7113.89,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},3121.22,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3255.49,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4446.18,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},8892.36,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6749.3,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},8892.36,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",8892.36,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",8892.36,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},8892.36,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},8892.36,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},7113.89,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},8892.36,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7113.89,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["RELOAD CUTTER WHITE GST60W",3300036260,"CDM",null,null,272,"RC",null,null,"facility","outpatient",{"$nulls":3},1649.7,989.82,579.04,1649.7,{"$nulls":37},1319.76,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},579.04,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},603.96,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},824.85,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1649.7,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1252.12,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1649.7,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1649.7,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1649.7,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},1649.7,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1649.7,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1319.76,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1649.7,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1319.76,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["NAIL HIP FRACTURE 8145-11-380",3300036449,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},6852,4111.2,2405.05,6852,{"$nulls":37},5481.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2405.05,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2508.52,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3426,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6852,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5200.67,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},6852,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6852,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6852,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},6852,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},6852,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5481.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6852,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5481.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["DISTAFLO BYPAS GRAFT DFM5006SC",3300036716,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},3193.82,1916.29,1121.03,3193.82,{"$nulls":37},2555.06,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1121.03,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1169.26,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1596.91,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3193.82,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2424.11,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3193.82,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3193.82,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3193.82,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3193.82,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3193.82,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2555.06,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3193.82,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2555.06,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["IMPLANT BREAST 350-5400BC",3300037014,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},2010,1206,705.51,2010,{"$nulls":37},1608,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},705.51,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},735.86,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1005,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2010,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1525.59,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2010,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2010,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2010,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2010,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2010,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1608,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2010,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1608,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SCREW LOCKING 2.3X24 53-23624E",3300037335,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},394.9,236.94,138.61,394.9,{"$nulls":37},315.92,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},138.61,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},144.57,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},197.45,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},394.9,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",299.73,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},394.9,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",394.9,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",394.9,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},394.9,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},394.9,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},315.92,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},394.9,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",315.92,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SCREW MULTIDIRECTION 13122736",3300037452,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},870.88,522.52,305.68,870.88,{"$nulls":37},696.7,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},305.68,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},318.83,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},435.44,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},870.88,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",661,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},870.88,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",870.88,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",870.88,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},870.88,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},870.88,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},696.7,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},870.88,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",696.7,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["BEARING TIBIAL E1 EP-189084",3300037763,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},4300,2580,1509.3,4300,{"$nulls":37},3440,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1509.3,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1574.23,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2150,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4300,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3263.7,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},4300,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4300,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4300,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},4300,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},4300,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3440,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4300,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3440,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["KNEE FEMORAL 02-020-13-0230",3300037870,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},4000,2400,1404,4000,{"$nulls":37},3200,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1404,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1464.4,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2000,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4000,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3036,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},4000,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4000,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4000,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},4000,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},4000,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3200,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4000,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3200,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ANGIOJET THROMBEC 114610-001",3300038063,"CDM","C1757","CPT",272,"RC",null,null,"facility","outpatient",{"$nulls":3},10857,6514.2,3810.81,10857,{"$nulls":37},8685.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},3810.81,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3974.75,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5428.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},10857,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",8240.46,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},10857,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",10857,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",10857,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},10857,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},10857,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},8685.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},10857,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",8685.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["NEXGEN STEM 00-5988-020-13",3300038151,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},3410,2046,1196.91,3410,{"$nulls":37},2728,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1196.91,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1248.4,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1705,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3410,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2588.19,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3410,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3410,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3410,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3410,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3410,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2728,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3410,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2728,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["TIBIAL BEARING KNEE 11-146352",3300038326,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},2561,1536.6,898.91,2561,{"$nulls":37},2048.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},898.91,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},937.58,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1280.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2561,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1943.8,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2561,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2561,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2561,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2561,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2561,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2048.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2561,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2048.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["PIN BONE 3.2 X 140M 213527",3300038546,"CDM",null,null,272,"RC",null,null,"facility","outpatient",{"$nulls":3},1800,1080,631.8,1800,{"$nulls":37},1440,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},631.8,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},658.98,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},900,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1800,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1366.2,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1800,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1800,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1800,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},1800,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1800,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1440,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1800,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1440,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["RSP BONE SCREW 506-03-114",3300038647,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},562.5,337.5,197.44,562.5,{"$nulls":37},450,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},197.44,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},205.93,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},281.25,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},562.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",426.94,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},562.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",562.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",562.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},562.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},562.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},450,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},562.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",450,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SUTURE 0-FIBERLINK AR-7258",3300038852,"CDM",null,null,272,"RC",null,null,"facility","outpatient",{"$nulls":3},292.5,175.5,102.67,292.5,{"$nulls":37},234,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},102.67,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},107.08,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},146.25,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},292.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",222.01,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},292.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",292.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",292.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},292.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},292.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},234,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},292.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",234,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["FIXED BEARING 42-5228-004-14",3300039002,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},7250,4350,2544.75,7250,{"$nulls":37},5800,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2544.75,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2654.22,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3625,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7250,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5502.75,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7250,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7250,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7250,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7250,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7250,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5800,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7250,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5800,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["FIBERTAK AR-3671",3300039104,"CDM","C1713","CPT",278,"RC",null,null,"facility","outpatient",{"$nulls":3},3360,2016,1179.36,3360,{"$nulls":37},2688,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1179.36,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1230.1,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1680,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3360,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2550.24,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},3360,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3360,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",3360,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},3360,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},3360,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2688,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3360,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2688,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REVISION STEM 42-5606-135-15",3300039301,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},7772,4663.2,2727.97,7772,{"$nulls":37},6217.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2727.97,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2845.33,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3886,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7772,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5898.95,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7772,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7772,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7772,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7772,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7772,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6217.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7772,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6217.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["TWIST-OFF SCREW 11M 110018484",3300039547,"CDM","C1713","CPT",278,"RC",null,null,"facility","outpatient",{"$nulls":3},936,561.6,328.54,936,{"$nulls":37},748.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},328.54,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},342.67,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},468,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},936,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",710.42,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},936,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",936,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",936,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},936,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},936,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},748.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},936,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",748.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["STEM EXTENSION 42-5606-135-18",3300039642,"CDM","C1776","CPT",278,"RC",null,null,"facility","outpatient",{"$nulls":3},9333.3,5599.98,3275.99,9333.3,{"$nulls":37},7466.64,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},3275.99,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3416.92,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4666.65,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},9333.3,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7083.97,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},9333.3,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",9333.3,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",9333.3,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},9333.3,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},9333.3,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},7466.64,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},9333.3,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7466.64,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["INSERT HUMERAL SOCK 508-00-036",3300039702,"CDM","C1776","CPT",278,"RC",null,null,"facility","outpatient",{"$nulls":3},2100,1260,737.1,2100,{"$nulls":37},1680,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},737.1,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},768.81,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1050,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2100,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1593.9,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2100,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2100,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2100,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2100,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2100,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1680,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2100,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1680,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["AAA ENDOPROSTHESIS RLT231212",3300039923,"CDM","C1874","CPT",278,"RC",null,null,"facility","outpatient",{"$nulls":3},12633,7579.8,4434.18,12633,{"$nulls":37},10106.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},4434.18,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},4624.94,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6316.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},12633,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",9588.45,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},12633,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",12633,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",12633,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},12633,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},12633,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},10106.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},12633,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",10106.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["FIXED TIBIA REV 42-5420-079-02",3300040060,"CDM","C1776","CPT",278,"RC",null,null,"facility","outpatient",{"$nulls":3},5610,3366,1969.11,5610,{"$nulls":37},4488,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},1969.11,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2053.82,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},2805,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5610,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4257.99,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},5610,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5610,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5610,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},5610,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},5610,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4488,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},5610,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4488,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["PIN TEMP FIXATION 07.01595.001",3300040138,"CDM",null,null,272,"RC",null,null,"facility","outpatient",{"$nulls":3},900,540,315.9,900,{"$nulls":37},720,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},315.9,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},329.49,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},450,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},900,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",683.1,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},900,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",900,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",900,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},900,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},900,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},720,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},900,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",720,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["BEARING TIBIAL 5532-G-409-E",3300040276,"CDM","C1776","CPT",278,"RC",null,null,"facility","outpatient",{"$nulls":3},6735,4041,2363.98,6735,{"$nulls":37},5388,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2363.98,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2465.68,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3367.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6735,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5111.86,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},6735,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6735,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6735,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},6735,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},6735,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},5388,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6735,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5388,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SHEATH STEERABLE TG0704517",3300040405,"CDM",null,null,272,"RC",null,null,"facility","outpatient",{"$nulls":3},2135,1281,749.38,2135,{"$nulls":37},1708,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},749.38,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},781.62,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1067.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2135,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1620.46,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2135,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2135,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2135,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2135,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2135,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1708,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2135,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1708,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["POWDER HEMOSTATIC ABSOR 3013SP",3300040480,"CDM",null,null,272,"RC",null,null,"facility","outpatient",{"$nulls":3},1798.34,1079,631.22,1798.34,{"$nulls":37},1438.67,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},631.22,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},658.37,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},899.17,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1798.34,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1364.94,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1798.34,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1798.34,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1798.34,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},1798.34,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1798.34,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1438.67,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1798.34,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1438.67,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["INTRODUCER KIT SC-4365",3300040624,"CDM",null,null,272,"RC",null,null,"facility","outpatient",{"$nulls":3},85,51,29.83,85,{"$nulls":37},68,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},29.83,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},31.12,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},42.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},85,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",64.52,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},85,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",85,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",85,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},85,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},85,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},68,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},85,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",68,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["COUNTERSINK BIT 2351-0335S",3300040750,"CDM",null,null,272,"RC",null,null,"facility","outpatient",{"$nulls":3},707.09,424.25,248.19,707.09,{"$nulls":37},565.67,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},248.19,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},258.87,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},353.54,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},707.09,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",536.68,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},707.09,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",707.09,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",707.09,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},707.09,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},707.09,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},565.67,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},707.09,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",565.67,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["NEEDLE 5IN INSERT SC-4205",3300040792,"CDM",null,null,272,"RC",null,null,"facility","outpatient",{"$nulls":3},820,492,287.82,820,{"$nulls":37},656,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},287.82,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},300.2,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},410,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},820,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",622.38,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},820,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",820,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",820,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},820,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},820,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},656,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},820,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",656,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SCRW 4.0X36MM 02.03155.036",3300040928,"CDM","C1713","CPT",278,"RC",null,null,"facility","outpatient",{"$nulls":3},652.5,391.5,229.03,652.5,{"$nulls":37},522,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},229.03,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},238.88,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},326.25,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},652.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",495.25,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},652.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",652.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",652.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},652.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},652.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},522,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},652.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",522,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["OR TIME (436 TO 450 MINUTES)",3300060030,"CDM",null,null,360,"RC",null,null,"facility","outpatient",{"$nulls":3},39583,23749.8,13893.63,39583,{"$nulls":37},31666.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},13893.63,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},14491.34,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},19791.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},39583,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",30043.5,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},39583,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",39583,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",39583,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},39583,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},39583,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},31666.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},39583,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",31666.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SCREW TUFF 2.7X14 P50-053-2714",3310036999,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},283.5,170.1,99.51,283.5,{"$nulls":37},226.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},99.51,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},103.79,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},141.75,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},283.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",215.18,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},283.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",283.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",283.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},283.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},283.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},226.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},283.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",226.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["PIN GUIDE META REAM 323-1300",3310037650,"CDM",null,null,272,"RC",null,null,"facility","outpatient",{"$nulls":3},249.38,149.62,87.53,249.38,{"$nulls":37},199.5,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},87.53,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},91.3,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},124.69,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},249.38,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",189.28,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},249.38,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",249.38,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",249.38,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},249.38,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},249.38,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},199.5,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},249.38,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",199.5,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SCREW MONSTER 3.5 P20-135-026S",3310038010,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},350,210,122.85,350,{"$nulls":37},280,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},122.85,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},128.14,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},175,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},350,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",265.65,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},350,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",350,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",350,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},350,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},350,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},280,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},350,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",280,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SCREW AR-8840.16",3310038572,"CDM","C1713","CPT",278,"RC",null,null,"facility","outpatient",{"$nulls":3},135.08,81.05,47.41,135.08,{"$nulls":37},108.06,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},47.41,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},49.45,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},67.54,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},135.08,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",102.53,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},135.08,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",135.08,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",135.08,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},135.08,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},135.08,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},108.06,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},135.08,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",108.06,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SCREW 3.5X80 AR-8835-80",3310039189,"CDM","C1713","CPT",278,"RC",null,null,"facility","outpatient",{"$nulls":3},140,84,49.14,140,{"$nulls":37},112,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},49.14,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},51.25,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},70,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},140,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",106.26,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},140,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",140,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",140,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},140,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},140,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},112,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},140,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",112,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REPAIR ENTROPION EXTENSVE BILA",3310679245,"CDM",67924,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},6083,3649.8,2135.13,6083,{"$nulls":37},4866.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2135.13,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2226.99,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3041.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6083,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4617,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},6083,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6083,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6083,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},6083,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},6083,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4866.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6083,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",4866.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["KNEE ARTHROSC CARTIL HARVEST",3310990011,"CDM",29999,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},639,383.4,224.29,639,{"$nulls":37},511.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},224.29,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},233.94,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},319.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},639,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",485,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},639,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",639,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",639,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},639,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},639,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},511.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},639,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",511.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["PACU (1-30 MINUTES)",3330062001,"CDM",null,null,710,"RC",null,null,"facility","outpatient",{"$nulls":3},1078,646.8,378.38,1078,{"$nulls":37},862.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},378.38,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},394.66,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},539,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",818.2,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},1078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},862.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",862.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REMOVE IMPACTED EAR WAX UNI",3400031256,"CDM",69209,"CPT",450,"RC",null,null,"facility","outpatient",{"$nulls":3},142,85.2,49.84,142,{"$nulls":37},113.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},49.84,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},51.99,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},71,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},142,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",107.78,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},142,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",142,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",142,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},142,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},142,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},113.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},142,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",113.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REPAIR OF WOUND OR LESION",3400450186,"CDM",13120,"CPT",450,"RC",null,null,"facility","outpatient",{"$nulls":3},340,204,119.34,340,{"$nulls":37},272,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},119.34,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},124.47,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},170,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},340,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",258.06,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},340,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",340,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",340,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},340,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},340,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},272,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},340,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",272,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["TREAT HUMERUS FRACTURE",3400450267,"CDM",24535,"CPT",450,"RC",null,null,"facility","outpatient",{"$nulls":3},383,229.8,134.43,383,{"$nulls":37},306.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},134.43,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},140.22,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},191.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},383,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",290.7,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},383,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",383,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",383,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},383,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},383,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},306.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},383,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",306.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["TREATMENT OF ANKLE FRACTURE",3400450352,"CDM",27788,"CPT",450,"RC",null,null,"facility","outpatient",{"$nulls":3},284,170.4,99.68,284,{"$nulls":37},227.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},99.68,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},103.97,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},142,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},284,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",215.56,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},284,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",284,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",284,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},284,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},284,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},227.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},284,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",227.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["REDUCTION OF HEMORRHOID/UNLIST",3400450491,"CDM",46999,"CPT",450,"RC",null,null,"facility","outpatient",{"$nulls":3},1078,646.8,378.38,1078,{"$nulls":37},862.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},378.38,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},394.66,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},539,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",818.2,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},1078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},862.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1078,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",862.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["PARACENTESIS WO US",3400450709,"CDM",49082,"CPT",450,"RC",null,null,"facility","outpatient",{"$nulls":3},882,529.2,309.58,882,{"$nulls":37},705.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},309.58,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},322.9,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},441,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},882,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",669.44,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},882,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",882,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",882,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},882,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},882,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},705.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},882,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",705.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["KETONE URINE OR SERUM",4100045137,"CDM",82009,"CPT",301,"RC",null,null,"facility","outpatient",{"$nulls":3},51,30.6,17.9,51,{"$nulls":37},40.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},17.9,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},18.67,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},25.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},51,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",38.71,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},51,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",51,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",51,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},51,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},51,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},40.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},51,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",40.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["WET PREP",4100045236,"CDM",87210,"CPT",306,"RC",null,null,"facility","outpatient",{"$nulls":3},70,42,24.57,70,{"$nulls":37},56,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},24.57,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},25.63,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},35,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},70,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",53.13,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},70,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",70,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",70,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},70,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},70,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},56,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},70,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",56,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ETHYLENE GLYCOL",4100051074,"CDM",82693,"CPT",301,"RC",null,null,"facility","outpatient",{"$nulls":3},87,52.2,30.54,87,{"$nulls":37},69.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},30.54,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},31.85,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},43.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},87,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",66.03,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},87,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",87,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",87,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},87,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},87,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},69.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},87,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",69.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["BLOOD FOR AFB",4100051284,"CDM",87118,"CPT",306,"RC",null,null,"facility","outpatient",{"$nulls":3},117,70.2,41.07,117,{"$nulls":37},93.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},41.07,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},42.83,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},58.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},117,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",88.8,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},117,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",117,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",117,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},117,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},117,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},93.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},117,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",93.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["PATERNITY TEST COLLECTION",4100058026,"CDM",36415,"CPT",300,"RC",null,null,"facility","outpatient",{"$nulls":3},44,26.4,15.44,44,{"$nulls":37},35.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},15.44,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},16.11,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},22,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},44,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",33.4,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},44,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",44,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",44,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},44,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},44,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},35.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},44,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",35.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["PROINSULIN",4100058274,"CDM",84206,"CPT",301,"RC",null,null,"facility","outpatient",{"$nulls":3},672,403.2,235.87,672,{"$nulls":37},537.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},235.87,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},246.02,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},336,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},672,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",510.05,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},672,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",672,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",672,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},672,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},672,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},537.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},672,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",537.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["HIV-1 DNA BY PCR, QUALITATIVE",4100058647,"CDM",87535,"CPT",306,"RC",null,null,"facility","outpatient",{"$nulls":3},475,285,166.72,475,{"$nulls":37},380,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},166.72,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},173.9,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},237.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},475,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",360.52,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},475,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",475,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",475,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},475,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},475,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},380,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},475,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",380,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["C1 COMPLEMENT COMPONENT",4100059395,"CDM",86160,"CPT",302,"RC",null,null,"facility","outpatient",{"$nulls":3},45,27,15.79,45,{"$nulls":37},36,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},15.79,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},16.47,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},22.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},45,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",34.16,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},45,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",45,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",45,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},45,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},45,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},36,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},45,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",36,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ADMARK PHOSPHO-TAU/TAU/AB42",4100079315,"CDM",83520,"CPT",301,"RC",null,null,"facility","outpatient",{"$nulls":3},51,30.6,17.9,51,{"$nulls":37},40.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},17.9,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},18.67,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},25.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},51,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",38.71,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},51,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",51,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",51,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},51,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},51,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},40.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},51,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",40.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["HM-ARSENIC",4100901460,"CDM",82175,"CPT",301,"RC",null,null,"facility","outpatient",{"$nulls":3},317,190.2,111.27,317,{"$nulls":37},253.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},111.27,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},116.05,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},158.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},317,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",240.6,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},317,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",317,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",317,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},317,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},317,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},253.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},317,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",253.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["METHAMPHETAMINE",4100901848,"CDM",80324,"CPT",301,"RC",null,null,"facility","outpatient",{"$nulls":3},146,87.6,51.25,146,{"$nulls":37},116.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},51.25,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},53.45,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},73,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},146,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",110.81,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},146,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",146,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",146,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},146,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},146,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},116.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},146,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",116.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["IGG SUBCLASS 3",4100902773,"CDM",82787,"CPT",300,"RC",null,null,"facility","outpatient",{"$nulls":3},32,19.2,11.23,32,{"$nulls":37},25.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},11.23,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},11.72,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},16,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},32,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",24.29,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},32,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",32,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",32,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},32,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},32,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},25.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},32,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",25.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["AMINO ACID PROFILE",4100907157,"CDM",82136,"CPT",301,"RC",null,null,"facility","outpatient",{"$nulls":3},186,111.6,65.29,186,{"$nulls":37},148.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},65.29,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},68.09,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},93,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},186,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",141.17,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},186,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",186,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",186,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},186,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},186,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},148.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},186,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",148.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SURGICAL PATH,LEVEL 3",4110075105,"CDM",88304,"CPT",310,"RC",null,null,"facility","outpatient",{"$nulls":3},254,152.4,89.15,254,{"$nulls":37},203.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},89.15,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},92.99,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},127,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},254,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",192.79,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},254,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",254,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",254,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},254,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},254,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},203.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},254,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",203.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["KRAS GENE",4110092259,"CDM",81275,"CPT",310,"RC",null,null,"facility","outpatient",{"$nulls":3},624.6,374.76,219.23,624.6,{"$nulls":37},499.68,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},219.23,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},228.67,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},312.3,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},624.6,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",474.07,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},624.6,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",624.6,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",624.6,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},624.6,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},624.6,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},499.68,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},624.6,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",499.68,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SINUSES LESS THAN 3 VIEWS",4200093073,"CDM",70210,"CPT",320,"RC",null,null,"facility","outpatient",{"$nulls":3},138,82.8,48.44,138,{"$nulls":37},110.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},48.44,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},50.52,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},69,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},138,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",104.74,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},138,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",138,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",138,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},138,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},138,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},110.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},138,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",110.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["RIBS BI 3 VIEWS",4200098048,"CDM",71110,"CPT",324,"RC",null,null,"facility","outpatient",{"$nulls":3},235,141,82.48,235,{"$nulls":37},188,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},82.48,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},86.03,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},117.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},235,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",178.36,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},235,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",235,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",235,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},235,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},235,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},188,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},235,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",188,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["MYLEOGRAPHY THORACIC INJ",4200903251,"CDM",62303,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},1652,991.2,579.85,1652,{"$nulls":37},1321.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},579.85,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},604.8,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},826,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1652,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1253.87,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1652,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1652,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1652,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},1652,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1652,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1321.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1652,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1321.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["US BLADDER",4220902089,"CDM",76857,"CPT",402,"RC",null,null,"facility","outpatient",{"$nulls":3},1142,685.2,400.84,1142,{"$nulls":37},913.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},400.84,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},418.09,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},571,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1142,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",866.78,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1142,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1142,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1142,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},1142,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1142,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},913.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1142,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",913.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CT MAKO KNEE",4230094133,"CDM",73700,"CPT",352,"RC",null,null,"facility","outpatient",{"$nulls":3},142.86,85.72,50.14,142.86,{"$nulls":37},114.29,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},50.14,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},52.3,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},71.43,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},142.86,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",108.43,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},142.86,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",142.86,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",142.86,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},142.86,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},142.86,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},114.29,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},142.86,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",114.29,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["MRA LOWER EXT BI WO CONT",4240093483,"CDM",null,null,616,"RC",null,null,"facility","outpatient",{"$nulls":3},1191,714.6,418.04,1191,{"$nulls":37},952.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},418.04,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},436.03,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},595.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1191,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",903.97,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1191,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1191,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1191,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},1191,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1191,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},952.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1191,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",952.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["US BREAST BX ADDL LESION RT",4270095068,"CDM",19084,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},1799,1079.4,631.45,1799,{"$nulls":37},1439.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},631.45,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},658.61,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},899.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1799,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1365.44,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1799,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1799,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1799,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},1799,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1799,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1439.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1799,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1439.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["DX MMG DIR DIGITAL UNI R",4270902017,"CDM",77065,"CPT",401,"RC",null,null,"facility","outpatient",{"$nulls":3},229,137.4,80.38,229,{"$nulls":37},183.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},80.38,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},83.84,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},114.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},229,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",173.81,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},229,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",229,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",229,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},229,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},229,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},183.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},229,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",183.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["BIALIARY DUCT DILATTION SIN",4280017210,"CDM",74363,"CPT",320,"RC",null,null,"facility","outpatient",{"$nulls":3},1958,1174.8,687.26,1958,{"$nulls":37},1566.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},687.26,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},716.82,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},979,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1958,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1486.12,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1958,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1958,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1958,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},1958,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1958,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1566.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1958,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1566.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SET NEFF PERC. ACCESS",4280024674,"CDM",null,null,272,"RC",null,null,"facility","outpatient",{"$nulls":3},1012.5,607.5,355.39,1012.5,{"$nulls":37},810,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},355.39,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},370.68,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},506.25,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1012.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",768.49,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1012.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1012.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1012.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},1012.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1012.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},810,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1012.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",810,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["NEEDLE BIOPSY ADJUST ACT1811",4280026079,"CDM",null,null,272,"RC",null,null,"facility","outpatient",{"$nulls":3},906.24,543.74,318.09,906.24,{"$nulls":37},724.99,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},318.09,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},331.77,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},453.12,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},906.24,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",687.84,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},906.24,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",906.24,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",906.24,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},906.24,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},906.24,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},724.99,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},906.24,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",724.99,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["VIATORR TIPS PTB8108275-1",4280039022,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},28335,17001,9945.58,28335,{"$nulls":37},22668,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},9945.58,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},10373.44,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},14167.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},28335,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",21506.26,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},28335,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",28335,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",28335,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},28335,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},28335,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},22668,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},28335,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",22668,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["IR INJ FORAMEN EPIDURAL L/S",4280093496,"CDM",64483,"CPT",361,"RC",null,null,"facility","outpatient",{"$nulls":3},2349,1409.4,824.5,2349,{"$nulls":37},1879.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},824.5,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},859.97,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1174.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2349,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1782.89,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},2349,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2349,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",2349,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},2349,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},2349,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1879.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2349,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1879.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CATH BALL MO 2.5X12 38959-1225",4290031563,"CDM","C1725","CPT",278,"RC",null,null,"facility","outpatient",{"$nulls":3},455,273,159.7,455,{"$nulls":37},364,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},159.7,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},166.58,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},227.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},455,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",345.34,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},455,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",455,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",455,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},455,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},455,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},364,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},455,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",364,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["LEAD STYLET 59CM 6601",4290031905,"CDM",null,null,278,"RC",null,null,"facility","outpatient",{"$nulls":3},175,105,61.42,175,{"$nulls":37},140,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},61.42,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},64.07,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},87.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},175,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",132.82,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},175,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",175,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",175,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},175,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},175,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},140,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},175,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",140,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["PACE ICD PUNCTURA E052",4290035671,"CDM",null,null,275,"RC",null,null,"facility","outpatient",{"$nulls":3},7547.5,4528.5,2649.17,7547.5,{"$nulls":37},6038,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},2649.17,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},2763.14,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},3773.75,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7547.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",5728.55,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},7547.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7547.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7547.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},7547.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},7547.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},6038,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7547.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6038,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CATH NC TRK 3.75x15 1012452-15",4290036821,"CDM",null,null,272,"RC",null,null,"facility","outpatient",{"$nulls":3},517.5,310.5,181.64,517.5,{"$nulls":37},414,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},181.64,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},189.46,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},258.75,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},517.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",392.78,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},517.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",517.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",517.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},517.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},517.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},414,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},517.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",414,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["PM BIV/ICD INOGEN G141",4290037909,"CDM","C1721","CPT",275,"RC",null,null,"facility","outpatient",{"$nulls":3},8786.5,5271.9,3084.06,8786.5,{"$nulls":37},7029.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},3084.06,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},3216.74,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},4393.25,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},8786.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",6668.95,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},8786.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",8786.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",8786.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},8786.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},8786.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},7029.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},8786.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",7029.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["LHC COR ANG W LVGRAM W SI",4290063918,"CDM",93458,"CPT",481,"RC",null,null,"facility","outpatient",{"$nulls":3},18661,11196.6,6550.01,18661,{"$nulls":37},14928.8,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},6550.01,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},6831.79,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},9330.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},18661,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",14163.7,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},18661,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",18661,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",18661,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},18661,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},18661,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},14928.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},18661,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",14928.8,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SPIROMETRY/CONTRACT",4300075034,"CDM",94010,"CPT",460,"RC",null,null,"facility","outpatient",{"$nulls":3},194,116.4,68.09,194,{"$nulls":37},155.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},68.09,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},71.02,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},97,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},194,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",147.25,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},194,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",194,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",194,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},194,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},194,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},155.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},194,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",155.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["APLISOL 1ML INJ",4400080074,"CDM",null,null,250,"RC",49281075221,"NDC","facility","outpatient",1,"ML",null,41.07,24.64,14.42,41.07,{"$nulls":37},32.86,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},14.42,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},15.04,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},20.54,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},41.07,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",31.17,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},41.07,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",41.07,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",41.07,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},41.07,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},41.07,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},32.86,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},41.07,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",32.86,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["METRONIDAZOLE 500 MG BAG INJ",4400080413,"CDM","S0030","CPT",636,"RC",409015224,"NDC","facility","outpatient",100,"ML",null,155.17,93.1,54.46,155.17,{"$nulls":37},124.14,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},54.46,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},56.81,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},77.58,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},155.17,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",117.77,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},155.17,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",155.17,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",155.17,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},155.17,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},155.17,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},124.14,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},155.17,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",124.14,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["PAMELOR 25MG",4400080750,"CDM",null,null,259,"RC",93081101,"NDC","facility","outpatient",1,"UN",null,1.26,0.76,0.44,1.26,{"$nulls":37},1.01,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},0.44,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},0.46,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},0.63,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1.26,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",0.96,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1.26,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1.26,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1.26,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},1.26,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1.26,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1.01,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1.26,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1.01,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["METHYLPREDNISOLONE INJ 40MG",4400080937,"CDM",null,null,636,"RC",9003928,"NDC","facility","outpatient",1,"ML",null,26.98,16.19,9.47,26.98,{"$nulls":37},21.58,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},9.47,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},9.88,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},13.49,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},26.98,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",20.48,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},26.98,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",26.98,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",26.98,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},26.98,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},26.98,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},21.58,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},26.98,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",21.58,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CARDIZEM CD 300MG",4400081370,"CDM",null,null,259,"RC",24979002907,"NDC","facility","outpatient",1,"UN",null,1.62,0.97,0.57,1.62,{"$nulls":37},1.3,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},0.57,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},0.59,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},0.81,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1.62,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1.23,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1.62,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1.62,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1.62,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},1.62,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1.62,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1.3,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1.62,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1.3,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["MYCOBUTIN 150MG CAPSULE",4400081596,"CDM",null,null,259,"RC",59762135001,"NDC","facility","outpatient",1,"UN",null,21.82,13.09,7.66,21.82,{"$nulls":37},17.46,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},7.66,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},7.99,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},10.91,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},21.82,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",16.56,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},21.82,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",21.82,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",21.82,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},21.82,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},21.82,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},17.46,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},21.82,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",17.46,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CLE PRE 900",4400081975,"CDM",null,null,636,"RC",338381424,"NDC","facility","outpatient",50,"ML",null,182.62,109.57,64.1,182.62,{"$nulls":37},146.1,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},64.1,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},66.86,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},91.31,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},182.62,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",138.61,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},182.62,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",182.62,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",182.62,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},182.62,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},182.62,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},146.1,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},182.62,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",146.1,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["XOPENEX 1.25MG INHALATION",4400082286,"CDM",null,null,259,"RC",76204090001,"NDC","facility","outpatient",3,"ML",null,43.72,26.23,15.35,43.72,{"$nulls":37},34.98,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},15.35,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},16.01,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},21.86,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},43.72,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",33.18,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},43.72,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",43.72,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",43.72,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},43.72,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},43.72,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},34.98,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},43.72,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",34.98,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["RISPERIDONE 0.25MG TABLET PO",4400082772,"CDM",null,null,259,"RC",904736061,"NDC","facility","outpatient",1,"UN",null,1.4,0.84,0.49,1.4,{"$nulls":37},1.12,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},0.49,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},0.51,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},0.7,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1.4,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1.06,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1.4,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1.4,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1.4,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},1.4,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1.4,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1.12,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1.4,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1.12,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ISOSORBIDE 30MG TAB PO",4400082811,"CDM",null,null,259,"RC",904644961,"NDC","facility","outpatient",1,"UN",null,1.5,0.9,0.53,1.5,{"$nulls":37},1.2,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},0.53,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},0.55,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},0.75,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1.14,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},1.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},1.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},1.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},1.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},1.5,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",1.2,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SODIUM CHLOR 0.9% INJ 100ML",4400088030,"CDM",null,null,250,"RC",65219046850,"NDC","facility","outpatient",100,"ML",null,103.08,61.85,36.18,103.08,{"$nulls":37},82.46,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},36.18,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},37.74,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},51.54,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},103.08,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",78.24,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},103.08,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",103.08,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",103.08,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},103.08,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},103.08,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},82.46,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},103.08,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",82.46,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["CEFTOLOZANE/TAZOBACTAM 1500 MG",4400902097,"CDM",null,null,636,"RC",67919003001,"NDC","facility","outpatient",1,"UN",null,608.35,365.01,213.53,608.35,{"$nulls":37},486.68,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},213.53,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},222.72,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},304.18,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},608.35,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",461.74,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},608.35,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",608.35,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",608.35,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},608.35,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},608.35,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},486.68,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},608.35,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",486.68,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["BARICITINIB 2 MG TAB",4400902333,"CDM",null,null,250,"RC",2418230,"NDC","facility","outpatient",1,"UN",null,246.45,147.87,86.5,246.45,{"$nulls":37},197.16,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},86.5,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},90.23,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},123.22,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},246.45,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",187.06,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},246.45,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",246.45,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",246.45,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},246.45,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},246.45,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},197.16,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},246.45,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",197.16,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["OFFICE CONSULT LEVEL 4",4790099244,"CDM",99244,"CPT",510,"RC",null,null,"facility","outpatient",{"$nulls":3},458,274.8,160.76,458,{"$nulls":37},366.4,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},160.76,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},167.67,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},229,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},458,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",347.62,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},458,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",458,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",458,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},458,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},458,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},366.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},458,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",366.4,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["SODM CHLORIDE 0.9% AVIVA 250ML",4820082930,"CDM",null,null,258,"RC",null,null,"facility","outpatient",{"$nulls":3},136.68,82.01,47.97,136.68,{"$nulls":37},109.34,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},47.97,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},50.04,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},68.34,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},136.68,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",103.74,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},136.68,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",136.68,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",136.68,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},136.68,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},136.68,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},109.34,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},136.68,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",109.34,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["ETOPOSIDE 10 MG INJ CHG",4820902014,"CDM",null,null,636,"RC",63323010425,"NDC","facility","outpatient",1,"ML",null,0.92,0.55,0.32,0.92,{"$nulls":37},0.74,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},0.32,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},0.34,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},0.46,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},0.92,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",0.7,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},0.92,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",0.92,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",0.92,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},0.92,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},0.92,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},0.74,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},0.92,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",0.74,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["DURVALUMAB 120 MG NC",4820990048,"CDM",null,null,636,"RC",310450012,"NDC","facility","outpatient",2,"ML",null,0.03,0.02,0.01,0.03,{"$nulls":37},0.02,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},0.01,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},0.01,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},0.02,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},0.03,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",0.02,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},0.03,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",0.03,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",0.03,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},0.03,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},0.03,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},0.02,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},0.03,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",0.02,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["EPIFIX 1 SQ CM",4980061049,"CDM",null,null,272,"RC",null,null,"facility","outpatient",{"$nulls":3},572,343.2,200.77,572,{"$nulls":37},457.6,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},200.77,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},209.41,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},286,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},572,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",434.15,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},572,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",572,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",572,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},572,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},572,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},457.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},572,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",457.6,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["INITIAL HOSP CARE, EXTENDED",5790099223,"CDM",99223,"CPT",987,"RC",null,null,"professional","outpatient",{"$nulls":3},595,357,208.84,595,{"$nulls":37},476,80,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":54},208.84,35.1,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},217.83,36.61,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},297.5,50,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},595,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",451.6,75.9,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":36},595,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",595,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",595,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":18},595,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":45},595,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":9},476,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",{"$nulls":27},595,100,{"$nulls":4},0,"percent of total billed charges","No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level.",476,80,{"$nulls":4},0,"percent of total billed charges","Rate only applies when calculated under All Other contract terms | No historical remittance data available for this CDM code type under the specified payer/plan, as remittances do not itemize at the CDM level."]
["BRAIN CONTUSION/LACERATION & COMPLICATED SKULL FX, COMA < 1 HR OR NO COMA ",561,"APR-DRG",{"$nulls":6},"facility","inpatient",{"$nulls":5},6956.57,6956.57,{"$nulls":10},6956.57,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00",{"$nulls":108},6956.57,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00",{"$nulls":99},6956.57,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00",{"$nulls":72},6956.57,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00",6956.57,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00"]
["INTERSTITIAL LUNG DISEASE",1423,"APR-DRG",{"$nulls":6},"facility","inpatient",{"$nulls":5},13095.35,13095.35,{"$nulls":10},13095.35,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00",{"$nulls":108},13095.35,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00",{"$nulls":99},13095.35,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00",{"$nulls":72},13095.35,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00",13095.35,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00"]
["ACUTE MYOCARDIAL INFARCTION ",1903,"APR-DRG",{"$nulls":6},"facility","inpatient",{"$nulls":5},13762.59,13762.59,{"$nulls":10},13762.59,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00",{"$nulls":108},13762.59,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00",{"$nulls":99},13762.59,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00",{"$nulls":72},13762.59,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00",13762.59,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00"]
["OTHER GASTROENTERITIS, NAUSEA & VOMITING ",2491,"APR-DRG",{"$nulls":6},"facility","inpatient",{"$nulls":5},4393.62,4393.62,{"$nulls":10},4393.62,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00",{"$nulls":108},4393.62,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00",{"$nulls":99},4393.62,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00",{"$nulls":72},4393.62,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00",4393.62,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00"]
["AMPUTATION OF LOWER LIMB EXCEPT TOES",3051,"APR-DRG",{"$nulls":6},"facility","inpatient",{"$nulls":5},12830.39,12830.39,{"$nulls":10},12830.39,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00",{"$nulls":108},12830.39,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00",{"$nulls":99},12830.39,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00",{"$nulls":72},12830.39,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00",12830.39,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00"]
["THYROID, PARATHYROID & THYROGLOSSAL PROCEDURES ",4044,"APR-DRG",{"$nulls":6},"facility","inpatient",{"$nulls":5},51209.54,51209.54,{"$nulls":10},51209.54,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00",{"$nulls":108},51209.54,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00",{"$nulls":99},51209.54,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00",{"$nulls":72},51209.54,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00",51209.54,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00"]
["DILATION & CURETTAGE FOR NON-OBSTETRIC DIAGNOSES ",5172,"APR-DRG",{"$nulls":6},"facility","inpatient",{"$nulls":5},9677.29,9677.29,{"$nulls":10},9677.29,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00",{"$nulls":108},9677.29,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00",{"$nulls":99},9677.29,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00",{"$nulls":72},9677.29,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00",9677.29,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00"]
["COAGULATION & PLATELET DISORDERS ",6613,"APR-DRG",{"$nulls":6},"facility","inpatient",{"$nulls":5},14973,14973,{"$nulls":10},14973,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00",{"$nulls":108},14973,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00",{"$nulls":99},14973,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00",{"$nulls":72},14973,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00",14973,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00"]
["OTHER O.R. PROCEDURES FOR LYMPHATIC/HEMATOPOIETIC/OTHER NEOPLASMS",6814,"APR-DRG",{"$nulls":6},"facility","inpatient",{"$nulls":5},71262.67,71262.67,{"$nulls":10},71262.67,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00",{"$nulls":108},71262.67,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00",{"$nulls":99},71262.67,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00",{"$nulls":72},71262.67,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00",71262.67,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00"]
["OTHER INJURY, POISONING & TOXIC EFFECT DIAGNOSES ",8152,"APR-DRG",{"$nulls":6},"facility","inpatient",{"$nulls":5},6035.21,6035.21,{"$nulls":10},6035.21,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00",{"$nulls":108},6035.21,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00",{"$nulls":99},6035.21,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00",{"$nulls":72},6035.21,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00",6035.21,{"$nulls":6},"case rate","Stop-loss discount of 60.0000 percent applies when charges exceed 98000.00"]
["ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC","MS-122","MS-DRG",{"$nulls":6},"facility","inpatient",{"$nulls":5},4026.69,21464.07,null,4910.99,{"$nulls":6},"case rate",{"$nulls":10},4814.7,{"$nulls":6},"case rate",{"$nulls":28},4959.14,{"$nulls":6},"case rate",null,4814.7,{"$nulls":6},"case rate",null,9051.63,{"$nulls":6},"case rate",{"$nulls":10},4814.7,{"$nulls":6},"case rate",{"$nulls":10},11155.22,{"$nulls":6},"case rate",null,11155.22,{"$nulls":6},"case rate",{"$nulls":19},4814.7,{"$nulls":6},"case rate",null,11155.22,{"$nulls":6},"case rate",{"$nulls":46},4026.69,{"$nulls":6},"case rate",null,4814.7,{"$nulls":6},"case rate",{"$nulls":46},4814.7,{"$nulls":6},"case rate",{"$nulls":19},4814.7,{"$nulls":6},"case rate",{"$nulls":28},4814.7,{"$nulls":6},"case rate",{"$nulls":11},30.2,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",21464.07,{"$nulls":6},"case rate",null,4814.7,{"$nulls":6},"case rate",null,4814.7,{"$nulls":6},"case rate",{"$nulls":28},4814.7,{"$nulls":6},"case rate"]
["ENDOVASCULAR CARDIAC VALVE REPLACEMENT W MCC","MS-266","MS-DRG",{"$nulls":6},"facility","inpatient",{"$nulls":5},35564.07,189572.4,null,38300.49,{"$nulls":6},"case rate",{"$nulls":10},37549.5,{"$nulls":6},"case rate",{"$nulls":28},38675.98,{"$nulls":6},"case rate",null,37549.5,{"$nulls":6},"case rate",null,70593.05,{"$nulls":6},"case rate",{"$nulls":10},37549.5,{"$nulls":6},"case rate",{"$nulls":10},157037.96,{"$nulls":6},"case rate",null,157037.96,{"$nulls":6},"case rate",{"$nulls":19},37549.5,{"$nulls":6},"case rate",null,157037.96,{"$nulls":6},"case rate",{"$nulls":46},35564.07,{"$nulls":6},"case rate",null,37549.5,{"$nulls":6},"case rate",{"$nulls":46},37549.5,{"$nulls":6},"case rate",{"$nulls":19},37549.5,{"$nulls":6},"case rate",{"$nulls":28},37549.5,{"$nulls":6},"case rate",{"$nulls":11},30.2,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",189572.4,{"$nulls":6},"case rate",null,37549.5,{"$nulls":6},"case rate",null,37549.5,{"$nulls":6},"case rate",{"$nulls":28},37549.5,{"$nulls":6},"case rate"]
["APPENDECTOMY WITHOUT COMPLICATED PRINCIPAL DIAGNOSIS WITH CC","MS-342","MS-DRG",{"$nulls":6},"facility","inpatient",{"$nulls":5},50956.2,50956.2,{"$nulls":361},50956.2,{"$nulls":6},"case rate"]
["MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIES","MS-483","MS-DRG",{"$nulls":6},"facility","inpatient",{"$nulls":5},15127.26,80635.04,null,17323.46,{"$nulls":6},"case rate",{"$nulls":10},16983.79,{"$nulls":6},"case rate",{"$nulls":28},17493.3,{"$nulls":6},"case rate",null,16983.79,{"$nulls":6},"case rate",null,31929.52,{"$nulls":6},"case rate",{"$nulls":10},16983.79,{"$nulls":6},"case rate",{"$nulls":10},30393.72,{"$nulls":6},"case rate",null,30393.72,{"$nulls":6},"case rate",{"$nulls":19},16983.79,{"$nulls":6},"case rate",null,30393.72,{"$nulls":6},"case rate",{"$nulls":46},15127.26,{"$nulls":6},"case rate",null,16983.79,{"$nulls":6},"case rate",{"$nulls":46},16983.79,{"$nulls":6},"case rate",{"$nulls":19},16983.79,{"$nulls":6},"case rate",{"$nulls":28},16983.79,{"$nulls":6},"case rate",{"$nulls":11},30.2,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",80635.04,{"$nulls":6},"case rate",null,16983.79,{"$nulls":6},"case rate",null,16983.79,{"$nulls":6},"case rate",{"$nulls":28},16983.79,{"$nulls":6},"case rate"]
["ENDOCRINE DISORDERS WITH MCC","MS-643","MS-DRG",{"$nulls":6},"facility","inpatient",{"$nulls":5},9838.47,52443.47,null,10287.58,{"$nulls":6},"case rate",{"$nulls":10},10085.87,{"$nulls":6},"case rate",{"$nulls":28},10388.44,{"$nulls":6},"case rate",null,10085.87,{"$nulls":6},"case rate",null,18961.43,{"$nulls":6},"case rate",{"$nulls":10},10085.87,{"$nulls":6},"case rate",{"$nulls":10},23506.25,{"$nulls":6},"case rate",null,23506.25,{"$nulls":6},"case rate",{"$nulls":19},10085.87,{"$nulls":6},"case rate",null,23506.25,{"$nulls":6},"case rate",{"$nulls":46},9838.47,{"$nulls":6},"case rate",null,10085.87,{"$nulls":6},"case rate",{"$nulls":46},10085.87,{"$nulls":6},"case rate",{"$nulls":19},10085.87,{"$nulls":6},"case rate",{"$nulls":28},10085.87,{"$nulls":6},"case rate",{"$nulls":11},30.2,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",52443.47,{"$nulls":6},"case rate",null,10085.87,{"$nulls":6},"case rate",null,10085.87,{"$nulls":6},"case rate",{"$nulls":28},10085.87,{"$nulls":6},"case rate"]
["OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC","MS-729","MS-DRG",{"$nulls":6},"facility","inpatient",{"$nulls":5},6486.79,34836.79,null,6616.53,{"$nulls":6},"case rate",{"$nulls":10},6486.79,{"$nulls":6},"case rate",{"$nulls":28},6681.4,{"$nulls":6},"case rate",null,6486.79,{"$nulls":6},"case rate",null,12195.17,{"$nulls":6},"case rate",{"$nulls":10},6486.79,{"$nulls":6},"case rate",{"$nulls":10},16105.92,{"$nulls":6},"case rate",null,16105.92,{"$nulls":6},"case rate",{"$nulls":19},6486.79,{"$nulls":6},"case rate",null,16105.92,{"$nulls":6},"case rate",{"$nulls":46},6535.43,{"$nulls":6},"case rate",null,6486.79,{"$nulls":6},"case rate",{"$nulls":46},6486.79,{"$nulls":6},"case rate",{"$nulls":19},6486.79,{"$nulls":6},"case rate",{"$nulls":28},6486.79,{"$nulls":6},"case rate",{"$nulls":11},30.2,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",34836.79,{"$nulls":6},"case rate",null,6486.79,{"$nulls":6},"case rate",null,6486.79,{"$nulls":6},"case rate",{"$nulls":28},6486.79,{"$nulls":6},"case rate"]
["CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC","MS-846","MS-DRG",{"$nulls":6},"facility","inpatient",{"$nulls":5},15160.5,80812.24,null,16202.27,{"$nulls":6},"case rate",{"$nulls":10},15884.58,{"$nulls":6},"case rate",{"$nulls":28},16361.12,{"$nulls":6},"case rate",null,15884.58,{"$nulls":6},"case rate",null,29863.01,{"$nulls":6},"case rate",{"$nulls":10},15884.58,{"$nulls":6},"case rate",{"$nulls":10},27886.07,{"$nulls":6},"case rate",null,27886.07,{"$nulls":6},"case rate",{"$nulls":19},15884.58,{"$nulls":6},"case rate",null,27886.07,{"$nulls":6},"case rate",{"$nulls":46},15160.5,{"$nulls":6},"case rate",null,15884.58,{"$nulls":6},"case rate",{"$nulls":46},15884.58,{"$nulls":6},"case rate",{"$nulls":19},15884.58,{"$nulls":6},"case rate",{"$nulls":28},15884.58,{"$nulls":6},"case rate",{"$nulls":11},30.2,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",80812.24,{"$nulls":6},"case rate",null,15884.58,{"$nulls":6},"case rate",null,15884.58,{"$nulls":6},"case rate",{"$nulls":28},15884.58,{"$nulls":6},"case rate"]
["Onc ovar 5 prtn ser alg scor","0003U","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},950,2299,null,969,{"$nulls":6},"fee schedule",{"$nulls":10},950,{"$nulls":6},"fee schedule",{"$nulls":28},978.5,{"$nulls":6},"fee schedule",null,950,{"$nulls":6},"fee schedule",null,2299,{"$nulls":6},"fee schedule",{"$nulls":10},950,{"$nulls":6},"fee schedule",{"$nulls":46},950,{"$nulls":6},"fee schedule",{"$nulls":55},950,{"$nulls":6},"fee schedule",null,950,{"$nulls":6},"fee schedule",{"$nulls":46},950,{"$nulls":6},"fee schedule",{"$nulls":19},950,{"$nulls":6},"fee schedule",{"$nulls":28},950,{"$nulls":6},"fee schedule",{"$nulls":28},950,{"$nulls":6},"fee schedule",null,950,{"$nulls":6},"fee schedule",{"$nulls":28},950,{"$nulls":6},"fee schedule"]
["Tpmt nudt15 genes","0034U","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},466.17,1128.13,null,475.49,{"$nulls":6},"fee schedule",{"$nulls":10},466.17,{"$nulls":6},"fee schedule",{"$nulls":28},480.16,{"$nulls":6},"fee schedule",null,466.17,{"$nulls":6},"fee schedule",null,1128.13,{"$nulls":6},"fee schedule",{"$nulls":10},466.17,{"$nulls":6},"fee schedule",{"$nulls":11},50,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",null,60.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":18},466.17,{"$nulls":6},"fee schedule",null,null,61.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":45},466.17,{"$nulls":6},"fee schedule",null,466.17,{"$nulls":6},"fee schedule",{"$nulls":46},466.17,{"$nulls":6},"fee schedule",{"$nulls":19},466.17,{"$nulls":6},"fee schedule",{"$nulls":28},466.17,{"$nulls":6},"fee schedule",{"$nulls":28},466.17,{"$nulls":6},"fee schedule",null,466.17,{"$nulls":6},"fee schedule",{"$nulls":28},466.17,{"$nulls":6},"fee schedule"]
["Anesth major vein ligation",882,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},12432.04,32221.61,null,12680.68,{"$nulls":6},"case rate",{"$nulls":10},12432.04,{"$nulls":6},"case rate",{"$nulls":28},12805,{"$nulls":6},"case rate",null,12432.04,{"$nulls":6},"case rate",null,32221.61,{"$nulls":6},"case rate",{"$nulls":10},12432.04,{"$nulls":6},"case rate",{"$nulls":46},12432.04,{"$nulls":6},"case rate",{"$nulls":55},13314.72,{"$nulls":6},"case rate",null,12432.04,{"$nulls":6},"case rate",{"$nulls":46},12432.04,{"$nulls":6},"case rate",{"$nulls":19},12432.04,{"$nulls":6},"case rate",{"$nulls":28},12432.04,{"$nulls":6},"case rate",{"$nulls":28},13314.72,{"$nulls":6},"case rate",null,12432.04,{"$nulls":6},"case rate",{"$nulls":28},12432.04,{"$nulls":6},"case rate"]
["Crd ceramides liq chrom plsm","0119U","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},83.76,202.7,null,85.44,{"$nulls":6},"fee schedule",{"$nulls":10},83.76,{"$nulls":6},"fee schedule",{"$nulls":28},86.27,{"$nulls":6},"fee schedule",null,83.76,{"$nulls":6},"fee schedule",null,202.7,{"$nulls":6},"fee schedule",{"$nulls":10},83.76,{"$nulls":6},"fee schedule",{"$nulls":46},83.76,{"$nulls":6},"fee schedule",{"$nulls":55},83.76,{"$nulls":6},"fee schedule",null,83.76,{"$nulls":6},"fee schedule",{"$nulls":46},83.76,{"$nulls":6},"fee schedule",{"$nulls":19},83.76,{"$nulls":6},"fee schedule",{"$nulls":28},83.76,{"$nulls":6},"fee schedule",{"$nulls":28},83.76,{"$nulls":6},"fee schedule",null,83.76,{"$nulls":6},"fee schedule",{"$nulls":28},83.76,{"$nulls":6},"fee schedule"]
["Jk gnotyp slc14a1 exon 9","0192U","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},274.83,665.09,null,280.33,{"$nulls":6},"fee schedule",{"$nulls":10},274.83,{"$nulls":6},"fee schedule",{"$nulls":28},283.07,{"$nulls":6},"fee schedule",null,274.83,{"$nulls":6},"fee schedule",null,665.09,{"$nulls":6},"fee schedule",{"$nulls":10},274.83,{"$nulls":6},"fee schedule",{"$nulls":11},50,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",null,60.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":18},274.83,{"$nulls":6},"fee schedule",null,null,61.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":45},274.83,{"$nulls":6},"fee schedule",null,274.83,{"$nulls":6},"fee schedule",{"$nulls":46},274.83,{"$nulls":6},"fee schedule",{"$nulls":19},274.83,{"$nulls":6},"fee schedule",{"$nulls":28},274.83,{"$nulls":6},"fee schedule",{"$nulls":28},274.83,{"$nulls":6},"fee schedule",null,274.83,{"$nulls":6},"fee schedule",{"$nulls":28},274.83,{"$nulls":6},"fee schedule"]
["Onc sphrd cell cul 12 rx pnl","0248U","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},12469.16,12469.16,{"$nulls":361},12469.16,{"$nulls":6},"fee schedule","0248U: RC 0300-0307|0248U: RC 0309|0248U: RC 0923|0248U: RC 0925"]
["Hem gen thrombosis 14 genes","0278U","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},2499.58,2499.58,{"$nulls":361},2499.58,{"$nulls":6},"fee schedule","0278U: RC 0300-0307|0278U: RC 0309|0278U: RC 0923|0278U: RC 0925"]
["Onc prst8 xom aly 442 sncrna","0343U","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},3123.6,3123.6,{"$nulls":361},3123.6,{"$nulls":6},"fee schedule","0343U: RC 0300-0307|0343U: RC 0309|0343U: RC 0923|0343U: RC 0925"]
["Onc pan solid tum alys dna","0422U","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},50,61.1,{"$nulls":110},50,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",null,60.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":28},61.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file"]
["Onc sol tum ctc slct er prtn","0491U","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},2435,5892.7,null,2483.7,{"$nulls":6},"fee schedule",{"$nulls":10},2435,{"$nulls":6},"fee schedule",{"$nulls":28},2508.05,{"$nulls":6},"fee schedule",null,2435,{"$nulls":6},"fee schedule",null,5892.7,{"$nulls":6},"fee schedule",{"$nulls":10},2435,{"$nulls":6},"fee schedule",{"$nulls":46},2435,{"$nulls":6},"fee schedule",{"$nulls":55},2435,{"$nulls":6},"fee schedule",null,2435,{"$nulls":6},"fee schedule",{"$nulls":46},2435,{"$nulls":6},"fee schedule",{"$nulls":19},2435,{"$nulls":6},"fee schedule",{"$nulls":28},2435,{"$nulls":6},"fee schedule",{"$nulls":28},2435,{"$nulls":6},"fee schedule",null,2435,{"$nulls":6},"fee schedule",{"$nulls":28},2435,{"$nulls":6},"fee schedule"]
["Evasc ven artlz tibl/prnl vn","0620T","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},32201.16,83459.61,null,32845.18,{"$nulls":6},"fee schedule",{"$nulls":10},32201.16,{"$nulls":6},"fee schedule",{"$nulls":28},33167.19,{"$nulls":6},"fee schedule",null,32201.16,{"$nulls":6},"fee schedule",null,83459.61,{"$nulls":6},"fee schedule",{"$nulls":10},32201.16,{"$nulls":6},"fee schedule",{"$nulls":46},32201.16,{"$nulls":6},"fee schedule",{"$nulls":55},35687.75,{"$nulls":6},"fee schedule",null,32201.16,{"$nulls":6},"fee schedule",{"$nulls":46},32201.16,{"$nulls":6},"fee schedule",{"$nulls":19},32201.16,{"$nulls":6},"fee schedule",{"$nulls":28},32201.16,{"$nulls":6},"fee schedule",{"$nulls":19},33217.65,{"$nulls":6},"case rate",null,34487.44,{"$nulls":6},"fee schedule",null,32201.16,{"$nulls":6},"fee schedule",{"$nulls":28},32201.16,{"$nulls":6},"fee schedule"]
["Intraop ther estim pn ue ea","0883T","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},2251.06,2251.06,{"$nulls":361},2251.06,{"$nulls":6},"case rate"]
["Exc tr-ext mal+marg 0.6-1 cm",11601,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},647.32,4196.26,null,660.26,{"$nulls":6},"fee schedule",null,846.9,{"$nulls":6},"fee schedule",null,647.32,{"$nulls":6},"fee schedule",{"$nulls":28},666.73,{"$nulls":6},"fee schedule",null,647.32,{"$nulls":6},"fee schedule",null,1677.72,{"$nulls":6},"fee schedule",{"$nulls":10},647.32,{"$nulls":6},"fee schedule",{"$nulls":10},877.2,{"$nulls":6},"fee schedule",null,2002.48,{"$nulls":6},"fee schedule",null,822.23,{"$nulls":6},"fee schedule",{"$nulls":10},647.32,{"$nulls":6},"fee schedule",null,1993.89,{"$nulls":6},"fee schedule",{"$nulls":46},693.27,{"$nulls":6},"fee schedule",null,647.32,{"$nulls":6},"fee schedule",{"$nulls":10},838.67,{"$nulls":6},"fee schedule",{"$nulls":28},647.32,{"$nulls":6},"fee schedule",{"$nulls":19},647.32,{"$nulls":6},"fee schedule",{"$nulls":10},838.67,{"$nulls":6},"fee schedule",null,838.67,{"$nulls":6},"fee schedule",null,647.32,{"$nulls":6},"fee schedule",{"$nulls":10},693.27,{"$nulls":6},"fee schedule",null,4196.26,{"$nulls":6},"case rate",null,693.27,{"$nulls":6},"fee schedule",null,647.32,{"$nulls":6},"fee schedule",{"$nulls":28},647.32,{"$nulls":6},"fee schedule"]
["Trim nail(s) any number",11719,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},54.65,2251.06,null,55.74,{"$nulls":6},"case rate",{"$nulls":10},54.65,{"$nulls":6},"case rate",{"$nulls":28},56.28,{"$nulls":6},"case rate",null,54.65,{"$nulls":6},"case rate",null,141.63,{"$nulls":6},"case rate",{"$nulls":10},54.65,{"$nulls":6},"case rate",{"$nulls":10},162.18,{"$nulls":6},"fee schedule",null,370.5,{"$nulls":6},"fee schedule",{"$nulls":19},54.65,{"$nulls":6},"case rate",null,368.9,{"$nulls":6},"fee schedule",{"$nulls":46},58.52,{"$nulls":6},"case rate",null,54.65,{"$nulls":6},"case rate",{"$nulls":46},54.65,{"$nulls":6},"case rate",{"$nulls":19},54.65,{"$nulls":6},"case rate",{"$nulls":28},54.65,{"$nulls":6},"case rate",{"$nulls":10},58.53,{"$nulls":6},"case rate",null,2251.06,{"$nulls":6},"case rate",null,58.52,{"$nulls":6},"case rate",null,54.65,{"$nulls":6},"case rate",{"$nulls":28},54.65,{"$nulls":6},"case rate"]
["Nerve palsy microsurg graft",15842,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},822.23,9423.86,null,1716.59,{"$nulls":6},"fee schedule",null,846.9,{"$nulls":6},"fee schedule",null,1682.93,{"$nulls":6},"fee schedule",{"$nulls":28},1733.42,{"$nulls":6},"fee schedule",null,1682.93,{"$nulls":6},"fee schedule",null,4361.85,{"$nulls":6},"fee schedule",{"$nulls":10},1682.93,{"$nulls":6},"fee schedule",{"$nulls":10},4128.96,{"$nulls":6},"fee schedule",null,9423.86,{"$nulls":6},"fee schedule",null,822.23,{"$nulls":6},"fee schedule",{"$nulls":10},1682.93,{"$nulls":6},"fee schedule",null,9383.48,{"$nulls":6},"fee schedule",{"$nulls":46},1802.42,{"$nulls":6},"fee schedule",null,1682.93,{"$nulls":6},"fee schedule",{"$nulls":10},838.67,{"$nulls":6},"fee schedule",{"$nulls":28},1682.93,{"$nulls":6},"fee schedule",{"$nulls":19},1682.93,{"$nulls":6},"fee schedule",{"$nulls":10},838.67,{"$nulls":6},"fee schedule",null,838.67,{"$nulls":6},"fee schedule",null,1682.93,{"$nulls":6},"fee schedule",{"$nulls":10},1802.42,{"$nulls":6},"fee schedule",null,5856.77,{"$nulls":6},"case rate",null,1802.42,{"$nulls":6},"fee schedule",null,1682.93,{"$nulls":6},"fee schedule",{"$nulls":28},1682.93,{"$nulls":6},"fee schedule"]
["Expl pentrg wound neck",20100,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},468.52,3369.93,null,477.89,{"$nulls":6},"fee schedule",null,1379.22,{"$nulls":6},"fee schedule",null,468.52,{"$nulls":6},"fee schedule",{"$nulls":28},482.58,{"$nulls":6},"fee schedule",null,468.52,{"$nulls":6},"fee schedule",null,1214.33,{"$nulls":6},"fee schedule",{"$nulls":10},468.52,{"$nulls":6},"fee schedule",{"$nulls":10},1475.94,{"$nulls":6},"fee schedule",null,3369.93,{"$nulls":6},"fee schedule",null,1339.05,{"$nulls":6},"fee schedule",{"$nulls":10},468.52,{"$nulls":6},"fee schedule",null,3355.49,{"$nulls":6},"fee schedule",{"$nulls":46},501.79,{"$nulls":6},"fee schedule",null,468.52,{"$nulls":6},"fee schedule",{"$nulls":10},1365.83,{"$nulls":6},"fee schedule",{"$nulls":28},468.52,{"$nulls":6},"fee schedule",{"$nulls":19},468.52,{"$nulls":6},"fee schedule",{"$nulls":10},1365.83,{"$nulls":6},"fee schedule",null,1365.83,{"$nulls":6},"fee schedule",null,468.52,{"$nulls":6},"fee schedule",{"$nulls":10},501.79,{"$nulls":6},"fee schedule",null,2251.06,{"$nulls":6},"case rate",null,501.79,{"$nulls":6},"fee schedule",null,468.52,{"$nulls":6},"fee schedule",{"$nulls":28},468.52,{"$nulls":6},"fee schedule"]
["Intercalary algrft compl",20934,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},551.58,2251.06,{"$nulls":10},568.13,{"$nulls":6},"fee schedule",{"$nulls":109},551.58,{"$nulls":6},"fee schedule",{"$nulls":100},562.61,{"$nulls":6},"fee schedule",{"$nulls":73},562.61,{"$nulls":6},"fee schedule",null,562.61,{"$nulls":6},"fee schedule",{"$nulls":28},2251.06,{"$nulls":6},"case rate"]
["Perq tx nasoethmoid fx",21340,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},273.12,19700.72,null,3043.36,{"$nulls":6},"case rate",null,281.31,{"$nulls":6},"case rate",null,2983.69,{"$nulls":6},"case rate",{"$nulls":28},3073.2,{"$nulls":6},"case rate",null,2983.69,{"$nulls":6},"case rate",null,7733.18,{"$nulls":6},"case rate",{"$nulls":10},2983.69,{"$nulls":6},"case rate",{"$nulls":10},8206.92,{"$nulls":6},"fee schedule",null,18732.6,{"$nulls":6},"fee schedule",null,273.12,{"$nulls":6},"case rate",{"$nulls":10},2983.69,{"$nulls":6},"case rate",null,18652.32,{"$nulls":6},"fee schedule",{"$nulls":46},3195.53,{"$nulls":6},"case rate",null,2983.69,{"$nulls":6},"case rate",{"$nulls":10},278.58,{"$nulls":6},"case rate",{"$nulls":28},2983.69,{"$nulls":6},"case rate",{"$nulls":19},2983.69,{"$nulls":6},"case rate",{"$nulls":10},278.58,{"$nulls":6},"case rate",null,278.58,{"$nulls":6},"case rate",null,2983.69,{"$nulls":6},"case rate",{"$nulls":10},3195.53,{"$nulls":6},"case rate",null,19700.72,{"$nulls":6},"case rate",null,3195.53,{"$nulls":6},"case rate",null,2983.69,{"$nulls":6},"case rate",{"$nulls":28},2983.69,{"$nulls":6},"case rate"]
["Arthrd pre-sac ntrbdy l5-s1",22586,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},822.23,33217.65,null,12680.68,{"$nulls":6},"case rate",null,846.9,{"$nulls":6},"case rate",null,12432.04,{"$nulls":6},"case rate",{"$nulls":28},12805,{"$nulls":6},"case rate",null,12432.04,{"$nulls":6},"case rate",null,32221.61,{"$nulls":6},"case rate",{"$nulls":10},12432.04,{"$nulls":6},"case rate",{"$nulls":10},20940.6,{"$nulls":6},"fee schedule",null,null,60.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",822.23,{"$nulls":6},"case rate",{"$nulls":10},12432.04,{"$nulls":6},"case rate",null,null,61.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":45},13314.72,{"$nulls":6},"case rate",null,12432.04,{"$nulls":6},"case rate",{"$nulls":10},838.67,{"$nulls":6},"case rate",{"$nulls":28},12432.04,{"$nulls":6},"case rate",{"$nulls":19},12432.04,{"$nulls":6},"case rate",{"$nulls":10},838.67,{"$nulls":6},"case rate",null,838.67,{"$nulls":6},"case rate",null,12432.04,{"$nulls":6},"case rate",{"$nulls":10},13314.73,{"$nulls":6},"case rate",null,33217.65,{"$nulls":6},"case rate",null,13314.72,{"$nulls":6},"case rate",null,12432.04,{"$nulls":6},"case rate",{"$nulls":28},12432.04,{"$nulls":6},"case rate"]
["Remove shoulder joint lining",23105,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},385.24,17557.61,null,6703.82,{"$nulls":6},"case rate",null,396.8,{"$nulls":6},"case rate",null,6572.37,{"$nulls":6},"case rate",{"$nulls":28},6769.55,{"$nulls":6},"case rate",null,6572.37,{"$nulls":6},"case rate",null,17034.41,{"$nulls":6},"case rate",{"$nulls":10},6572.37,{"$nulls":6},"case rate",{"$nulls":10},5856.84,{"$nulls":6},"fee schedule",null,13367.75,{"$nulls":6},"fee schedule",null,385.24,{"$nulls":6},"case rate",{"$nulls":10},6572.37,{"$nulls":6},"case rate",null,13310.46,{"$nulls":6},"fee schedule",{"$nulls":46},7039.01,{"$nulls":6},"case rate",null,6572.37,{"$nulls":6},"case rate",{"$nulls":10},392.94,{"$nulls":6},"case rate",{"$nulls":28},6572.37,{"$nulls":6},"case rate",{"$nulls":19},6572.37,{"$nulls":6},"case rate",{"$nulls":10},392.94,{"$nulls":6},"case rate",null,392.94,{"$nulls":6},"case rate",null,6572.37,{"$nulls":6},"case rate",{"$nulls":10},7039.01,{"$nulls":6},"case rate",null,17557.61,{"$nulls":6},"case rate",null,7039.01,{"$nulls":6},"case rate",null,6572.37,{"$nulls":6},"case rate",{"$nulls":28},6572.37,{"$nulls":6},"case rate"]
["Repr elbow lat ligmnt w/tiss",24343,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},1339.05,17557.61,null,3044.81,{"$nulls":6},"case rate",null,1379.22,{"$nulls":6},"fee schedule",null,2985.11,{"$nulls":6},"case rate",{"$nulls":28},3074.66,{"$nulls":6},"case rate",null,2985.11,{"$nulls":6},"case rate",null,7736.86,{"$nulls":6},"case rate",{"$nulls":10},2985.11,{"$nulls":6},"case rate",{"$nulls":10},5856.84,{"$nulls":6},"fee schedule",null,13367.75,{"$nulls":6},"fee schedule",null,1339.05,{"$nulls":6},"fee schedule",{"$nulls":10},2985.11,{"$nulls":6},"case rate",null,13310.46,{"$nulls":6},"fee schedule",{"$nulls":46},3197.05,{"$nulls":6},"case rate",null,2985.11,{"$nulls":6},"case rate",{"$nulls":10},1365.83,{"$nulls":6},"fee schedule",{"$nulls":28},2985.11,{"$nulls":6},"case rate",{"$nulls":19},2985.11,{"$nulls":6},"case rate",{"$nulls":10},1365.83,{"$nulls":6},"fee schedule",null,1365.83,{"$nulls":6},"fee schedule",null,2985.11,{"$nulls":6},"case rate",{"$nulls":10},3197.05,{"$nulls":6},"case rate",null,17557.61,{"$nulls":6},"case rate",null,3197.05,{"$nulls":6},"case rate",null,2985.11,{"$nulls":6},"case rate",{"$nulls":28},2985.11,{"$nulls":6},"case rate"]
["Revise radius & ulna",25365,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},312.23,30681.27,null,12074.49,{"$nulls":6},"case rate",null,321.6,{"$nulls":6},"case rate",null,11837.73,{"$nulls":6},"case rate",{"$nulls":28},12192.86,{"$nulls":6},"case rate",null,11837.73,{"$nulls":6},"case rate",null,30681.27,{"$nulls":6},"case rate",{"$nulls":10},11837.73,{"$nulls":6},"case rate",{"$nulls":10},5856.84,{"$nulls":6},"fee schedule",null,13367.75,{"$nulls":6},"fee schedule",null,312.23,{"$nulls":6},"case rate",{"$nulls":10},11837.73,{"$nulls":6},"case rate",null,13310.46,{"$nulls":6},"fee schedule",{"$nulls":46},12678.21,{"$nulls":6},"case rate",null,11837.73,{"$nulls":6},"case rate",{"$nulls":10},318.47,{"$nulls":6},"case rate",{"$nulls":28},11837.73,{"$nulls":6},"case rate",{"$nulls":19},11837.73,{"$nulls":6},"case rate",{"$nulls":10},318.47,{"$nulls":6},"case rate",null,318.47,{"$nulls":6},"case rate",null,11837.73,{"$nulls":6},"case rate",{"$nulls":10},12678.21,{"$nulls":6},"case rate",null,19700.72,{"$nulls":6},"case rate",null,12678.21,{"$nulls":6},"case rate",null,11837.73,{"$nulls":6},"case rate",{"$nulls":28},11837.73,{"$nulls":6},"case rate"]
["Amputation follow-up surgery",25907,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},312.23,13882.05,null,3044.81,{"$nulls":6},"case rate",null,321.6,{"$nulls":6},"case rate",null,2985.11,{"$nulls":6},"case rate",{"$nulls":28},3074.66,{"$nulls":6},"case rate",null,2985.11,{"$nulls":6},"case rate",null,7736.86,{"$nulls":6},"case rate",{"$nulls":10},2985.11,{"$nulls":6},"case rate",{"$nulls":10},4268.7,{"$nulls":6},"fee schedule",null,9743.87,{"$nulls":6},"fee schedule",null,312.23,{"$nulls":6},"case rate",{"$nulls":10},2985.11,{"$nulls":6},"case rate",null,9702.11,{"$nulls":6},"fee schedule",{"$nulls":46},3197.05,{"$nulls":6},"case rate",null,2985.11,{"$nulls":6},"case rate",{"$nulls":10},318.47,{"$nulls":6},"case rate",{"$nulls":28},2985.11,{"$nulls":6},"case rate",{"$nulls":19},2985.11,{"$nulls":6},"case rate",{"$nulls":10},318.47,{"$nulls":6},"case rate",null,318.47,{"$nulls":6},"case rate",null,2985.11,{"$nulls":6},"case rate",{"$nulls":10},3197.05,{"$nulls":6},"case rate",null,13882.05,{"$nulls":6},"case rate",null,3197.05,{"$nulls":6},"case rate",null,2985.11,{"$nulls":6},"case rate",{"$nulls":28},2985.11,{"$nulls":6},"case rate"]
["Repair muscles of hand",26591,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},312.23,13882.05,null,3044.81,{"$nulls":6},"case rate",null,321.6,{"$nulls":6},"case rate",null,2985.11,{"$nulls":6},"case rate",{"$nulls":28},3074.66,{"$nulls":6},"case rate",null,2985.11,{"$nulls":6},"case rate",null,7736.86,{"$nulls":6},"case rate",{"$nulls":10},2985.11,{"$nulls":6},"case rate",{"$nulls":10},5487.6,{"$nulls":6},"fee schedule",null,12525.72,{"$nulls":6},"fee schedule",null,312.23,{"$nulls":6},"case rate",{"$nulls":10},2985.11,{"$nulls":6},"case rate",null,12472.03,{"$nulls":6},"fee schedule",{"$nulls":46},3197.05,{"$nulls":6},"case rate",null,2985.11,{"$nulls":6},"case rate",{"$nulls":10},318.47,{"$nulls":6},"case rate",{"$nulls":28},2985.11,{"$nulls":6},"case rate",{"$nulls":19},2985.11,{"$nulls":6},"case rate",{"$nulls":10},318.47,{"$nulls":6},"case rate",null,318.47,{"$nulls":6},"case rate",null,2985.11,{"$nulls":6},"case rate",{"$nulls":10},3197.05,{"$nulls":6},"case rate",null,13882.05,{"$nulls":6},"case rate",null,3197.05,{"$nulls":6},"case rate",null,2985.11,{"$nulls":6},"case rate",{"$nulls":28},2985.11,{"$nulls":6},"case rate"]
["Removal of tail bone",27080,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},273.12,17557.61,null,3044.81,{"$nulls":6},"case rate",null,281.31,{"$nulls":6},"case rate",null,2985.11,{"$nulls":6},"case rate",{"$nulls":28},3074.66,{"$nulls":6},"case rate",null,2985.11,{"$nulls":6},"case rate",null,7736.86,{"$nulls":6},"case rate",{"$nulls":10},2985.11,{"$nulls":6},"case rate",{"$nulls":10},5856.84,{"$nulls":6},"fee schedule",null,13367.75,{"$nulls":6},"fee schedule",null,273.12,{"$nulls":6},"case rate",{"$nulls":10},2985.11,{"$nulls":6},"case rate",null,13310.46,{"$nulls":6},"fee schedule",{"$nulls":46},3197.05,{"$nulls":6},"case rate",null,2985.11,{"$nulls":6},"case rate",{"$nulls":10},278.58,{"$nulls":6},"case rate",{"$nulls":28},2985.11,{"$nulls":6},"case rate",{"$nulls":19},2985.11,{"$nulls":6},"case rate",{"$nulls":10},278.58,{"$nulls":6},"case rate",null,278.58,{"$nulls":6},"case rate",null,2985.11,{"$nulls":6},"case rate",{"$nulls":10},3197.05,{"$nulls":6},"case rate",null,17557.61,{"$nulls":6},"case rate",null,3197.05,{"$nulls":6},"case rate",null,2985.11,{"$nulls":6},"case rate",{"$nulls":28},2985.11,{"$nulls":6},"case rate"]
["Lengthening of thigh tendons",27394,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},312.23,17557.61,null,6703.82,{"$nulls":6},"case rate",null,321.6,{"$nulls":6},"case rate",null,6572.37,{"$nulls":6},"case rate",{"$nulls":28},6769.55,{"$nulls":6},"case rate",null,6572.37,{"$nulls":6},"case rate",null,17034.41,{"$nulls":6},"case rate",{"$nulls":10},6572.37,{"$nulls":6},"case rate",{"$nulls":10},5856.84,{"$nulls":6},"fee schedule",null,13367.75,{"$nulls":6},"fee schedule",null,312.23,{"$nulls":6},"case rate",{"$nulls":10},6572.37,{"$nulls":6},"case rate",null,13310.46,{"$nulls":6},"fee schedule",{"$nulls":46},7039.01,{"$nulls":6},"case rate",null,6572.37,{"$nulls":6},"case rate",{"$nulls":10},318.47,{"$nulls":6},"case rate",{"$nulls":28},6572.37,{"$nulls":6},"case rate",{"$nulls":19},6572.37,{"$nulls":6},"case rate",{"$nulls":10},318.47,{"$nulls":6},"case rate",null,318.47,{"$nulls":6},"case rate",null,6572.37,{"$nulls":6},"case rate",{"$nulls":10},7039.01,{"$nulls":6},"case rate",null,17557.61,{"$nulls":6},"case rate",null,7039.01,{"$nulls":6},"case rate",null,6572.37,{"$nulls":6},"case rate",{"$nulls":28},6572.37,{"$nulls":6},"case rate"]
["Revision of calf tendon",27687,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},312.23,17557.61,null,3044.81,{"$nulls":6},"case rate",null,321.6,{"$nulls":6},"case rate",null,2985.11,{"$nulls":6},"case rate",{"$nulls":28},3074.66,{"$nulls":6},"case rate",null,2985.11,{"$nulls":6},"case rate",null,7736.86,{"$nulls":6},"case rate",{"$nulls":10},2985.11,{"$nulls":6},"case rate",{"$nulls":10},5856.84,{"$nulls":6},"fee schedule",null,13367.75,{"$nulls":6},"fee schedule",null,312.23,{"$nulls":6},"case rate",{"$nulls":10},2985.11,{"$nulls":6},"case rate",null,13310.46,{"$nulls":6},"fee schedule",{"$nulls":46},3197.05,{"$nulls":6},"case rate",null,2985.11,{"$nulls":6},"case rate",{"$nulls":10},318.47,{"$nulls":6},"case rate",{"$nulls":28},2985.11,{"$nulls":6},"case rate",{"$nulls":19},2985.11,{"$nulls":6},"case rate",{"$nulls":10},318.47,{"$nulls":6},"case rate",null,318.47,{"$nulls":6},"case rate",null,2985.11,{"$nulls":6},"case rate",{"$nulls":10},3197.05,{"$nulls":6},"case rate",null,17557.61,{"$nulls":6},"case rate",null,3197.05,{"$nulls":6},"case rate",null,2985.11,{"$nulls":6},"case rate",{"$nulls":28},2985.11,{"$nulls":6},"case rate"]
["Treatment of ankle fracture",28436,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},273.12,17034.41,null,6703.82,{"$nulls":6},"case rate",null,281.31,{"$nulls":6},"case rate",null,6572.37,{"$nulls":6},"case rate",{"$nulls":28},6769.55,{"$nulls":6},"case rate",null,6572.37,{"$nulls":6},"case rate",null,17034.41,{"$nulls":6},"case rate",{"$nulls":10},6572.37,{"$nulls":6},"case rate",{"$nulls":10},4986.78,{"$nulls":6},"fee schedule",null,11382.6,{"$nulls":6},"fee schedule",null,273.12,{"$nulls":6},"case rate",{"$nulls":10},6572.37,{"$nulls":6},"case rate",null,11333.82,{"$nulls":6},"fee schedule",{"$nulls":46},7039.01,{"$nulls":6},"case rate",null,6572.37,{"$nulls":6},"case rate",{"$nulls":10},278.58,{"$nulls":6},"case rate",{"$nulls":28},6572.37,{"$nulls":6},"case rate",{"$nulls":19},6572.37,{"$nulls":6},"case rate",{"$nulls":10},278.58,{"$nulls":6},"case rate",null,278.58,{"$nulls":6},"case rate",null,6572.37,{"$nulls":6},"case rate",{"$nulls":10},7039.01,{"$nulls":6},"case rate",null,13882.05,{"$nulls":6},"case rate",null,7039.01,{"$nulls":6},"case rate",null,6572.37,{"$nulls":6},"case rate",{"$nulls":28},6572.37,{"$nulls":6},"case rate"]
["Treat toe fracture",28525,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},312.23,13882.05,null,3044.81,{"$nulls":6},"case rate",null,321.6,{"$nulls":6},"case rate",null,2985.11,{"$nulls":6},"case rate",{"$nulls":28},3074.66,{"$nulls":6},"case rate",null,2985.11,{"$nulls":6},"case rate",null,7736.86,{"$nulls":6},"case rate",{"$nulls":10},2985.11,{"$nulls":6},"case rate",{"$nulls":10},4986.78,{"$nulls":6},"fee schedule",null,11382.6,{"$nulls":6},"fee schedule",null,312.23,{"$nulls":6},"case rate",{"$nulls":10},2985.11,{"$nulls":6},"case rate",null,11333.82,{"$nulls":6},"fee schedule",{"$nulls":46},3197.05,{"$nulls":6},"case rate",null,2985.11,{"$nulls":6},"case rate",{"$nulls":10},318.47,{"$nulls":6},"case rate",{"$nulls":28},2985.11,{"$nulls":6},"case rate",{"$nulls":19},2985.11,{"$nulls":6},"case rate",{"$nulls":10},318.47,{"$nulls":6},"case rate",null,318.47,{"$nulls":6},"case rate",null,2985.11,{"$nulls":6},"case rate",{"$nulls":10},3197.05,{"$nulls":6},"case rate",null,13882.05,{"$nulls":6},"case rate",null,3197.05,{"$nulls":6},"case rate",null,2985.11,{"$nulls":6},"case rate",{"$nulls":28},2985.11,{"$nulls":6},"case rate"]
["Knee arthroscopy/surgery",29877,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},385.24,17557.61,null,3044.81,{"$nulls":6},"case rate",null,396.8,{"$nulls":6},"case rate",null,2985.11,{"$nulls":6},"case rate",{"$nulls":28},3074.66,{"$nulls":6},"case rate",null,2985.11,{"$nulls":6},"case rate",null,7736.86,{"$nulls":6},"case rate",{"$nulls":10},2985.11,{"$nulls":6},"case rate",{"$nulls":10},3543.48,{"$nulls":6},"fee schedule",null,13158.97,{"$nulls":6},"fee schedule",null,385.24,{"$nulls":6},"case rate",{"$nulls":10},2985.11,{"$nulls":6},"case rate",null,13102.57,{"$nulls":6},"fee schedule",{"$nulls":46},3197.05,{"$nulls":6},"case rate",null,2985.11,{"$nulls":6},"case rate",{"$nulls":10},392.94,{"$nulls":6},"case rate",{"$nulls":28},2985.11,{"$nulls":6},"case rate",{"$nulls":19},2985.11,{"$nulls":6},"case rate",{"$nulls":10},392.94,{"$nulls":6},"case rate",null,392.94,{"$nulls":6},"case rate",null,2985.11,{"$nulls":6},"case rate",{"$nulls":10},3197.05,{"$nulls":6},"case rate",null,17557.61,{"$nulls":6},"case rate",null,3197.05,{"$nulls":6},"case rate",null,2985.11,{"$nulls":6},"case rate",{"$nulls":28},2985.11,{"$nulls":6},"case rate"]
["Perq trchl pnxr ttrach aspir",31612,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},203.38,13882.05,null,3043.36,{"$nulls":6},"case rate",null,209.48,{"$nulls":6},"case rate",null,2983.69,{"$nulls":6},"case rate",{"$nulls":28},3073.2,{"$nulls":6},"case rate",null,2983.69,{"$nulls":6},"case rate",null,7733.18,{"$nulls":6},"case rate",{"$nulls":10},2983.69,{"$nulls":6},"case rate",{"$nulls":10},4852.14,{"$nulls":6},"fee schedule",null,11074.65,{"$nulls":6},"fee schedule",null,203.38,{"$nulls":6},"case rate",{"$nulls":10},2983.69,{"$nulls":6},"case rate",null,11027.19,{"$nulls":6},"fee schedule",{"$nulls":46},3195.53,{"$nulls":6},"case rate",null,2983.69,{"$nulls":6},"case rate",{"$nulls":10},207.45,{"$nulls":6},"case rate",{"$nulls":28},2983.69,{"$nulls":6},"case rate",{"$nulls":19},2983.69,{"$nulls":6},"case rate",{"$nulls":10},207.45,{"$nulls":6},"case rate",null,207.45,{"$nulls":6},"case rate",null,2983.69,{"$nulls":6},"case rate",{"$nulls":10},3195.53,{"$nulls":6},"case rate",null,13882.05,{"$nulls":6},"case rate",null,3195.53,{"$nulls":6},"case rate",null,2983.69,{"$nulls":6},"case rate",{"$nulls":28},2983.69,{"$nulls":6},"case rate"]
["Bronchoscopy w/fb removal",31635,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},273.12,5856.77,null,1618.28,{"$nulls":6},"case rate",null,281.31,{"$nulls":6},"case rate",null,1586.55,{"$nulls":6},"case rate",{"$nulls":28},1634.15,{"$nulls":6},"case rate",null,1586.55,{"$nulls":6},"case rate",null,4112.06,{"$nulls":6},"case rate",{"$nulls":10},1586.55,{"$nulls":6},"case rate",{"$nulls":10},1999.2,{"$nulls":6},"fee schedule",null,4562.68,{"$nulls":6},"fee schedule",null,273.12,{"$nulls":6},"case rate",{"$nulls":10},1586.55,{"$nulls":6},"case rate",null,4543.13,{"$nulls":6},"fee schedule",{"$nulls":46},1699.2,{"$nulls":6},"case rate",null,1586.55,{"$nulls":6},"case rate",{"$nulls":10},278.58,{"$nulls":6},"case rate",{"$nulls":28},1586.55,{"$nulls":6},"case rate",{"$nulls":19},1586.55,{"$nulls":6},"case rate",{"$nulls":10},278.58,{"$nulls":6},"case rate",null,278.58,{"$nulls":6},"case rate",null,1586.55,{"$nulls":6},"case rate",{"$nulls":10},1699.19,{"$nulls":6},"case rate",null,5856.77,{"$nulls":6},"case rate",null,1699.2,{"$nulls":6},"case rate",null,1586.55,{"$nulls":6},"case rate",{"$nulls":28},1586.55,{"$nulls":6},"case rate"]
["Ablate atria x10sv add-on",33258,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},504.24,32221.61,null,12680.68,{"$nulls":6},"case rate",null,519.37,{"$nulls":6},"case rate",null,12432.04,{"$nulls":6},"case rate",{"$nulls":28},12805,{"$nulls":6},"case rate",null,12432.04,{"$nulls":6},"case rate",null,32221.61,{"$nulls":6},"case rate",{"$nulls":10},12432.04,{"$nulls":6},"case rate",{"$nulls":11},50,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",null,60.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",504.24,{"$nulls":6},"case rate",{"$nulls":10},12432.04,{"$nulls":6},"case rate",null,null,61.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":45},13314.72,{"$nulls":6},"case rate",null,12432.04,{"$nulls":6},"case rate",{"$nulls":10},514.32,{"$nulls":6},"case rate",{"$nulls":28},12432.04,{"$nulls":6},"case rate",{"$nulls":19},12432.04,{"$nulls":6},"case rate",{"$nulls":10},514.32,{"$nulls":6},"case rate",null,514.32,{"$nulls":6},"case rate",null,12432.04,{"$nulls":6},"case rate",{"$nulls":10},13314.73,{"$nulls":6},"case rate",null,5856.77,{"$nulls":6},"case rate",null,13314.72,{"$nulls":6},"case rate",null,12432.04,{"$nulls":6},"case rate",{"$nulls":28},12432.04,{"$nulls":6},"case rate"]
["Clsr 1 vsd w/wo patch w/vlvt",33684,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},1585.73,32221.61,null,12680.68,{"$nulls":6},"case rate",null,1633.3,{"$nulls":6},"case rate",null,12432.04,{"$nulls":6},"case rate",{"$nulls":28},12805,{"$nulls":6},"case rate",null,12432.04,{"$nulls":6},"case rate",null,32221.61,{"$nulls":6},"case rate",{"$nulls":10},12432.04,{"$nulls":6},"case rate",{"$nulls":11},50,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",null,60.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",1585.73,{"$nulls":6},"case rate",{"$nulls":10},12432.04,{"$nulls":6},"case rate",null,null,61.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":45},13314.72,{"$nulls":6},"case rate",null,12432.04,{"$nulls":6},"case rate",{"$nulls":10},1617.44,{"$nulls":6},"case rate",{"$nulls":28},12432.04,{"$nulls":6},"case rate",{"$nulls":19},12432.04,{"$nulls":6},"case rate",{"$nulls":10},1617.44,{"$nulls":6},"case rate",null,1617.44,{"$nulls":6},"case rate",null,12432.04,{"$nulls":6},"case rate",{"$nulls":10},13314.73,{"$nulls":6},"case rate",null,5856.77,{"$nulls":6},"case rate",null,13314.72,{"$nulls":6},"case rate",null,12432.04,{"$nulls":6},"case rate",{"$nulls":28},12432.04,{"$nulls":6},"case rate"]
["Reposg perq r/l hrt vad",33993,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},5856.77,32221.61,null,12680.68,{"$nulls":6},"case rate",{"$nulls":10},12432.04,{"$nulls":6},"case rate",{"$nulls":28},12805,{"$nulls":6},"case rate",null,12432.04,{"$nulls":6},"case rate",null,32221.61,{"$nulls":6},"case rate",{"$nulls":10},12432.04,{"$nulls":6},"case rate",{"$nulls":11},50,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",null,60.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":18},12432.04,{"$nulls":6},"case rate",null,null,61.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":45},13314.72,{"$nulls":6},"case rate",null,12432.04,{"$nulls":6},"case rate",{"$nulls":46},12432.04,{"$nulls":6},"case rate",{"$nulls":19},12432.04,{"$nulls":6},"case rate",{"$nulls":28},12432.04,{"$nulls":6},"case rate",{"$nulls":10},13314.73,{"$nulls":6},"case rate",null,5856.77,{"$nulls":6},"case rate",null,13314.72,{"$nulls":6},"case rate",null,12432.04,{"$nulls":6},"case rate",{"$nulls":28},12432.04,{"$nulls":6},"case rate"]
["Repair artery rupture groin",35132,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},5856.77,32221.61,null,12680.68,{"$nulls":6},"case rate",{"$nulls":10},12432.04,{"$nulls":6},"case rate",{"$nulls":28},12805,{"$nulls":6},"case rate",null,12432.04,{"$nulls":6},"case rate",null,32221.61,{"$nulls":6},"case rate",{"$nulls":10},12432.04,{"$nulls":6},"case rate",{"$nulls":11},50,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",null,60.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":18},12432.04,{"$nulls":6},"case rate",null,null,61.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":45},13314.72,{"$nulls":6},"case rate",null,12432.04,{"$nulls":6},"case rate",{"$nulls":46},12432.04,{"$nulls":6},"case rate",{"$nulls":19},12432.04,{"$nulls":6},"case rate",{"$nulls":28},12432.04,{"$nulls":6},"case rate",{"$nulls":10},13314.73,{"$nulls":6},"case rate",null,5856.77,{"$nulls":6},"case rate",null,13314.72,{"$nulls":6},"case rate",null,12432.04,{"$nulls":6},"case rate",{"$nulls":28},12432.04,{"$nulls":6},"case rate"]
["Composite byp grft 3/> segmt",35683,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},5856.77,32221.61,null,12680.68,{"$nulls":6},"case rate",{"$nulls":10},12432.04,{"$nulls":6},"case rate",{"$nulls":28},12805,{"$nulls":6},"case rate",null,12432.04,{"$nulls":6},"case rate",null,32221.61,{"$nulls":6},"case rate",{"$nulls":10},12432.04,{"$nulls":6},"case rate",{"$nulls":11},50,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",null,60.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":18},12432.04,{"$nulls":6},"case rate",null,null,61.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":45},13314.72,{"$nulls":6},"case rate",null,12432.04,{"$nulls":6},"case rate",{"$nulls":46},12432.04,{"$nulls":6},"case rate",{"$nulls":19},12432.04,{"$nulls":6},"case rate",{"$nulls":28},12432.04,{"$nulls":6},"case rate",{"$nulls":10},13314.73,{"$nulls":6},"case rate",null,5856.77,{"$nulls":6},"case rate",null,13314.72,{"$nulls":6},"case rate",null,12432.04,{"$nulls":6},"case rate",{"$nulls":28},12432.04,{"$nulls":6},"case rate"]
["Insert tunneled cv cath",36558,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},273.12,17557.61,null,2953.67,{"$nulls":6},"case rate",null,281.31,{"$nulls":6},"case rate",null,2895.76,{"$nulls":6},"case rate",{"$nulls":28},2982.63,{"$nulls":6},"case rate",null,2895.76,{"$nulls":6},"case rate",null,7505.29,{"$nulls":6},"case rate",{"$nulls":10},2895.76,{"$nulls":6},"case rate",{"$nulls":10},4882.74,{"$nulls":6},"fee schedule",null,11146.04,{"$nulls":6},"fee schedule",null,273.12,{"$nulls":6},"case rate",{"$nulls":10},2895.76,{"$nulls":6},"case rate",null,11098.27,{"$nulls":6},"fee schedule",{"$nulls":46},3101.36,{"$nulls":6},"case rate",null,2895.76,{"$nulls":6},"case rate",{"$nulls":10},278.58,{"$nulls":6},"case rate",{"$nulls":28},2895.76,{"$nulls":6},"case rate",{"$nulls":19},2895.76,{"$nulls":6},"case rate",{"$nulls":10},278.58,{"$nulls":6},"case rate",null,278.58,{"$nulls":6},"case rate",null,2895.76,{"$nulls":6},"case rate",{"$nulls":10},3101.36,{"$nulls":6},"case rate",null,17557.61,{"$nulls":6},"case rate",null,3101.36,{"$nulls":6},"case rate",null,2895.76,{"$nulls":6},"case rate",{"$nulls":28},2895.76,{"$nulls":6},"case rate"]
["Lig&div&compl strpg saph vn",37735,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},312.23,19590.75,null,2953.67,{"$nulls":6},"case rate",null,321.6,{"$nulls":6},"case rate",null,2895.76,{"$nulls":6},"case rate",{"$nulls":28},2982.63,{"$nulls":6},"case rate",null,2895.76,{"$nulls":6},"case rate",null,7505.29,{"$nulls":6},"case rate",{"$nulls":10},2895.76,{"$nulls":6},"case rate",{"$nulls":10},8583.3,{"$nulls":6},"fee schedule",null,19590.75,{"$nulls":6},"fee schedule",null,312.23,{"$nulls":6},"case rate",{"$nulls":10},2895.76,{"$nulls":6},"case rate",null,19506.78,{"$nulls":6},"fee schedule",{"$nulls":46},3101.36,{"$nulls":6},"case rate",null,2895.76,{"$nulls":6},"case rate",{"$nulls":10},318.47,{"$nulls":6},"case rate",{"$nulls":28},2895.76,{"$nulls":6},"case rate",{"$nulls":19},2895.76,{"$nulls":6},"case rate",{"$nulls":10},318.47,{"$nulls":6},"case rate",null,318.47,{"$nulls":6},"case rate",null,2895.76,{"$nulls":6},"case rate",{"$nulls":10},3101.36,{"$nulls":6},"case rate",null,17557.61,{"$nulls":6},"case rate",null,3101.36,{"$nulls":6},"case rate",null,2895.76,{"$nulls":6},"case rate",{"$nulls":28},2895.76,{"$nulls":6},"case rate"]
["Drainage of mouth lesion",41017,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},203.38,7733.18,null,3043.36,{"$nulls":6},"case rate",null,209.48,{"$nulls":6},"case rate",null,2983.69,{"$nulls":6},"case rate",{"$nulls":28},3073.2,{"$nulls":6},"case rate",null,2983.69,{"$nulls":6},"case rate",null,7733.18,{"$nulls":6},"case rate",{"$nulls":10},2983.69,{"$nulls":6},"case rate",{"$nulls":10},1475.94,{"$nulls":6},"fee schedule",null,3369.93,{"$nulls":6},"fee schedule",null,203.38,{"$nulls":6},"case rate",{"$nulls":10},2983.69,{"$nulls":6},"case rate",null,3355.49,{"$nulls":6},"fee schedule",{"$nulls":46},3195.53,{"$nulls":6},"case rate",null,2983.69,{"$nulls":6},"case rate",{"$nulls":10},207.45,{"$nulls":6},"case rate",{"$nulls":28},2983.69,{"$nulls":6},"case rate",{"$nulls":19},2983.69,{"$nulls":6},"case rate",{"$nulls":10},207.45,{"$nulls":6},"case rate",null,207.45,{"$nulls":6},"case rate",null,2983.69,{"$nulls":6},"case rate",{"$nulls":10},3195.53,{"$nulls":6},"case rate",null,5856.77,{"$nulls":6},"case rate",null,3195.53,{"$nulls":6},"case rate",null,2983.69,{"$nulls":6},"case rate",{"$nulls":28},2983.69,{"$nulls":6},"case rate"]
["Removal of salivary stone",42340,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},273.12,7733.18,null,3043.36,{"$nulls":6},"case rate",null,281.31,{"$nulls":6},"case rate",null,2983.69,{"$nulls":6},"case rate",{"$nulls":28},3073.2,{"$nulls":6},"case rate",null,2983.69,{"$nulls":6},"case rate",null,7733.18,{"$nulls":6},"case rate",{"$nulls":10},2983.69,{"$nulls":6},"case rate",{"$nulls":10},3379.26,{"$nulls":6},"fee schedule",null,7712.52,{"$nulls":6},"fee schedule",null,273.12,{"$nulls":6},"case rate",{"$nulls":10},2983.69,{"$nulls":6},"case rate",null,7679.46,{"$nulls":6},"fee schedule",{"$nulls":46},3195.53,{"$nulls":6},"case rate",null,2983.69,{"$nulls":6},"case rate",{"$nulls":10},278.58,{"$nulls":6},"case rate",{"$nulls":28},2983.69,{"$nulls":6},"case rate",{"$nulls":19},2983.69,{"$nulls":6},"case rate",{"$nulls":10},278.58,{"$nulls":6},"case rate",null,278.58,{"$nulls":6},"case rate",null,2983.69,{"$nulls":6},"case rate",{"$nulls":10},3195.53,{"$nulls":6},"case rate",null,5856.77,{"$nulls":6},"case rate",null,3195.53,{"$nulls":6},"case rate",null,2983.69,{"$nulls":6},"case rate",{"$nulls":28},2983.69,{"$nulls":6},"case rate"]
["Ercp lithotripsy calculi",43265,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},273.12,14194.62,null,5586.24,{"$nulls":6},"case rate",null,281.31,{"$nulls":6},"case rate",null,5476.7,{"$nulls":6},"case rate",{"$nulls":28},5641,{"$nulls":6},"case rate",null,5476.7,{"$nulls":6},"case rate",null,14194.62,{"$nulls":6},"case rate",{"$nulls":10},5476.7,{"$nulls":6},"case rate",{"$nulls":10},855.78,{"$nulls":6},"fee schedule",null,2032.31,{"$nulls":6},"fee schedule",null,273.12,{"$nulls":6},"case rate",{"$nulls":10},5476.7,{"$nulls":6},"case rate",null,2023.6,{"$nulls":6},"fee schedule",{"$nulls":46},5865.55,{"$nulls":6},"case rate",null,5476.7,{"$nulls":6},"case rate",{"$nulls":10},278.58,{"$nulls":6},"case rate",{"$nulls":28},5476.7,{"$nulls":6},"case rate",{"$nulls":19},5476.7,{"$nulls":6},"case rate",{"$nulls":10},278.58,{"$nulls":6},"case rate",null,278.58,{"$nulls":6},"case rate",null,5476.7,{"$nulls":6},"case rate",{"$nulls":10},5865.55,{"$nulls":6},"case rate",null,13882.05,{"$nulls":6},"case rate",null,5865.55,{"$nulls":6},"case rate",null,5476.7,{"$nulls":6},"case rate",{"$nulls":28},5476.7,{"$nulls":6},"case rate"]
["Removal of small intestine",44120,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},1339.05,32221.61,null,12680.68,{"$nulls":6},"case rate",null,1379.22,{"$nulls":6},"case rate",null,12432.04,{"$nulls":6},"case rate",{"$nulls":28},12805,{"$nulls":6},"case rate",null,12432.04,{"$nulls":6},"case rate",null,32221.61,{"$nulls":6},"case rate",{"$nulls":10},12432.04,{"$nulls":6},"case rate",{"$nulls":11},50,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",null,60.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",1339.05,{"$nulls":6},"case rate",{"$nulls":10},12432.04,{"$nulls":6},"case rate",null,null,61.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":45},13314.72,{"$nulls":6},"case rate",null,12432.04,{"$nulls":6},"case rate",{"$nulls":10},1365.83,{"$nulls":6},"case rate",{"$nulls":28},12432.04,{"$nulls":6},"case rate",{"$nulls":19},12432.04,{"$nulls":6},"case rate",{"$nulls":10},1365.83,{"$nulls":6},"case rate",null,1365.83,{"$nulls":6},"case rate",null,12432.04,{"$nulls":6},"case rate",{"$nulls":10},13314.73,{"$nulls":6},"case rate",null,5856.77,{"$nulls":6},"case rate",null,13314.72,{"$nulls":6},"case rate",null,12432.04,{"$nulls":6},"case rate",{"$nulls":28},12432.04,{"$nulls":6},"case rate"]
["Colonoscopy for foreign body",44390,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},203.38,5856.77,null,855.57,{"$nulls":6},"fee schedule",null,209.48,{"$nulls":6},"case rate",null,838.79,{"$nulls":6},"fee schedule",{"$nulls":28},863.95,{"$nulls":6},"fee schedule",null,838.79,{"$nulls":6},"fee schedule",null,2173.99,{"$nulls":6},"fee schedule",{"$nulls":10},838.79,{"$nulls":6},"fee schedule",{"$nulls":10},780.3,{"$nulls":6},"fee schedule",null,1855.31,{"$nulls":6},"fee schedule",null,203.38,{"$nulls":6},"case rate",{"$nulls":10},838.79,{"$nulls":6},"fee schedule",null,1847.36,{"$nulls":6},"fee schedule",{"$nulls":46},898.34,{"$nulls":6},"fee schedule",null,838.79,{"$nulls":6},"fee schedule",{"$nulls":10},207.45,{"$nulls":6},"case rate",{"$nulls":28},838.79,{"$nulls":6},"fee schedule",{"$nulls":19},838.79,{"$nulls":6},"fee schedule",{"$nulls":10},207.45,{"$nulls":6},"case rate",null,207.45,{"$nulls":6},"case rate",null,838.79,{"$nulls":6},"fee schedule",{"$nulls":10},898.34,{"$nulls":6},"fee schedule",null,5856.77,{"$nulls":6},"case rate",null,898.34,{"$nulls":6},"fee schedule",null,838.79,{"$nulls":6},"fee schedule",{"$nulls":28},838.79,{"$nulls":6},"fee schedule"]
["Incision of anal abscess",46050,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},203.38,5463.93,null,855.57,{"$nulls":6},"fee schedule",null,209.48,{"$nulls":6},"case rate",null,838.79,{"$nulls":6},"fee schedule",{"$nulls":28},863.95,{"$nulls":6},"fee schedule",null,838.79,{"$nulls":6},"fee schedule",null,2173.99,{"$nulls":6},"fee schedule",{"$nulls":10},838.79,{"$nulls":6},"fee schedule",{"$nulls":10},2393.94,{"$nulls":6},"fee schedule",null,5463.93,{"$nulls":6},"fee schedule",null,203.38,{"$nulls":6},"case rate",{"$nulls":10},838.79,{"$nulls":6},"fee schedule",null,5440.51,{"$nulls":6},"fee schedule",{"$nulls":46},898.34,{"$nulls":6},"fee schedule",null,838.79,{"$nulls":6},"fee schedule",{"$nulls":10},207.45,{"$nulls":6},"case rate",{"$nulls":28},838.79,{"$nulls":6},"fee schedule",{"$nulls":19},838.79,{"$nulls":6},"fee schedule",{"$nulls":10},207.45,{"$nulls":6},"case rate",null,207.45,{"$nulls":6},"case rate",null,838.79,{"$nulls":6},"fee schedule",{"$nulls":10},898.34,{"$nulls":6},"fee schedule",null,4196.26,{"$nulls":6},"case rate",null,898.34,{"$nulls":6},"fee schedule",null,838.79,{"$nulls":6},"fee schedule",{"$nulls":28},838.79,{"$nulls":6},"fee schedule"]
["Abd paracentesis",49082,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},273.12,5856.77,null,879.82,{"$nulls":6},"fee schedule",null,281.31,{"$nulls":6},"case rate",null,862.57,{"$nulls":6},"fee schedule",{"$nulls":28},888.45,{"$nulls":6},"fee schedule",null,862.57,{"$nulls":6},"fee schedule",null,2235.63,{"$nulls":6},"fee schedule",{"$nulls":10},862.57,{"$nulls":6},"fee schedule",{"$nulls":10},1045.5,{"$nulls":6},"fee schedule",null,2386.31,{"$nulls":6},"fee schedule",null,273.12,{"$nulls":6},"case rate",{"$nulls":10},862.57,{"$nulls":6},"fee schedule",null,2376.08,{"$nulls":6},"fee schedule",{"$nulls":46},923.82,{"$nulls":6},"fee schedule",null,862.57,{"$nulls":6},"fee schedule",{"$nulls":10},278.58,{"$nulls":6},"case rate",{"$nulls":28},862.57,{"$nulls":6},"fee schedule",{"$nulls":19},862.57,{"$nulls":6},"fee schedule",{"$nulls":10},278.58,{"$nulls":6},"case rate",null,278.58,{"$nulls":6},"case rate",null,862.57,{"$nulls":6},"fee schedule",{"$nulls":10},923.82,{"$nulls":6},"fee schedule",null,5856.77,{"$nulls":6},"case rate",null,923.82,{"$nulls":6},"fee schedule",null,862.57,{"$nulls":6},"fee schedule",{"$nulls":28},862.57,{"$nulls":6},"fee schedule"]
["Diag laparo separate proc",49320,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},312.23,19700.72,null,5475.09,{"$nulls":6},"case rate",null,321.6,{"$nulls":6},"case rate",null,5367.73,{"$nulls":6},"case rate",{"$nulls":28},5528.76,{"$nulls":6},"case rate",null,5367.73,{"$nulls":6},"case rate",null,13912.19,{"$nulls":6},"case rate",{"$nulls":10},5367.73,{"$nulls":6},"case rate",{"$nulls":10},7425.6,{"$nulls":6},"fee schedule",null,16949.77,{"$nulls":6},"fee schedule",null,312.23,{"$nulls":6},"case rate",{"$nulls":10},5367.73,{"$nulls":6},"case rate",null,16877.14,{"$nulls":6},"fee schedule",{"$nulls":46},5748.84,{"$nulls":6},"case rate",null,5367.73,{"$nulls":6},"case rate",{"$nulls":10},318.47,{"$nulls":6},"case rate",{"$nulls":28},5367.73,{"$nulls":6},"case rate",{"$nulls":19},5367.73,{"$nulls":6},"case rate",{"$nulls":10},318.47,{"$nulls":6},"case rate",null,318.47,{"$nulls":6},"case rate",null,5367.73,{"$nulls":6},"case rate",{"$nulls":10},5748.84,{"$nulls":6},"case rate",null,19700.72,{"$nulls":6},"case rate",null,5748.84,{"$nulls":6},"case rate",null,5367.73,{"$nulls":6},"case rate",{"$nulls":28},5367.73,{"$nulls":6},"case rate"]
["Change ureter stent percut",50382,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},822.23,13882.05,null,1922.36,{"$nulls":6},"case rate",null,846.9,{"$nulls":6},"fee schedule",null,1884.67,{"$nulls":6},"case rate",{"$nulls":28},1941.21,{"$nulls":6},"case rate",null,1884.67,{"$nulls":6},"case rate",null,4884.72,{"$nulls":6},"case rate",{"$nulls":10},1884.67,{"$nulls":6},"case rate",{"$nulls":10},5015.34,{"$nulls":6},"fee schedule",null,11446.55,{"$nulls":6},"fee schedule",null,822.23,{"$nulls":6},"fee schedule",{"$nulls":10},1884.67,{"$nulls":6},"case rate",null,11397.49,{"$nulls":6},"fee schedule",{"$nulls":46},2018.48,{"$nulls":6},"case rate",null,1884.67,{"$nulls":6},"case rate",{"$nulls":10},838.67,{"$nulls":6},"fee schedule",{"$nulls":28},1884.67,{"$nulls":6},"case rate",{"$nulls":19},1884.67,{"$nulls":6},"case rate",{"$nulls":10},838.67,{"$nulls":6},"fee schedule",null,838.67,{"$nulls":6},"fee schedule",null,1884.67,{"$nulls":6},"case rate",{"$nulls":10},2018.48,{"$nulls":6},"case rate",null,13882.05,{"$nulls":6},"case rate",null,2018.48,{"$nulls":6},"case rate",null,1884.67,{"$nulls":6},"case rate",{"$nulls":28},1884.67,{"$nulls":6},"case rate"]
["Cystoscopy and treatment",52283,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},273.12,13882.05,null,1922.36,{"$nulls":6},"case rate",null,281.31,{"$nulls":6},"case rate",null,1884.67,{"$nulls":6},"case rate",{"$nulls":28},1941.21,{"$nulls":6},"case rate",null,1884.67,{"$nulls":6},"case rate",null,4884.72,{"$nulls":6},"case rate",{"$nulls":10},1884.67,{"$nulls":6},"case rate",{"$nulls":10},5015.34,{"$nulls":6},"fee schedule",null,11446.55,{"$nulls":6},"fee schedule",null,273.12,{"$nulls":6},"case rate",{"$nulls":10},1884.67,{"$nulls":6},"case rate",null,11397.49,{"$nulls":6},"fee schedule",{"$nulls":46},2018.48,{"$nulls":6},"case rate",null,1884.67,{"$nulls":6},"case rate",{"$nulls":10},278.58,{"$nulls":6},"case rate",{"$nulls":28},1884.67,{"$nulls":6},"case rate",{"$nulls":19},1884.67,{"$nulls":6},"case rate",{"$nulls":10},278.58,{"$nulls":6},"case rate",null,278.58,{"$nulls":6},"case rate",null,1884.67,{"$nulls":6},"case rate",{"$nulls":10},2018.48,{"$nulls":6},"case rate",null,13882.05,{"$nulls":6},"case rate",null,2018.48,{"$nulls":6},"case rate",null,1884.67,{"$nulls":6},"case rate",{"$nulls":28},1884.67,{"$nulls":6},"case rate"]
["Reconstruction of urethra",54312,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},312.23,17557.61,null,3236.58,{"$nulls":6},"case rate",null,321.6,{"$nulls":6},"case rate",null,3173.12,{"$nulls":6},"case rate",{"$nulls":28},3268.31,{"$nulls":6},"case rate",null,3173.12,{"$nulls":6},"case rate",null,8224.15,{"$nulls":6},"case rate",{"$nulls":10},3173.12,{"$nulls":6},"case rate",{"$nulls":10},6970.68,{"$nulls":6},"fee schedule",null,15909.73,{"$nulls":6},"fee schedule",null,312.23,{"$nulls":6},"case rate",{"$nulls":10},3173.12,{"$nulls":6},"case rate",null,15841.54,{"$nulls":6},"fee schedule",{"$nulls":46},3398.41,{"$nulls":6},"case rate",null,3173.12,{"$nulls":6},"case rate",{"$nulls":10},318.47,{"$nulls":6},"case rate",{"$nulls":28},3173.12,{"$nulls":6},"case rate",{"$nulls":19},3173.12,{"$nulls":6},"case rate",{"$nulls":10},318.47,{"$nulls":6},"case rate",null,318.47,{"$nulls":6},"case rate",null,3173.12,{"$nulls":6},"case rate",{"$nulls":10},3398.41,{"$nulls":6},"case rate",null,17557.61,{"$nulls":6},"case rate",null,3398.41,{"$nulls":6},"case rate",null,3173.12,{"$nulls":6},"case rate",{"$nulls":28},3173.12,{"$nulls":6},"case rate"]
["Removal of hydrocele",55500,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},312.23,17557.61,null,3236.58,{"$nulls":6},"case rate",null,321.6,{"$nulls":6},"case rate",null,3173.12,{"$nulls":6},"case rate",{"$nulls":28},3268.31,{"$nulls":6},"case rate",null,3173.12,{"$nulls":6},"case rate",null,8224.15,{"$nulls":6},"case rate",{"$nulls":10},3173.12,{"$nulls":6},"case rate",{"$nulls":10},4475.76,{"$nulls":6},"fee schedule",null,10216.53,{"$nulls":6},"fee schedule",null,312.23,{"$nulls":6},"case rate",{"$nulls":10},3173.12,{"$nulls":6},"case rate",null,10172.75,{"$nulls":6},"fee schedule",{"$nulls":46},3398.41,{"$nulls":6},"case rate",null,3173.12,{"$nulls":6},"case rate",{"$nulls":10},318.47,{"$nulls":6},"case rate",{"$nulls":28},3173.12,{"$nulls":6},"case rate",{"$nulls":19},3173.12,{"$nulls":6},"case rate",{"$nulls":10},318.47,{"$nulls":6},"case rate",null,318.47,{"$nulls":6},"case rate",null,3173.12,{"$nulls":6},"case rate",{"$nulls":10},3398.41,{"$nulls":6},"case rate",null,17557.61,{"$nulls":6},"case rate",null,3398.41,{"$nulls":6},"case rate",null,3173.12,{"$nulls":6},"case rate",{"$nulls":28},3173.12,{"$nulls":6},"case rate"]
["Endocervical curettage",57505,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},801.1,4196.26,null,817.12,{"$nulls":6},"fee schedule",null,846.9,{"$nulls":6},"fee schedule",null,801.1,{"$nulls":6},"fee schedule",{"$nulls":28},825.14,{"$nulls":6},"fee schedule",null,801.1,{"$nulls":6},"fee schedule",null,2076.31,{"$nulls":6},"fee schedule",{"$nulls":10},801.1,{"$nulls":6},"fee schedule",{"$nulls":10},1202.58,{"$nulls":6},"fee schedule",null,2745.83,{"$nulls":6},"fee schedule",null,822.23,{"$nulls":6},"fee schedule",{"$nulls":10},801.1,{"$nulls":6},"fee schedule",null,2734.06,{"$nulls":6},"fee schedule",{"$nulls":46},857.98,{"$nulls":6},"fee schedule",null,801.1,{"$nulls":6},"fee schedule",{"$nulls":10},838.67,{"$nulls":6},"fee schedule",{"$nulls":28},801.1,{"$nulls":6},"fee schedule",{"$nulls":19},801.1,{"$nulls":6},"fee schedule",{"$nulls":10},838.67,{"$nulls":6},"fee schedule",null,838.67,{"$nulls":6},"fee schedule",null,801.1,{"$nulls":6},"fee schedule",{"$nulls":10},857.98,{"$nulls":6},"fee schedule",null,4196.26,{"$nulls":6},"case rate",null,857.98,{"$nulls":6},"fee schedule",null,801.1,{"$nulls":6},"fee schedule",{"$nulls":28},801.1,{"$nulls":6},"fee schedule"]
["Fetal shunt placement w/us",59076,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},279.86,2251.06,null,285.46,{"$nulls":6},"fee schedule",null,316.21,{"$nulls":6},"fee schedule",null,279.86,{"$nulls":6},"fee schedule",{"$nulls":28},288.26,{"$nulls":6},"fee schedule",null,279.86,{"$nulls":6},"fee schedule",null,725.35,{"$nulls":6},"fee schedule",{"$nulls":10},279.86,{"$nulls":6},"fee schedule",{"$nulls":10},588.54,{"$nulls":6},"fee schedule",null,1342.61,{"$nulls":6},"fee schedule",null,307,{"$nulls":6},"fee schedule",{"$nulls":10},279.86,{"$nulls":6},"fee schedule",null,1336.85,{"$nulls":6},"fee schedule",{"$nulls":46},299.73,{"$nulls":6},"fee schedule",null,279.86,{"$nulls":6},"fee schedule",{"$nulls":10},313.14,{"$nulls":6},"fee schedule",{"$nulls":28},279.86,{"$nulls":6},"fee schedule",{"$nulls":19},279.86,{"$nulls":6},"fee schedule",{"$nulls":10},313.14,{"$nulls":6},"fee schedule",null,313.14,{"$nulls":6},"fee schedule",null,279.86,{"$nulls":6},"fee schedule",{"$nulls":10},299.73,{"$nulls":6},"fee schedule",null,2251.06,{"$nulls":6},"case rate",null,299.73,{"$nulls":6},"fee schedule",null,279.86,{"$nulls":6},"fee schedule",{"$nulls":28},279.86,{"$nulls":6},"fee schedule"]
["Remove carotid body lesion",60600,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},822.23,32221.61,null,12680.68,{"$nulls":6},"case rate",null,846.9,{"$nulls":6},"case rate",null,12432.04,{"$nulls":6},"case rate",{"$nulls":28},12805,{"$nulls":6},"case rate",null,12432.04,{"$nulls":6},"case rate",null,32221.61,{"$nulls":6},"case rate",{"$nulls":10},12432.04,{"$nulls":6},"case rate",{"$nulls":11},50,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",null,60.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",822.23,{"$nulls":6},"case rate",{"$nulls":10},12432.04,{"$nulls":6},"case rate",null,null,61.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":45},13314.72,{"$nulls":6},"case rate",null,12432.04,{"$nulls":6},"case rate",{"$nulls":10},838.67,{"$nulls":6},"case rate",{"$nulls":28},12432.04,{"$nulls":6},"case rate",{"$nulls":19},12432.04,{"$nulls":6},"case rate",{"$nulls":10},838.67,{"$nulls":6},"case rate",null,838.67,{"$nulls":6},"case rate",null,12432.04,{"$nulls":6},"case rate",{"$nulls":10},13314.73,{"$nulls":6},"case rate",null,5856.77,{"$nulls":6},"case rate",null,13314.72,{"$nulls":6},"case rate",null,12432.04,{"$nulls":6},"case rate",{"$nulls":28},12432.04,{"$nulls":6},"case rate"]
["Revise circulation to head",61705,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},822.23,32221.61,null,12680.68,{"$nulls":6},"case rate",null,846.9,{"$nulls":6},"case rate",null,12432.04,{"$nulls":6},"case rate",{"$nulls":28},12805,{"$nulls":6},"case rate",null,12432.04,{"$nulls":6},"case rate",null,32221.61,{"$nulls":6},"case rate",{"$nulls":10},12432.04,{"$nulls":6},"case rate",{"$nulls":11},50,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",null,60.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",822.23,{"$nulls":6},"case rate",{"$nulls":10},12432.04,{"$nulls":6},"case rate",null,null,61.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":45},13314.72,{"$nulls":6},"case rate",null,12432.04,{"$nulls":6},"case rate",{"$nulls":10},838.67,{"$nulls":6},"case rate",{"$nulls":28},12432.04,{"$nulls":6},"case rate",{"$nulls":19},12432.04,{"$nulls":6},"case rate",{"$nulls":10},838.67,{"$nulls":6},"case rate",null,838.67,{"$nulls":6},"case rate",null,12432.04,{"$nulls":6},"case rate",{"$nulls":10},13314.73,{"$nulls":6},"case rate",null,5856.77,{"$nulls":6},"case rate",null,13314.72,{"$nulls":6},"case rate",null,12432.04,{"$nulls":6},"case rate",{"$nulls":28},12432.04,{"$nulls":6},"case rate"]
["Decompress spine cord add-on",63057,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},2251.06,21744.6,{"$nulls":109},9526.8,{"$nulls":6},"fee schedule",null,21744.6,{"$nulls":6},"fee schedule",{"$nulls":28},21651.41,{"$nulls":6},"fee schedule",{"$nulls":199},2251.06,{"$nulls":6},"case rate"]
["Revise spine eltrd plate",63664,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},822.23,29735.78,null,11702.39,{"$nulls":6},"case rate",null,846.9,{"$nulls":6},"fee schedule",null,11472.94,{"$nulls":6},"case rate",{"$nulls":28},11817.12,{"$nulls":6},"case rate",null,11472.94,{"$nulls":6},"case rate",null,29735.78,{"$nulls":6},"case rate",{"$nulls":10},11472.94,{"$nulls":6},"case rate",{"$nulls":10},3848.46,{"$nulls":6},"fee schedule",null,8785.25,{"$nulls":6},"fee schedule",null,822.23,{"$nulls":6},"fee schedule",{"$nulls":10},11472.94,{"$nulls":6},"case rate",null,8747.6,{"$nulls":6},"fee schedule",{"$nulls":46},12287.51,{"$nulls":6},"case rate",null,11472.94,{"$nulls":6},"case rate",{"$nulls":10},838.67,{"$nulls":6},"fee schedule",{"$nulls":28},11472.94,{"$nulls":6},"case rate",{"$nulls":19},11472.94,{"$nulls":6},"case rate",{"$nulls":10},838.67,{"$nulls":6},"fee schedule",null,838.67,{"$nulls":6},"fee schedule",null,11472.94,{"$nulls":6},"case rate",{"$nulls":10},12287.51,{"$nulls":6},"case rate",null,27379.93,{"$nulls":6},"case rate",null,12287.51,{"$nulls":6},"case rate",null,11472.94,{"$nulls":6},"case rate",{"$nulls":28},11472.94,{"$nulls":6},"case rate"]
["Remove skin nerve lesion",64774,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},203.38,13882.05,null,1832.52,{"$nulls":6},"case rate",null,209.48,{"$nulls":6},"case rate",null,1796.59,{"$nulls":6},"case rate",{"$nulls":28},1850.49,{"$nulls":6},"case rate",null,1796.59,{"$nulls":6},"case rate",null,4656.44,{"$nulls":6},"case rate",{"$nulls":10},1796.59,{"$nulls":6},"case rate",{"$nulls":10},3628.14,{"$nulls":6},"fee schedule",null,8280.93,{"$nulls":6},"fee schedule",null,203.38,{"$nulls":6},"case rate",{"$nulls":10},1796.59,{"$nulls":6},"case rate",null,8245.45,{"$nulls":6},"fee schedule",{"$nulls":46},1924.15,{"$nulls":6},"case rate",null,1796.59,{"$nulls":6},"case rate",{"$nulls":10},207.45,{"$nulls":6},"case rate",{"$nulls":28},1796.59,{"$nulls":6},"case rate",{"$nulls":19},1796.59,{"$nulls":6},"case rate",{"$nulls":10},207.45,{"$nulls":6},"case rate",null,207.45,{"$nulls":6},"case rate",null,1796.59,{"$nulls":6},"case rate",{"$nulls":10},1924.15,{"$nulls":6},"case rate",null,13882.05,{"$nulls":6},"case rate",null,1924.15,{"$nulls":6},"case rate",null,1796.59,{"$nulls":6},"case rate",{"$nulls":28},1796.59,{"$nulls":6},"case rate"]
["Remove foreign body from eye",65220,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},182.58,2251.06,null,374.47,{"$nulls":6},"case rate",null,302.46,{"$nulls":6},"fee schedule",null,367.13,{"$nulls":6},"case rate",{"$nulls":28},378.14,{"$nulls":6},"case rate",null,367.13,{"$nulls":6},"case rate",null,951.52,{"$nulls":6},"case rate",{"$nulls":10},367.13,{"$nulls":6},"case rate",{"$nulls":10},182.58,{"$nulls":6},"fee schedule",null,417.75,{"$nulls":6},"fee schedule",null,293.65,{"$nulls":6},"fee schedule",{"$nulls":10},367.13,{"$nulls":6},"case rate",null,415.95,{"$nulls":6},"fee schedule",{"$nulls":46},393.19,{"$nulls":6},"case rate",null,367.13,{"$nulls":6},"case rate",{"$nulls":10},299.52,{"$nulls":6},"fee schedule",{"$nulls":28},367.13,{"$nulls":6},"case rate",{"$nulls":19},367.13,{"$nulls":6},"case rate",{"$nulls":10},299.52,{"$nulls":6},"fee schedule",null,299.52,{"$nulls":6},"fee schedule",null,367.13,{"$nulls":6},"case rate",{"$nulls":10},393.19,{"$nulls":6},"case rate",null,2251.06,{"$nulls":6},"case rate",null,393.19,{"$nulls":6},"case rate",null,367.13,{"$nulls":6},"case rate",{"$nulls":28},367.13,{"$nulls":6},"case rate"]
["Treatment of retinal lesion",67210,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},203.38,4196.26,null,514.82,{"$nulls":6},"fee schedule",null,209.48,{"$nulls":6},"case rate",null,504.73,{"$nulls":6},"fee schedule",{"$nulls":28},519.87,{"$nulls":6},"fee schedule",null,504.73,{"$nulls":6},"fee schedule",null,1308.16,{"$nulls":6},"fee schedule",{"$nulls":10},504.73,{"$nulls":6},"fee schedule",{"$nulls":10},1032.24,{"$nulls":6},"fee schedule",null,2355.23,{"$nulls":6},"fee schedule",null,203.38,{"$nulls":6},"case rate",{"$nulls":10},504.73,{"$nulls":6},"fee schedule",null,2345.14,{"$nulls":6},"fee schedule",{"$nulls":46},540.56,{"$nulls":6},"fee schedule",null,504.73,{"$nulls":6},"fee schedule",{"$nulls":10},207.45,{"$nulls":6},"case rate",{"$nulls":28},504.73,{"$nulls":6},"fee schedule",{"$nulls":19},504.73,{"$nulls":6},"fee schedule",{"$nulls":10},207.45,{"$nulls":6},"case rate",null,207.45,{"$nulls":6},"case rate",null,504.73,{"$nulls":6},"fee schedule",{"$nulls":10},540.56,{"$nulls":6},"fee schedule",null,4196.26,{"$nulls":6},"case rate",null,540.56,{"$nulls":6},"fee schedule",null,504.73,{"$nulls":6},"fee schedule",{"$nulls":28},504.73,{"$nulls":6},"fee schedule"]
["Exc les conjunctiva adj scl",68130,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},273.12,13882.05,null,2189.29,{"$nulls":6},"case rate",null,281.31,{"$nulls":6},"case rate",null,2146.37,{"$nulls":6},"case rate",{"$nulls":28},2210.76,{"$nulls":6},"case rate",null,2146.37,{"$nulls":6},"case rate",null,5562.99,{"$nulls":6},"case rate",{"$nulls":10},2146.37,{"$nulls":6},"case rate",{"$nulls":10},3281.34,{"$nulls":6},"fee schedule",null,7489.18,{"$nulls":6},"fee schedule",null,273.12,{"$nulls":6},"case rate",{"$nulls":10},2146.37,{"$nulls":6},"case rate",null,7457.07,{"$nulls":6},"fee schedule",{"$nulls":46},2298.76,{"$nulls":6},"case rate",null,2146.37,{"$nulls":6},"case rate",{"$nulls":10},278.58,{"$nulls":6},"case rate",{"$nulls":28},2146.37,{"$nulls":6},"case rate",{"$nulls":19},2146.37,{"$nulls":6},"case rate",{"$nulls":10},278.58,{"$nulls":6},"case rate",null,278.58,{"$nulls":6},"case rate",null,2146.37,{"$nulls":6},"case rate",{"$nulls":10},2298.77,{"$nulls":6},"case rate",null,13882.05,{"$nulls":6},"case rate",null,2298.76,{"$nulls":6},"case rate",null,2146.37,{"$nulls":6},"case rate",{"$nulls":28},2146.37,{"$nulls":6},"case rate"]
["Release facial nerve",69720,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},439.34,19700.72,null,5551.37,{"$nulls":6},"case rate",null,452.52,{"$nulls":6},"case rate",null,5442.52,{"$nulls":6},"case rate",{"$nulls":28},5605.8,{"$nulls":6},"case rate",null,5442.52,{"$nulls":6},"case rate",null,14106.04,{"$nulls":6},"case rate",{"$nulls":10},5442.52,{"$nulls":6},"case rate",{"$nulls":10},8206.92,{"$nulls":6},"fee schedule",null,18732.6,{"$nulls":6},"fee schedule",null,439.34,{"$nulls":6},"case rate",{"$nulls":10},5442.52,{"$nulls":6},"case rate",null,18652.32,{"$nulls":6},"fee schedule",{"$nulls":46},5828.94,{"$nulls":6},"case rate",null,5442.52,{"$nulls":6},"case rate",{"$nulls":10},448.13,{"$nulls":6},"case rate",{"$nulls":28},5442.52,{"$nulls":6},"case rate",{"$nulls":19},5442.52,{"$nulls":6},"case rate",{"$nulls":10},448.13,{"$nulls":6},"case rate",null,448.13,{"$nulls":6},"case rate",null,5442.52,{"$nulls":6},"case rate",{"$nulls":10},5828.94,{"$nulls":6},"case rate",null,19700.72,{"$nulls":6},"case rate",null,5828.94,{"$nulls":6},"case rate",null,5442.52,{"$nulls":6},"case rate",{"$nulls":28},5442.52,{"$nulls":6},"case rate"]
["Mri neck spine w/o & w/dye",72156,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},148.67,4220.97,null,335.14,{"$nulls":6},"case rate",null,153.13,{"$nulls":6},"fee schedule",null,328.57,{"$nulls":6},"case rate",{"$nulls":28},338.42,{"$nulls":6},"case rate",null,328.57,{"$nulls":6},"case rate",null,851.59,{"$nulls":6},"case rate",{"$nulls":10},328.57,{"$nulls":6},"case rate",{"$nulls":10},1042,{"$nulls":6},"fee schedule",null,4178.78,{"$nulls":6},"fee schedule",null,148.67,{"$nulls":6},"fee schedule",{"$nulls":10},328.57,{"$nulls":6},"case rate",null,4220.97,{"$nulls":6},"fee schedule",{"$nulls":46},351.9,{"$nulls":6},"case rate",null,328.57,{"$nulls":6},"case rate",{"$nulls":10},151.64,{"$nulls":6},"fee schedule",{"$nulls":28},328.57,{"$nulls":6},"case rate",{"$nulls":19},328.57,{"$nulls":6},"case rate",{"$nulls":10},151.64,{"$nulls":6},"fee schedule",null,151.64,{"$nulls":6},"fee schedule",null,328.57,{"$nulls":6},"case rate",{"$nulls":10},351.9,{"$nulls":6},"case rate",{"$nulls":10},351.9,{"$nulls":6},"case rate",null,328.57,{"$nulls":6},"case rate",{"$nulls":28},328.57,{"$nulls":6},"case rate"]
["X-ray urethra/bladder",74450,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},76.3,909.4,null,226.83,{"$nulls":6},"case rate",null,78.59,{"$nulls":6},"fee schedule",null,222.39,{"$nulls":6},"case rate",{"$nulls":28},229.06,{"$nulls":6},"case rate",null,222.39,{"$nulls":6},"case rate",null,576.39,{"$nulls":6},"case rate",{"$nulls":10},222.39,{"$nulls":6},"case rate",{"$nulls":10},212.45,{"$nulls":6},"fee schedule",null,909.4,{"$nulls":6},"fee schedule",null,76.3,{"$nulls":6},"fee schedule",{"$nulls":10},222.39,{"$nulls":6},"case rate",null,905.49,{"$nulls":6},"fee schedule",{"$nulls":46},238.18,{"$nulls":6},"case rate",null,222.39,{"$nulls":6},"case rate",{"$nulls":10},77.83,{"$nulls":6},"fee schedule",{"$nulls":28},222.39,{"$nulls":6},"case rate",{"$nulls":19},222.39,{"$nulls":6},"case rate",{"$nulls":10},77.83,{"$nulls":6},"fee schedule",null,77.83,{"$nulls":6},"fee schedule",null,222.39,{"$nulls":6},"case rate",{"$nulls":10},238.18,{"$nulls":6},"case rate",{"$nulls":10},238.18,{"$nulls":6},"case rate",null,222.39,{"$nulls":6},"case rate",{"$nulls":28},222.39,{"$nulls":6},"case rate"]
["Radex osseous survey compl",77075,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},44.83,443.08,null,99.79,{"$nulls":6},"case rate",null,46.17,{"$nulls":6},"fee schedule",null,97.84,{"$nulls":6},"case rate",{"$nulls":28},100.77,{"$nulls":6},"case rate",null,97.84,{"$nulls":6},"case rate",null,253.58,{"$nulls":6},"case rate",{"$nulls":10},97.84,{"$nulls":6},"case rate",{"$nulls":10},213.18,{"$nulls":6},"fee schedule",null,443.08,{"$nulls":6},"fee schedule",null,44.83,{"$nulls":6},"fee schedule",{"$nulls":10},97.84,{"$nulls":6},"case rate",null,441.19,{"$nulls":6},"fee schedule",{"$nulls":46},104.78,{"$nulls":6},"case rate",null,97.84,{"$nulls":6},"case rate",{"$nulls":10},45.73,{"$nulls":6},"fee schedule",{"$nulls":28},97.84,{"$nulls":6},"case rate",{"$nulls":19},97.84,{"$nulls":6},"case rate",{"$nulls":10},45.73,{"$nulls":6},"fee schedule",null,45.73,{"$nulls":6},"fee schedule",null,97.84,{"$nulls":6},"case rate",{"$nulls":10},104.78,{"$nulls":6},"case rate",{"$nulls":10},104.78,{"$nulls":6},"case rate",null,97.84,{"$nulls":6},"case rate",{"$nulls":28},97.84,{"$nulls":6},"case rate"]
["Respirator motion mgmt simul",77293,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},183.46,188.96,{"$nulls":10},188.96,{"$nulls":6},"fee schedule",{"$nulls":109},183.46,{"$nulls":6},"fee schedule",{"$nulls":100},187.13,{"$nulls":6},"fee schedule",{"$nulls":73},187.13,{"$nulls":6},"fee schedule",null,187.13,{"$nulls":6},"fee schedule"]
["Nuclr rx interstit colloid",79300,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},206.2,1404.82,null,210.32,{"$nulls":6},"fee schedule",null,258.77,{"$nulls":6},"fee schedule",null,206.2,{"$nulls":6},"fee schedule",{"$nulls":28},212.39,{"$nulls":6},"fee schedule",null,206.2,{"$nulls":6},"fee schedule",null,534.43,{"$nulls":6},"fee schedule",{"$nulls":10},206.2,{"$nulls":6},"fee schedule",{"$nulls":10},615.06,{"$nulls":6},"fee schedule",null,1404.82,{"$nulls":6},"fee schedule",null,251.23,{"$nulls":6},"fee schedule",{"$nulls":10},206.2,{"$nulls":6},"fee schedule",null,1398.8,{"$nulls":6},"fee schedule",{"$nulls":46},220.84,{"$nulls":6},"fee schedule",null,206.2,{"$nulls":6},"fee schedule",{"$nulls":10},256.25,{"$nulls":6},"fee schedule",{"$nulls":28},206.2,{"$nulls":6},"fee schedule",{"$nulls":19},206.2,{"$nulls":6},"fee schedule",{"$nulls":10},256.25,{"$nulls":6},"fee schedule",null,256.25,{"$nulls":6},"fee schedule",null,206.2,{"$nulls":6},"fee schedule",{"$nulls":10},220.84,{"$nulls":6},"fee schedule",{"$nulls":10},220.84,{"$nulls":6},"fee schedule",null,206.2,{"$nulls":6},"fee schedule",{"$nulls":28},206.2,{"$nulls":6},"fee schedule"]
["Assay of vancomycin",80202,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},55.65,55.65,{"$nulls":361},55.65,{"$nulls":6},"fee schedule","80202: RC 0300-0307|80202: RC 0309|80202: RC 0923|80202: RC 0925"]
["Quantitative assay drug",80299,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},0.5,220.36,null,19.01,{"$nulls":6},"fee schedule",null,9.48,{"$nulls":6},"fee schedule",null,18.64,{"$nulls":6},"fee schedule",{"$nulls":28},19.2,{"$nulls":6},"fee schedule",null,18.64,{"$nulls":6},"fee schedule",null,45.11,{"$nulls":6},"fee schedule",{"$nulls":10},18.64,{"$nulls":6},"fee schedule",{"$nulls":10},0.5,{"$nulls":6},"fee schedule",null,218.15,{"$nulls":6},"fee schedule",null,9.2,{"$nulls":6},"fee schedule",{"$nulls":10},18.64,{"$nulls":6},"fee schedule",null,220.36,{"$nulls":6},"fee schedule",{"$nulls":46},18.64,{"$nulls":6},"fee schedule",null,18.64,{"$nulls":6},"fee schedule",{"$nulls":10},9.38,{"$nulls":6},"fee schedule",{"$nulls":28},18.64,{"$nulls":6},"fee schedule",{"$nulls":19},18.64,{"$nulls":6},"fee schedule",{"$nulls":10},9.38,{"$nulls":6},"fee schedule",null,9.38,{"$nulls":6},"fee schedule",null,18.64,{"$nulls":6},"fee schedule",{"$nulls":10},16.4,{"$nulls":6},"fee schedule",{"$nulls":10},18.64,{"$nulls":6},"fee schedule",null,18.64,{"$nulls":6},"fee schedule",{"$nulls":19},30.53,{"$nulls":6},"fee schedule",null,18.64,{"$nulls":6},"fee schedule"]
["Brca1&2 185&5385&6174 vrnt",81212,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},1808.4,1808.4,{"$nulls":361},1808.4,{"$nulls":6},"fee schedule","81212: RC 0300-0307|81212: RC 0309|81212: RC 0923|81212: RC 0925"]
["Fxn gene full gene sequence",81286,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},1129.55,1129.55,{"$nulls":361},1129.55,{"$nulls":6},"fee schedule","81286: RC 0300-0307|81286: RC 0309|81286: RC 0923|81286: RC 0925"]
["Pmp22 gene dup/delet",81324,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},3116.86,3116.86,{"$nulls":361},3116.86,{"$nulls":6},"fee schedule","81324: RC 0300-0307|81324: RC 0309|81324: RC 0923|81324: RC 0925"]
["Mopath procedure level 9",81408,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},987.34,4840,null,2040,{"$nulls":6},"fee schedule",null,1016.96,{"$nulls":6},"fee schedule",null,2000,{"$nulls":6},"fee schedule",{"$nulls":28},2060,{"$nulls":6},"fee schedule",null,2000,{"$nulls":6},"fee schedule",null,4840,{"$nulls":6},"fee schedule",{"$nulls":10},2000,{"$nulls":6},"fee schedule",{"$nulls":11},50,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",null,60.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",987.34,{"$nulls":6},"fee schedule",{"$nulls":10},2000,{"$nulls":6},"fee schedule",null,null,61.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":45},2000,{"$nulls":6},"fee schedule",null,2000,{"$nulls":6},"fee schedule",{"$nulls":10},1007.09,{"$nulls":6},"fee schedule",{"$nulls":28},2000,{"$nulls":6},"fee schedule",{"$nulls":19},2000,{"$nulls":6},"fee schedule",{"$nulls":10},1007.09,{"$nulls":6},"fee schedule",null,1007.09,{"$nulls":6},"fee schedule",null,2000,{"$nulls":6},"fee schedule",{"$nulls":28},2000,{"$nulls":6},"fee schedule",null,2000,{"$nulls":6},"fee schedule",{"$nulls":28},2000,{"$nulls":6},"fee schedule"]
["Cardiology hrt trnspl mrna",81595,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},1599.49,7840.8,null,3304.8,{"$nulls":6},"fee schedule",null,1647.47,{"$nulls":6},"fee schedule",null,3240,{"$nulls":6},"fee schedule",{"$nulls":28},3337.2,{"$nulls":6},"fee schedule",null,3240,{"$nulls":6},"fee schedule",null,7840.8,{"$nulls":6},"fee schedule",{"$nulls":10},3240,{"$nulls":6},"fee schedule",{"$nulls":11},50,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",null,60.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",1599.49,{"$nulls":6},"fee schedule",{"$nulls":10},3240,{"$nulls":6},"fee schedule",null,null,61.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":45},3240,{"$nulls":6},"fee schedule",null,3240,{"$nulls":6},"fee schedule",{"$nulls":10},1631.48,{"$nulls":6},"fee schedule",{"$nulls":28},3240,{"$nulls":6},"fee schedule",{"$nulls":19},3240,{"$nulls":6},"fee schedule",{"$nulls":10},1631.48,{"$nulls":6},"fee schedule",null,1631.48,{"$nulls":6},"fee schedule",null,3240,{"$nulls":6},"fee schedule",{"$nulls":10},2850.88,{"$nulls":6},"fee schedule",{"$nulls":10},3240,{"$nulls":6},"fee schedule",null,3240,{"$nulls":6},"fee schedule",{"$nulls":28},3240,{"$nulls":6},"fee schedule"]
["Androstanediol glucuronide",82154,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},118.49,118.49,{"$nulls":361},118.49,{"$nulls":6},"fee schedule","82154: RC 0300-0307|82154: RC 0309|82154: RC 0923|82154: RC 0925"]
["Column chromotograph/isotope",82543,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},40.58,40.58,{"$nulls":406},40.58,{"$nulls":6},"fee schedule"]
["Glucose other fluid",82945,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},16.15,16.15,{"$nulls":361},16.15,{"$nulls":6},"fee schedule","82945: RC 0300-0307|82945: RC 0309|82945: RC 0923|82945: RC 0925"]
["Hemoglobin plasma",83051,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},30.04,30.04,{"$nulls":361},30.04,{"$nulls":6},"fee schedule","83051: RC 0300-0307|83051: RC 0309|83051: RC 0923|83051: RC 0925"]
["Assay of csf protein",83873,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},8.49,174.72,null,17.54,{"$nulls":6},"fee schedule",null,8.74,{"$nulls":6},"fee schedule",null,17.2,{"$nulls":6},"fee schedule",{"$nulls":28},17.72,{"$nulls":6},"fee schedule",null,17.2,{"$nulls":6},"fee schedule",null,41.62,{"$nulls":6},"fee schedule",{"$nulls":10},17.2,{"$nulls":6},"fee schedule",{"$nulls":10},49.86,{"$nulls":6},"fee schedule",null,174.72,{"$nulls":6},"fee schedule",null,8.49,{"$nulls":6},"fee schedule",{"$nulls":10},17.2,{"$nulls":6},"fee schedule",null,173.97,{"$nulls":6},"fee schedule",{"$nulls":46},17.2,{"$nulls":6},"fee schedule",null,17.2,{"$nulls":6},"fee schedule",{"$nulls":10},8.66,{"$nulls":6},"fee schedule",{"$nulls":28},17.2,{"$nulls":6},"fee schedule",{"$nulls":19},17.2,{"$nulls":6},"fee schedule",{"$nulls":10},8.66,{"$nulls":6},"fee schedule",null,8.66,{"$nulls":6},"fee schedule",null,17.2,{"$nulls":6},"fee schedule",{"$nulls":10},15.13,{"$nulls":6},"fee schedule",{"$nulls":10},17.2,{"$nulls":6},"fee schedule",null,17.2,{"$nulls":6},"fee schedule",{"$nulls":19},39.06,{"$nulls":6},"fee schedule",null,17.2,{"$nulls":6},"fee schedule"]
["Assay alkaline phosphatases",84080,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},7.3,228.64,null,15.08,{"$nulls":6},"fee schedule",null,7.52,{"$nulls":6},"fee schedule",null,14.78,{"$nulls":6},"fee schedule",{"$nulls":28},15.22,{"$nulls":6},"fee schedule",null,14.78,{"$nulls":6},"fee schedule",null,35.77,{"$nulls":6},"fee schedule",{"$nulls":10},14.78,{"$nulls":6},"fee schedule",{"$nulls":10},56.6,{"$nulls":6},"fee schedule",null,228.64,{"$nulls":6},"fee schedule",null,7.3,{"$nulls":6},"fee schedule",{"$nulls":10},14.78,{"$nulls":6},"fee schedule",null,227.66,{"$nulls":6},"fee schedule",{"$nulls":46},14.78,{"$nulls":6},"fee schedule",null,14.78,{"$nulls":6},"fee schedule",{"$nulls":10},7.45,{"$nulls":6},"fee schedule",{"$nulls":28},14.78,{"$nulls":6},"fee schedule",{"$nulls":19},14.78,{"$nulls":6},"fee schedule",{"$nulls":10},7.45,{"$nulls":6},"fee schedule",null,7.45,{"$nulls":6},"fee schedule",null,14.78,{"$nulls":6},"fee schedule",{"$nulls":10},13,{"$nulls":6},"fee schedule",{"$nulls":10},14.78,{"$nulls":6},"fee schedule",null,14.78,{"$nulls":6},"fee schedule",{"$nulls":19},33.43,{"$nulls":6},"fee schedule",null,14.78,{"$nulls":6},"fee schedule"]
["Testosterone bioavailable",84410,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},210.76,210.76,{"$nulls":361},210.76,{"$nulls":6},"fee schedule","84410: RC 0300-0307|84410: RC 0309|84410: RC 0923|84410: RC 0925"]
["Reticyte/hgb concentrate",85046,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},2.75,56.71,null,5.68,{"$nulls":6},"fee schedule",null,2.83,{"$nulls":6},"fee schedule",null,5.57,{"$nulls":6},"fee schedule",{"$nulls":28},5.74,{"$nulls":6},"fee schedule",null,5.57,{"$nulls":6},"fee schedule",null,13.48,{"$nulls":6},"fee schedule",{"$nulls":10},5.57,{"$nulls":6},"fee schedule",{"$nulls":10},15.96,{"$nulls":6},"fee schedule",null,56.71,{"$nulls":6},"fee schedule",null,2.75,{"$nulls":6},"fee schedule",{"$nulls":10},5.57,{"$nulls":6},"fee schedule",null,56.48,{"$nulls":6},"fee schedule",{"$nulls":46},5.57,{"$nulls":6},"fee schedule",null,5.57,{"$nulls":6},"fee schedule",{"$nulls":10},2.81,{"$nulls":6},"fee schedule",{"$nulls":28},5.57,{"$nulls":6},"fee schedule",{"$nulls":19},5.57,{"$nulls":6},"fee schedule",{"$nulls":10},2.81,{"$nulls":6},"fee schedule",null,2.81,{"$nulls":6},"fee schedule",null,5.57,{"$nulls":6},"fee schedule",{"$nulls":10},4.9,{"$nulls":6},"fee schedule",{"$nulls":10},5.57,{"$nulls":6},"fee schedule",null,5.57,{"$nulls":6},"fee schedule",{"$nulls":19},12.49,{"$nulls":6},"fee schedule",null,5.57,{"$nulls":6},"fee schedule"]
["Anca screen each antibody",86036,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},49.53,49.53,{"$nulls":361},49.53,{"$nulls":6},"fee schedule","86036: RC 0300-0307|86036: RC 0309|86036: RC 0923|86036: RC 0925"]
["Antistreptolysin o titer",86060,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},30,30,{"$nulls":361},30,{"$nulls":6},"fee schedule","86060: RC 0300-0307|86060: RC 0309|86060: RC 0923|86060: RC 0925"]
["Blastomyces antibody",86612,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},6.37,131.02,null,13.16,{"$nulls":6},"fee schedule",null,6.56,{"$nulls":6},"fee schedule",null,12.9,{"$nulls":6},"fee schedule",{"$nulls":28},13.29,{"$nulls":6},"fee schedule",null,12.9,{"$nulls":6},"fee schedule",null,31.22,{"$nulls":6},"fee schedule",{"$nulls":10},12.9,{"$nulls":6},"fee schedule",{"$nulls":10},37.88,{"$nulls":6},"fee schedule",null,131.02,{"$nulls":6},"fee schedule",null,6.37,{"$nulls":6},"fee schedule",{"$nulls":10},12.9,{"$nulls":6},"fee schedule",null,130.46,{"$nulls":6},"fee schedule",{"$nulls":46},12.9,{"$nulls":6},"fee schedule",null,12.9,{"$nulls":6},"fee schedule",{"$nulls":10},6.5,{"$nulls":6},"fee schedule",{"$nulls":28},12.9,{"$nulls":6},"fee schedule",{"$nulls":19},12.9,{"$nulls":6},"fee schedule",{"$nulls":10},6.5,{"$nulls":6},"fee schedule",null,6.5,{"$nulls":6},"fee schedule",null,12.9,{"$nulls":6},"fee schedule",{"$nulls":10},11.35,{"$nulls":6},"fee schedule",{"$nulls":10},12.9,{"$nulls":6},"fee schedule",null,12.9,{"$nulls":6},"fee schedule",{"$nulls":19},28.87,{"$nulls":6},"fee schedule",null,12.9,{"$nulls":6},"fee schedule"]
["Toxoplasma antibody",86777,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},7.1,278.03,null,14.68,{"$nulls":6},"fee schedule",null,7.31,{"$nulls":6},"fee schedule",null,14.39,{"$nulls":6},"fee schedule",{"$nulls":28},14.82,{"$nulls":6},"fee schedule",null,14.39,{"$nulls":6},"fee schedule",null,34.82,{"$nulls":6},"fee schedule",{"$nulls":10},14.39,{"$nulls":6},"fee schedule",{"$nulls":10},64.42,{"$nulls":6},"fee schedule",null,278.03,{"$nulls":6},"fee schedule",null,7.1,{"$nulls":6},"fee schedule",{"$nulls":10},14.39,{"$nulls":6},"fee schedule",null,276.83,{"$nulls":6},"fee schedule",{"$nulls":46},14.39,{"$nulls":6},"fee schedule",null,14.39,{"$nulls":6},"fee schedule",{"$nulls":10},7.24,{"$nulls":6},"fee schedule",{"$nulls":28},14.39,{"$nulls":6},"fee schedule",{"$nulls":19},14.39,{"$nulls":6},"fee schedule",{"$nulls":10},7.24,{"$nulls":6},"fee schedule",null,7.24,{"$nulls":6},"fee schedule",null,14.39,{"$nulls":6},"fee schedule",{"$nulls":10},12.66,{"$nulls":6},"fee schedule",{"$nulls":10},14.39,{"$nulls":6},"fee schedule",null,14.39,{"$nulls":6},"fee schedule",{"$nulls":19},31.38,{"$nulls":6},"fee schedule",null,14.39,{"$nulls":6},"fee schedule"]
["Rbc pretx incubatj w/chemicl",86970,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},142.08,142.08,{"$nulls":361},142.08,{"$nulls":6},"fee schedule","86970: RC 0300-0307|86970: RC 0309|86970: RC 0923|86970: RC 0925"]
["Culture typing glc/hplc",87143,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},51.46,51.46,{"$nulls":361},51.46,{"$nulls":6},"fee schedule","87143: RC 0300-0307|87143: RC 0309|87143: RC 0923|87143: RC 0925"]
["Entamoeb hist dispr ag ia",87336,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},65.76,65.76,{"$nulls":361},65.76,{"$nulls":6},"fee schedule","87336: RC 0300-0307|87336: RC 0309|87336: RC 0923|87336: RC 0925"]
["Hhv-6 dna dir probe",87531,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},238.38,238.38,{"$nulls":361},238.38,{"$nulls":6},"fee schedule","87531: RC 0300-0307|87531: RC 0309|87531: RC 0923|87531: RC 0925"]
["Rsv dna/rna amp probe",87634,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},288.52,288.52,{"$nulls":361},288.52,{"$nulls":6},"fee schedule","87634: RC 0300-0307|87634: RC 0309|87634: RC 0923|87634: RC 0925"]
["CYTOPATH CERV/VAG THIN PREP-MAN SCRN-COMPUT RE-",88144,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},50.9,50.9,{"$nulls":406},50.9,{"$nulls":6},"fee schedule"]
["Chromosome analysis 5",88261,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},130.5,2224.17,null,269.63,{"$nulls":6},"fee schedule",null,134.42,{"$nulls":6},"fee schedule",null,264.34,{"$nulls":6},"fee schedule",{"$nulls":28},272.27,{"$nulls":6},"fee schedule",null,264.34,{"$nulls":6},"fee schedule",null,639.7,{"$nulls":6},"fee schedule",{"$nulls":10},264.34,{"$nulls":6},"fee schedule",{"$nulls":10},553.2,{"$nulls":6},"fee schedule",null,2224.17,{"$nulls":6},"fee schedule",null,130.5,{"$nulls":6},"fee schedule",{"$nulls":10},264.34,{"$nulls":6},"fee schedule",null,2214.65,{"$nulls":6},"fee schedule",{"$nulls":46},264.34,{"$nulls":6},"fee schedule",null,264.34,{"$nulls":6},"fee schedule",{"$nulls":10},133.11,{"$nulls":6},"fee schedule",{"$nulls":28},264.34,{"$nulls":6},"fee schedule",{"$nulls":19},264.34,{"$nulls":6},"fee schedule",{"$nulls":10},133.11,{"$nulls":6},"fee schedule",null,133.11,{"$nulls":6},"fee schedule",null,264.34,{"$nulls":6},"fee schedule",{"$nulls":10},232.59,{"$nulls":6},"fee schedule",{"$nulls":10},264.34,{"$nulls":6},"fee schedule",null,264.34,{"$nulls":6},"fee schedule",{"$nulls":19},393.56,{"$nulls":6},"fee schedule",null,264.34,{"$nulls":6},"fee schedule"]
["Hgb quant transcutaneous",88738,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},2.48,12.15,null,5.12,{"$nulls":6},"fee schedule",null,2.55,{"$nulls":6},"fee schedule",null,5.02,{"$nulls":6},"fee schedule",{"$nulls":28},5.17,{"$nulls":6},"fee schedule",null,5.02,{"$nulls":6},"fee schedule",null,12.15,{"$nulls":6},"fee schedule",{"$nulls":10},5.02,{"$nulls":6},"fee schedule",{"$nulls":11},50,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",null,60.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",2.48,{"$nulls":6},"fee schedule",{"$nulls":10},5.02,{"$nulls":6},"fee schedule",null,null,61.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":45},5.02,{"$nulls":6},"fee schedule",null,5.02,{"$nulls":6},"fee schedule",{"$nulls":10},2.53,{"$nulls":6},"fee schedule",{"$nulls":28},5.02,{"$nulls":6},"fee schedule",{"$nulls":19},5.02,{"$nulls":6},"fee schedule",{"$nulls":10},2.53,{"$nulls":6},"fee schedule",null,2.53,{"$nulls":6},"fee schedule",null,5.02,{"$nulls":6},"fee schedule",{"$nulls":10},4.42,{"$nulls":6},"fee schedule",{"$nulls":10},5.02,{"$nulls":6},"fee schedule",null,5.02,{"$nulls":6},"fee schedule",{"$nulls":28},5.02,{"$nulls":6},"fee schedule"]
["Immunization admin each add",90472,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},73.44,168.53,{"$nulls":109},73.44,{"$nulls":6},"fee schedule",null,168.53,{"$nulls":6},"fee schedule",{"$nulls":28},167.81,{"$nulls":6},"fee schedule"]
["Var vaccine live subq",90716,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},143.82,328.97,{"$nulls":10},185.35,{"$nulls":6},"fee schedule",{"$nulls":91},143.82,{"$nulls":6},"fee schedule",null,328.97,{"$nulls":6},"fee schedule",null,179.95,{"$nulls":6},"fee schedule",{"$nulls":19},327.56,{"$nulls":6},"fee schedule",{"$nulls":73},183.55,{"$nulls":6},"fee schedule",{"$nulls":73},183.55,{"$nulls":6},"fee schedule",null,183.55,{"$nulls":6},"fee schedule"]
["Img rta detcj/mntr ds staff",92227,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},42.84,141.63,null,55.74,{"$nulls":6},"case rate",{"$nulls":10},54.65,{"$nulls":6},"case rate",{"$nulls":28},56.28,{"$nulls":6},"case rate",null,54.65,{"$nulls":6},"case rate",null,141.63,{"$nulls":6},"case rate",{"$nulls":10},54.65,{"$nulls":6},"case rate",{"$nulls":10},42.84,{"$nulls":6},"fee schedule",null,97.77,{"$nulls":6},"fee schedule",{"$nulls":19},54.65,{"$nulls":6},"case rate",null,97.35,{"$nulls":6},"fee schedule",{"$nulls":46},58.52,{"$nulls":6},"case rate",null,54.65,{"$nulls":6},"case rate",{"$nulls":46},54.65,{"$nulls":6},"case rate",{"$nulls":19},54.65,{"$nulls":6},"case rate",{"$nulls":28},54.65,{"$nulls":6},"case rate",{"$nulls":10},58.53,{"$nulls":6},"case rate",{"$nulls":10},58.52,{"$nulls":6},"case rate",null,54.65,{"$nulls":6},"case rate",{"$nulls":28},54.65,{"$nulls":6},"case rate"]
["Motion fluoroscopy/swallow",92611,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},0.5,331.04,null,86.53,{"$nulls":6},"fee schedule",{"$nulls":10},84.83,{"$nulls":6},"fee schedule",{"$nulls":28},87.37,{"$nulls":6},"fee schedule",null,84.83,{"$nulls":6},"fee schedule",null,205.29,{"$nulls":6},"fee schedule",{"$nulls":10},84.83,{"$nulls":6},"fee schedule",{"$nulls":10},0.5,{"$nulls":6},"fee schedule",null,327.73,{"$nulls":6},"fee schedule",{"$nulls":19},84.83,{"$nulls":6},"fee schedule",null,331.04,{"$nulls":6},"fee schedule",{"$nulls":46},84.83,{"$nulls":6},"fee schedule",null,84.83,{"$nulls":6},"fee schedule",{"$nulls":46},84.83,{"$nulls":6},"fee schedule",{"$nulls":19},84.83,{"$nulls":6},"fee schedule",{"$nulls":28},84.83,{"$nulls":6},"fee schedule",{"$nulls":10},87.53,{"$nulls":6},"fee schedule",{"$nulls":10},84.83,{"$nulls":6},"fee schedule",null,84.83,{"$nulls":6},"fee schedule",{"$nulls":28},84.83,{"$nulls":6},"fee schedule"]
["Echo transthoracic",93304,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},331.34,1516.61,null,514.54,{"$nulls":6},"fee schedule",{"$nulls":10},504.45,{"$nulls":6},"fee schedule",{"$nulls":28},519.58,{"$nulls":6},"fee schedule",null,504.45,{"$nulls":6},"fee schedule",null,1307.44,{"$nulls":6},"fee schedule",{"$nulls":10},504.45,{"$nulls":6},"fee schedule",{"$nulls":10},331.34,{"$nulls":6},"fee schedule",null,1516.61,{"$nulls":6},"fee schedule",{"$nulls":19},504.45,{"$nulls":6},"fee schedule",null,1510.11,{"$nulls":6},"fee schedule",{"$nulls":46},540.26,{"$nulls":6},"fee schedule",null,504.45,{"$nulls":6},"fee schedule",{"$nulls":46},504.45,{"$nulls":6},"fee schedule",{"$nulls":19},504.45,{"$nulls":6},"fee schedule",{"$nulls":28},504.45,{"$nulls":6},"fee schedule",{"$nulls":10},540.26,{"$nulls":6},"fee schedule",{"$nulls":10},540.26,{"$nulls":6},"fee schedule",null,504.45,{"$nulls":6},"fee schedule",{"$nulls":28},504.45,{"$nulls":6},"fee schedule"]
["Vent mgmt inpat init day",94002,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},572.22,1576.41,null,620.39,{"$nulls":6},"fee schedule",{"$nulls":10},608.22,{"$nulls":6},"fee schedule",{"$nulls":28},626.47,{"$nulls":6},"fee schedule",null,608.22,{"$nulls":6},"fee schedule",null,1576.41,{"$nulls":6},"fee schedule",{"$nulls":10},608.22,{"$nulls":6},"fee schedule",{"$nulls":10},572.22,{"$nulls":6},"fee schedule",null,661.91,{"$nulls":6},"fee schedule",{"$nulls":19},608.22,{"$nulls":6},"fee schedule",null,668.59,{"$nulls":6},"fee schedule",{"$nulls":46},651.41,{"$nulls":6},"fee schedule",null,608.22,{"$nulls":6},"fee schedule",{"$nulls":46},608.22,{"$nulls":6},"fee schedule",{"$nulls":19},608.22,{"$nulls":6},"fee schedule",{"$nulls":28},608.22,{"$nulls":6},"fee schedule",{"$nulls":10},651.41,{"$nulls":6},"fee schedule",{"$nulls":10},651.41,{"$nulls":6},"fee schedule",null,608.22,{"$nulls":6},"fee schedule",{"$nulls":28},608.22,{"$nulls":6},"fee schedule"]
["Unlisted neurological dx px",95999,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},117.3,373.07,null,146.82,{"$nulls":6},"case rate",{"$nulls":10},143.94,{"$nulls":6},"case rate",{"$nulls":28},148.26,{"$nulls":6},"case rate",null,143.94,{"$nulls":6},"case rate",null,373.07,{"$nulls":6},"case rate",{"$nulls":10},143.94,{"$nulls":6},"case rate",{"$nulls":10},117.3,{"$nulls":6},"fee schedule",null,268.11,{"$nulls":6},"fee schedule",{"$nulls":19},143.94,{"$nulls":6},"case rate",null,266.96,{"$nulls":6},"fee schedule",{"$nulls":46},154.16,{"$nulls":6},"case rate",null,143.94,{"$nulls":6},"case rate",{"$nulls":46},143.94,{"$nulls":6},"case rate",{"$nulls":19},143.94,{"$nulls":6},"case rate",{"$nulls":28},143.94,{"$nulls":6},"case rate",{"$nulls":10},154.16,{"$nulls":6},"fee schedule",{"$nulls":10},154.16,{"$nulls":6},"case rate",null,143.94,{"$nulls":6},"case rate",{"$nulls":28},143.94,{"$nulls":6},"case rate"]
["Hlth bhv ivntj indiv 1st 30",96158,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},147.82,383.13,null,150.78,{"$nulls":6},"fee schedule",{"$nulls":10},147.82,{"$nulls":6},"fee schedule",{"$nulls":28},152.26,{"$nulls":6},"fee schedule",null,147.82,{"$nulls":6},"fee schedule",null,383.13,{"$nulls":6},"fee schedule",{"$nulls":10},147.82,{"$nulls":6},"fee schedule",{"$nulls":10},159.12,{"$nulls":6},"fee schedule",null,363.74,{"$nulls":6},"fee schedule",{"$nulls":19},147.82,{"$nulls":6},"fee schedule",null,362.19,{"$nulls":6},"fee schedule",{"$nulls":46},158.32,{"$nulls":6},"fee schedule",null,147.82,{"$nulls":6},"fee schedule",{"$nulls":46},147.82,{"$nulls":6},"fee schedule",{"$nulls":19},147.82,{"$nulls":6},"fee schedule",{"$nulls":28},147.82,{"$nulls":6},"fee schedule",{"$nulls":10},158.32,{"$nulls":6},"fee schedule",{"$nulls":10},158.32,{"$nulls":6},"fee schedule",null,147.82,{"$nulls":6},"fee schedule",{"$nulls":28},147.82,{"$nulls":6},"fee schedule"]
["Self care mngment training",97535,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},12.33,12.7,{"$nulls":10},12.7,{"$nulls":6},"fee schedule","97535 0424-0424|97535 0430-0430|97535 0434-0434|97535 0440-0440|97535 0444-0444",{"$nulls":108},12.33,{"$nulls":6},"fee schedule","97535 0424-0424|97535 0430-0430|97535 0434-0434|97535 0440-0440|97535 0444-0444",{"$nulls":99},12.58,{"$nulls":6},"fee schedule","97535 0424-0424|97535 0430-0430|97535 0434-0434|97535 0440-0440|97535 0444-0444",{"$nulls":72},12.58,{"$nulls":6},"fee schedule","97535 0424-0424|97535 0430-0430|97535 0434-0434|97535 0440-0440|97535 0444-0444",12.58,{"$nulls":6},"fee schedule","97535 0424-0424|97535 0430-0430|97535 0434-0434|97535 0440-0440|97535 0444-0444"]
["Init nb em per day hosp",99460,"CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},118.56,467.05,null,120.93,{"$nulls":6},"fee schedule",{"$nulls":10},118.56,{"$nulls":6},"fee schedule",{"$nulls":28},122.12,{"$nulls":6},"fee schedule",null,118.56,{"$nulls":6},"fee schedule",null,307.29,{"$nulls":6},"fee schedule",{"$nulls":10},118.56,{"$nulls":6},"fee schedule",{"$nulls":10},205.02,{"$nulls":6},"fee schedule",null,467.05,{"$nulls":6},"fee schedule",{"$nulls":19},118.56,{"$nulls":6},"fee schedule",null,465.05,{"$nulls":6},"fee schedule",{"$nulls":46},126.98,{"$nulls":6},"fee schedule",null,118.56,{"$nulls":6},"fee schedule",{"$nulls":46},118.56,{"$nulls":6},"fee schedule",{"$nulls":19},118.56,{"$nulls":6},"fee schedule",{"$nulls":28},118.56,{"$nulls":6},"fee schedule",{"$nulls":10},126.98,{"$nulls":6},"fee schedule",{"$nulls":10},126.98,{"$nulls":6},"fee schedule",null,118.56,{"$nulls":6},"fee schedule",{"$nulls":28},118.56,{"$nulls":6},"fee schedule"]
["Home lancing/test cartridges","A4271","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},33.43,80.9,null,34.1,{"$nulls":6},"fee schedule",{"$nulls":10},33.43,{"$nulls":6},"fee schedule",{"$nulls":28},34.43,{"$nulls":6},"fee schedule",null,33.43,{"$nulls":6},"fee schedule",null,80.9,{"$nulls":6},"fee schedule",{"$nulls":10},33.43,{"$nulls":6},"fee schedule",{"$nulls":46},33.43,{"$nulls":6},"fee schedule",{"$nulls":55},33.43,{"$nulls":6},"fee schedule",null,33.43,{"$nulls":6},"fee schedule",{"$nulls":46},33.43,{"$nulls":6},"fee schedule",{"$nulls":19},33.43,{"$nulls":6},"fee schedule",{"$nulls":28},33.43,{"$nulls":6},"fee schedule",{"$nulls":10},33.43,{"$nulls":6},"fee schedule",{"$nulls":10},33.43,{"$nulls":6},"fee schedule",null,33.43,{"$nulls":6},"fee schedule",{"$nulls":28},33.43,{"$nulls":6},"fee schedule"]
["Ostomy irrig cone/cath w brs","A4399","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},50,61.1,{"$nulls":110},50,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",null,60.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":28},61.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file"]
["Disk/foam pad +or- adhesive","A5126","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},50,61.1,{"$nulls":110},50,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",null,60.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":28},61.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file"]
["Gc stocking full lngth 40+","A6538","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},99.95,241.88,null,101.95,{"$nulls":6},"fee schedule",{"$nulls":10},99.95,{"$nulls":6},"fee schedule",{"$nulls":28},102.95,{"$nulls":6},"fee schedule",null,99.95,{"$nulls":6},"fee schedule",null,241.88,{"$nulls":6},"fee schedule",{"$nulls":10},99.95,{"$nulls":6},"fee schedule",{"$nulls":11},50,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",null,60.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":18},99.95,{"$nulls":6},"fee schedule",null,null,61.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":45},99.95,{"$nulls":6},"fee schedule",null,99.95,{"$nulls":6},"fee schedule",{"$nulls":46},99.95,{"$nulls":6},"fee schedule",{"$nulls":19},99.95,{"$nulls":6},"fee schedule",{"$nulls":28},99.95,{"$nulls":6},"fee schedule",{"$nulls":10},99.95,{"$nulls":6},"fee schedule",{"$nulls":10},99.95,{"$nulls":6},"fee schedule",null,99.95,{"$nulls":6},"fee schedule",{"$nulls":28},99.95,{"$nulls":6},"fee schedule"]
["Disposable compressor filter","A7013","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},50,61.1,{"$nulls":110},50,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",null,60.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":28},61.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file"]
["Enteral feed sup kit grav by","B4036","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},5.31,5.31,{"$nulls":110},50,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",null,60.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":28},61.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":189},5.31,{"$nulls":6},"fee schedule"]
["Insrt a & v pm w/l vent lead","C7539","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},5856.77,5856.77,{"$nulls":110},50,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",null,60.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":28},61.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":198},5856.77,{"$nulls":6},"case rate"]
["Inj  aponvie  1 mg","C9145","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},1.86,4.62,null,1.95,{"$nulls":6},"fee schedule",{"$nulls":10},1.91,{"$nulls":6},"fee schedule",{"$nulls":28},1.97,{"$nulls":6},"fee schedule",null,1.91,{"$nulls":6},"fee schedule",null,4.62,{"$nulls":6},"fee schedule",{"$nulls":10},1.91,{"$nulls":6},"fee schedule",{"$nulls":10},2.04,{"$nulls":6},"fee schedule",null,2.41,{"$nulls":6},"fee schedule",{"$nulls":19},1.91,{"$nulls":6},"fee schedule",null,2.41,{"$nulls":6},"fee schedule",{"$nulls":46},1.92,{"$nulls":6},"fee schedule",null,1.91,{"$nulls":6},"fee schedule",{"$nulls":46},1.91,{"$nulls":6},"fee schedule",{"$nulls":19},1.91,{"$nulls":6},"fee schedule",{"$nulls":28},1.91,{"$nulls":6},"fee schedule",{"$nulls":10},1.86,{"$nulls":6},"fee schedule",{"$nulls":10},1.91,{"$nulls":6},"fee schedule",null,1.91,{"$nulls":6},"fee schedule",{"$nulls":28},1.91,{"$nulls":6},"fee schedule"]
["Analysis of saliva sample","D0418","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},50,61.1,{"$nulls":110},50,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",null,60.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":28},61.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file"]
["Dental onlay porcelin 2 surf","D2642","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},203.38,3964.58,null,1560.24,{"$nulls":6},"fee schedule",null,209.48,{"$nulls":6},"case rate",null,1529.65,{"$nulls":6},"fee schedule",{"$nulls":28},1575.54,{"$nulls":6},"fee schedule",null,1529.65,{"$nulls":6},"fee schedule",null,3964.58,{"$nulls":6},"fee schedule",{"$nulls":10},1529.65,{"$nulls":6},"fee schedule",{"$nulls":10},1101.19,{"$nulls":6},"fee schedule",null,null,60.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",203.38,{"$nulls":6},"case rate",{"$nulls":10},1529.65,{"$nulls":6},"fee schedule",null,null,61.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":45},1638.26,{"$nulls":6},"fee schedule",null,1529.65,{"$nulls":6},"fee schedule",{"$nulls":10},207.45,{"$nulls":6},"case rate",{"$nulls":28},1529.65,{"$nulls":6},"fee schedule",{"$nulls":19},1529.65,{"$nulls":6},"fee schedule",{"$nulls":10},207.45,{"$nulls":6},"case rate",null,207.45,{"$nulls":6},"case rate",null,1529.65,{"$nulls":6},"fee schedule",{"$nulls":10},1638.26,{"$nulls":6},"fee schedule",{"$nulls":10},1638.26,{"$nulls":6},"fee schedule",null,1529.65,{"$nulls":6},"fee schedule",{"$nulls":28},1529.65,{"$nulls":6},"fee schedule"]
["Scaling gingiv inflammation","D4346","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},203.38,3964.58,null,1560.24,{"$nulls":6},"fee schedule",null,209.48,{"$nulls":6},"case rate",null,1529.65,{"$nulls":6},"fee schedule",{"$nulls":28},1575.54,{"$nulls":6},"fee schedule",null,1529.65,{"$nulls":6},"fee schedule",null,3964.58,{"$nulls":6},"fee schedule",{"$nulls":10},1529.65,{"$nulls":6},"fee schedule",{"$nulls":28},203.38,{"$nulls":6},"case rate",{"$nulls":10},1529.65,{"$nulls":6},"fee schedule",{"$nulls":55},1638.26,{"$nulls":6},"fee schedule",null,1529.65,{"$nulls":6},"fee schedule",{"$nulls":10},207.45,{"$nulls":6},"case rate",{"$nulls":28},1529.65,{"$nulls":6},"fee schedule",{"$nulls":19},1529.65,{"$nulls":6},"fee schedule",{"$nulls":10},207.45,{"$nulls":6},"case rate",null,207.45,{"$nulls":6},"case rate",null,1529.65,{"$nulls":6},"fee schedule",{"$nulls":10},1638.26,{"$nulls":6},"fee schedule",{"$nulls":10},1638.26,{"$nulls":6},"fee schedule",null,1529.65,{"$nulls":6},"fee schedule",{"$nulls":28},1529.65,{"$nulls":6},"fee schedule"]
["Recement supp part denture","D6093","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},203.38,209.48,{"$nulls":10},209.48,{"$nulls":6},"case rate",{"$nulls":92},50,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",null,60.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",203.38,{"$nulls":6},"case rate",{"$nulls":20},61.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":72},207.45,{"$nulls":6},"case rate",{"$nulls":73},207.45,{"$nulls":6},"case rate",null,207.45,{"$nulls":6},"case rate"]
["Dental connector bar","D6920","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},273.12,3964.58,null,1560.24,{"$nulls":6},"fee schedule",null,281.31,{"$nulls":6},"case rate",null,1529.65,{"$nulls":6},"fee schedule",{"$nulls":28},1575.54,{"$nulls":6},"fee schedule",null,1529.65,{"$nulls":6},"fee schedule",null,3964.58,{"$nulls":6},"fee schedule",{"$nulls":10},1529.65,{"$nulls":6},"fee schedule",{"$nulls":10},1500.42,{"$nulls":6},"fee schedule",null,3423.79,{"$nulls":6},"fee schedule",null,273.12,{"$nulls":6},"case rate",{"$nulls":10},1529.65,{"$nulls":6},"fee schedule",null,3409.12,{"$nulls":6},"fee schedule",{"$nulls":46},1638.26,{"$nulls":6},"fee schedule",null,1529.65,{"$nulls":6},"fee schedule",{"$nulls":10},278.58,{"$nulls":6},"case rate",{"$nulls":28},1529.65,{"$nulls":6},"fee schedule",{"$nulls":19},1529.65,{"$nulls":6},"fee schedule",{"$nulls":10},278.58,{"$nulls":6},"case rate",null,278.58,{"$nulls":6},"case rate",null,1529.65,{"$nulls":6},"fee schedule",{"$nulls":10},1638.26,{"$nulls":6},"fee schedule",{"$nulls":10},1638.26,{"$nulls":6},"fee schedule",null,1529.65,{"$nulls":6},"fee schedule",{"$nulls":28},1529.65,{"$nulls":6},"fee schedule"]
["Excision of salivary gland","D7981","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},50,61.1,{"$nulls":110},50,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",null,60.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":28},61.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file"]
["Hospital bed var ht w/ mattr","E0255","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},50,61.1,{"$nulls":110},50,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",null,60.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":28},61.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file"]
["W/c acc saf belt pelv strap","E0978","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},50,61.1,{"$nulls":110},50,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",null,60.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":28},61.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file"]
["Pwr seat combo w/shear","E1007","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},50,61.1,{"$nulls":110},50,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",null,60.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":28},61.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file"]
["Pwr wc dr wh motor/gear comb","E2370","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},50,61.1,{"$nulls":110},50,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",null,60.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":28},61.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file"]
["Hhc slp ea 15 min","G0161","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},50,61.1,{"$nulls":110},50,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",null,60.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":28},61.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file"]
["Provide inr test mater/equip","G0249","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},118.56,769.07,null,120.93,{"$nulls":6},"fee schedule",{"$nulls":10},118.56,{"$nulls":6},"fee schedule",{"$nulls":28},122.12,{"$nulls":6},"fee schedule",null,118.56,{"$nulls":6},"fee schedule",null,307.29,{"$nulls":6},"fee schedule",{"$nulls":10},118.56,{"$nulls":6},"fee schedule",{"$nulls":10},336.6,{"$nulls":6},"fee schedule",null,769.07,{"$nulls":6},"fee schedule",{"$nulls":19},118.56,{"$nulls":6},"fee schedule",null,765.77,{"$nulls":6},"fee schedule",{"$nulls":46},126.98,{"$nulls":6},"fee schedule",null,118.56,{"$nulls":6},"fee schedule",{"$nulls":46},118.56,{"$nulls":6},"fee schedule",{"$nulls":19},118.56,{"$nulls":6},"fee schedule",{"$nulls":28},118.56,{"$nulls":6},"fee schedule",{"$nulls":10},126.98,{"$nulls":6},"fee schedule",{"$nulls":10},126.98,{"$nulls":6},"fee schedule",null,118.56,{"$nulls":6},"fee schedule",{"$nulls":28},118.56,{"$nulls":6},"fee schedule"]
["Blinded conv. tx mdd clin tr","G2000","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},488.16,1265.23,null,497.93,{"$nulls":6},"fee schedule",{"$nulls":10},488.16,{"$nulls":6},"fee schedule",{"$nulls":28},502.81,{"$nulls":6},"fee schedule",null,488.16,{"$nulls":6},"fee schedule",null,1265.23,{"$nulls":6},"fee schedule",{"$nulls":10},488.16,{"$nulls":6},"fee schedule",{"$nulls":46},488.16,{"$nulls":6},"fee schedule",{"$nulls":55},522.82,{"$nulls":6},"fee schedule",null,488.16,{"$nulls":6},"fee schedule",{"$nulls":46},488.16,{"$nulls":6},"fee schedule",{"$nulls":19},488.16,{"$nulls":6},"fee schedule",{"$nulls":28},488.16,{"$nulls":6},"fee schedule",{"$nulls":28},522.82,{"$nulls":6},"fee schedule",null,488.16,{"$nulls":6},"fee schedule",{"$nulls":28},488.16,{"$nulls":6},"fee schedule"]
["Aripiprazole injection","J0400","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},0.57,0.59,{"$nulls":10},0.59,{"$nulls":6},"fee schedule",{"$nulls":109},0.57,{"$nulls":6},"fee schedule",{"$nulls":100},0.58,{"$nulls":6},"fee schedule",{"$nulls":73},0.58,{"$nulls":6},"fee schedule",null,0.58,{"$nulls":6},"fee schedule"]
["Sterile cefuroxime injection","J0697","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},2.38,2.45,{"$nulls":10},2.45,{"$nulls":6},"fee schedule",{"$nulls":109},2.38,{"$nulls":6},"fee schedule",{"$nulls":100},2.43,{"$nulls":6},"fee schedule",{"$nulls":73},2.43,{"$nulls":6},"fee schedule",null,2.43,{"$nulls":6},"fee schedule"]
["Fecal microbiota jslm 1 ml","J1440","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},63.6,154.49,null,65.12,{"$nulls":6},"fee schedule",{"$nulls":10},63.84,{"$nulls":6},"fee schedule",{"$nulls":28},65.76,{"$nulls":6},"fee schedule",null,63.84,{"$nulls":6},"fee schedule",null,154.49,{"$nulls":6},"fee schedule",{"$nulls":10},63.84,{"$nulls":6},"fee schedule",{"$nulls":10},75.48,{"$nulls":6},"fee schedule",null,79.9,{"$nulls":6},"fee schedule",{"$nulls":19},63.84,{"$nulls":6},"fee schedule",null,79.91,{"$nulls":6},"fee schedule",{"$nulls":46},64.03,{"$nulls":6},"fee schedule",null,63.84,{"$nulls":6},"fee schedule",{"$nulls":46},63.84,{"$nulls":6},"fee schedule",{"$nulls":19},63.84,{"$nulls":6},"fee schedule",{"$nulls":28},63.84,{"$nulls":6},"fee schedule",{"$nulls":10},63.6,{"$nulls":6},"fee schedule",{"$nulls":10},63.84,{"$nulls":6},"fee schedule",null,63.84,{"$nulls":6},"fee schedule",{"$nulls":28},63.84,{"$nulls":6},"fee schedule"]
["Inj  micafungin (par pharm)","J2247","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},0.36,0.37,{"$nulls":10},0.37,{"$nulls":6},"fee schedule",{"$nulls":109},0.36,{"$nulls":6},"fee schedule",{"$nulls":100},0.37,{"$nulls":6},"fee schedule",{"$nulls":73},0.37,{"$nulls":6},"fee schedule",null,0.37,{"$nulls":6},"fee schedule"]
["Inj  vasopressin  1 unit","J2598","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},1.26,1.3,{"$nulls":10},1.3,{"$nulls":6},"fee schedule",{"$nulls":109},1.26,{"$nulls":6},"fee schedule",{"$nulls":100},1.29,{"$nulls":6},"fee schedule",{"$nulls":73},1.29,{"$nulls":6},"fee schedule",null,1.29,{"$nulls":6},"fee schedule"]
["D5w infusion","J7070","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},3.16,3.25,{"$nulls":10},3.25,{"$nulls":6},"fee schedule",{"$nulls":109},3.16,{"$nulls":6},"fee schedule",{"$nulls":100},3.22,{"$nulls":6},"fee schedule",{"$nulls":73},3.22,{"$nulls":6},"fee schedule",null,3.22,{"$nulls":6},"fee schedule"]
["Doxorubicin hcl injection","J9000","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},2.83,2.91,{"$nulls":10},2.91,{"$nulls":6},"fee schedule",{"$nulls":109},2.83,{"$nulls":6},"fee schedule",{"$nulls":100},2.89,{"$nulls":6},"fee schedule",{"$nulls":73},2.89,{"$nulls":6},"fee schedule",null,2.89,{"$nulls":6},"fee schedule"]
["Fludarabine phosphate inj","J9185","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},68.2,168.3,null,69.56,{"$nulls":6},"fee schedule",null,76.58,{"$nulls":6},"fee schedule",null,68.2,{"$nulls":6},"fee schedule",{"$nulls":28},70.25,{"$nulls":6},"fee schedule",null,68.2,{"$nulls":6},"fee schedule",null,165.04,{"$nulls":6},"fee schedule",{"$nulls":10},68.2,{"$nulls":6},"fee schedule",{"$nulls":10},147.9,{"$nulls":6},"fee schedule",null,133.91,{"$nulls":6},"fee schedule",null,74.35,{"$nulls":6},"fee schedule",{"$nulls":10},68.2,{"$nulls":6},"fee schedule",null,135.26,{"$nulls":6},"fee schedule",{"$nulls":46},71.65,{"$nulls":6},"fee schedule",null,68.2,{"$nulls":6},"fee schedule",{"$nulls":10},75.84,{"$nulls":6},"fee schedule",{"$nulls":28},68.2,{"$nulls":6},"fee schedule",{"$nulls":19},68.2,{"$nulls":6},"fee schedule",{"$nulls":10},75.84,{"$nulls":6},"fee schedule",null,75.84,{"$nulls":6},"fee schedule",null,68.2,{"$nulls":6},"fee schedule",{"$nulls":10},168.3,{"$nulls":6},"fee schedule",{"$nulls":10},68.2,{"$nulls":6},"fee schedule",null,68.2,{"$nulls":6},"fee schedule",{"$nulls":28},68.2,{"$nulls":6},"fee schedule"]
["Inj lon tesirin-lpyl 0.075mg","J9359","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},212.12,524.9,null,221.24,{"$nulls":6},"fee schedule",null,223.24,{"$nulls":6},"fee schedule",null,216.9,{"$nulls":6},"fee schedule",{"$nulls":28},223.41,{"$nulls":6},"fee schedule",null,216.9,{"$nulls":6},"fee schedule",null,524.9,{"$nulls":6},"fee schedule",{"$nulls":10},216.9,{"$nulls":6},"fee schedule",{"$nulls":10},222.36,{"$nulls":6},"fee schedule",null,225.55,{"$nulls":6},"fee schedule",null,216.74,{"$nulls":6},"fee schedule",{"$nulls":10},216.9,{"$nulls":6},"fee schedule",null,225.54,{"$nulls":6},"fee schedule",{"$nulls":46},216.74,{"$nulls":6},"fee schedule",null,216.9,{"$nulls":6},"fee schedule",{"$nulls":10},221.07,{"$nulls":6},"fee schedule",{"$nulls":28},216.9,{"$nulls":6},"fee schedule",{"$nulls":19},216.9,{"$nulls":6},"fee schedule",{"$nulls":10},221.07,{"$nulls":6},"fee schedule",null,221.07,{"$nulls":6},"fee schedule",null,216.9,{"$nulls":6},"fee schedule",{"$nulls":10},212.12,{"$nulls":6},"fee schedule",{"$nulls":10},216.9,{"$nulls":6},"fee schedule",null,216.9,{"$nulls":6},"fee schedule",{"$nulls":28},216.9,{"$nulls":6},"fee schedule"]
["Ctlso milwauke initial model","L1000","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},2287.23,5535.1,null,2332.97,{"$nulls":6},"fee schedule",{"$nulls":10},2287.23,{"$nulls":6},"fee schedule",{"$nulls":28},2355.85,{"$nulls":6},"fee schedule",null,2287.23,{"$nulls":6},"fee schedule",null,5535.1,{"$nulls":6},"fee schedule",{"$nulls":10},2287.23,{"$nulls":6},"fee schedule",{"$nulls":11},50,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",null,60.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":18},2287.23,{"$nulls":6},"fee schedule",null,null,61.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":45},2287.23,{"$nulls":6},"fee schedule",null,2287.23,{"$nulls":6},"fee schedule",{"$nulls":46},2287.23,{"$nulls":6},"fee schedule",{"$nulls":19},2287.23,{"$nulls":6},"fee schedule",{"$nulls":28},2287.23,{"$nulls":6},"fee schedule",{"$nulls":10},2287.23,{"$nulls":6},"fee schedule",{"$nulls":10},2287.23,{"$nulls":6},"fee schedule",null,2287.23,{"$nulls":6},"fee schedule",{"$nulls":28},2287.23,{"$nulls":6},"fee schedule"]
["Covers for upright each","L1120","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},49.18,119.02,null,50.16,{"$nulls":6},"fee schedule",{"$nulls":10},49.18,{"$nulls":6},"fee schedule",{"$nulls":28},50.66,{"$nulls":6},"fee schedule",null,49.18,{"$nulls":6},"fee schedule",null,119.02,{"$nulls":6},"fee schedule",{"$nulls":10},49.18,{"$nulls":6},"fee schedule",{"$nulls":11},50,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",null,60.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":18},49.18,{"$nulls":6},"fee schedule",null,null,61.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":45},49.18,{"$nulls":6},"fee schedule",null,49.18,{"$nulls":6},"fee schedule",{"$nulls":46},49.18,{"$nulls":6},"fee schedule",{"$nulls":19},49.18,{"$nulls":6},"fee schedule",{"$nulls":28},49.18,{"$nulls":6},"fee schedule",{"$nulls":10},49.18,{"$nulls":6},"fee schedule",{"$nulls":10},49.18,{"$nulls":6},"fee schedule",null,49.18,{"$nulls":6},"fee schedule",{"$nulls":28},49.18,{"$nulls":6},"fee schedule"]
["Knee disc/dial lock/adj flex","L2425","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},173.65,420.23,null,177.12,{"$nulls":6},"fee schedule",{"$nulls":10},173.65,{"$nulls":6},"fee schedule",{"$nulls":28},178.86,{"$nulls":6},"fee schedule",null,173.65,{"$nulls":6},"fee schedule",null,420.23,{"$nulls":6},"fee schedule",{"$nulls":10},173.65,{"$nulls":6},"fee schedule",{"$nulls":11},50,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",null,60.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":18},173.65,{"$nulls":6},"fee schedule",null,null,61.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":45},173.65,{"$nulls":6},"fee schedule",null,173.65,{"$nulls":6},"fee schedule",{"$nulls":46},173.65,{"$nulls":6},"fee schedule",{"$nulls":19},173.65,{"$nulls":6},"fee schedule",{"$nulls":28},173.65,{"$nulls":6},"fee schedule",{"$nulls":10},173.65,{"$nulls":6},"fee schedule",{"$nulls":10},173.65,{"$nulls":6},"fee schedule",null,173.65,{"$nulls":6},"fee schedule",{"$nulls":28},173.65,{"$nulls":6},"fee schedule"]
["Replace strap  any orthosis","L4002","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},50,61.1,{"$nulls":110},50,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",null,60.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":28},61.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file"]
["Ankle control ortho pre ots","L4350","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},118.46,286.67,null,120.83,{"$nulls":6},"fee schedule",{"$nulls":10},118.46,{"$nulls":6},"fee schedule",{"$nulls":28},122.01,{"$nulls":6},"fee schedule",null,118.46,{"$nulls":6},"fee schedule",null,286.67,{"$nulls":6},"fee schedule",{"$nulls":10},118.46,{"$nulls":6},"fee schedule",{"$nulls":11},50,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",null,60.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":18},118.46,{"$nulls":6},"fee schedule",null,null,61.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":45},118.46,{"$nulls":6},"fee schedule",null,118.46,{"$nulls":6},"fee schedule",{"$nulls":46},118.46,{"$nulls":6},"fee schedule",{"$nulls":19},118.46,{"$nulls":6},"fee schedule",{"$nulls":28},118.46,{"$nulls":6},"fee schedule",{"$nulls":10},118.46,{"$nulls":6},"fee schedule",{"$nulls":10},118.46,{"$nulls":6},"fee schedule",null,118.46,{"$nulls":6},"fee schedule",{"$nulls":28},118.46,{"$nulls":6},"fee schedule"]
["Vertical shock reducing pylo","L5988","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},2424.7,5867.77,null,2473.19,{"$nulls":6},"fee schedule",{"$nulls":10},2424.7,{"$nulls":6},"fee schedule",{"$nulls":28},2497.44,{"$nulls":6},"fee schedule",null,2424.7,{"$nulls":6},"fee schedule",null,5867.77,{"$nulls":6},"fee schedule",{"$nulls":10},2424.7,{"$nulls":6},"fee schedule",{"$nulls":11},50,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",null,60.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":18},2424.7,{"$nulls":6},"fee schedule",null,null,61.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":45},2424.7,{"$nulls":6},"fee schedule",null,2424.7,{"$nulls":6},"fee schedule",{"$nulls":46},2424.7,{"$nulls":6},"fee schedule",{"$nulls":19},2424.7,{"$nulls":6},"fee schedule",{"$nulls":28},2424.7,{"$nulls":6},"fee schedule",{"$nulls":10},2424.7,{"$nulls":6},"fee schedule",{"$nulls":10},2424.7,{"$nulls":6},"fee schedule",null,2424.7,{"$nulls":6},"fee schedule",{"$nulls":28},2424.7,{"$nulls":6},"fee schedule"]
["Electron elbow child switch","L7186","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},10616.81,25692.68,null,10829.15,{"$nulls":6},"fee schedule",{"$nulls":10},10616.81,{"$nulls":6},"fee schedule",{"$nulls":28},10935.31,{"$nulls":6},"fee schedule",null,10616.81,{"$nulls":6},"fee schedule",null,25692.68,{"$nulls":6},"fee schedule",{"$nulls":10},10616.81,{"$nulls":6},"fee schedule",{"$nulls":11},50,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",null,60.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":18},10616.81,{"$nulls":6},"fee schedule",null,null,61.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":45},10616.81,{"$nulls":6},"fee schedule",null,10616.81,{"$nulls":6},"fee schedule",{"$nulls":46},10616.81,{"$nulls":6},"fee schedule",{"$nulls":19},10616.81,{"$nulls":6},"fee schedule",{"$nulls":28},10616.81,{"$nulls":6},"fee schedule",{"$nulls":10},10616.81,{"$nulls":6},"fee schedule",{"$nulls":10},10616.81,{"$nulls":6},"fee schedule",null,10616.81,{"$nulls":6},"fee schedule",{"$nulls":28},10616.81,{"$nulls":6},"fee schedule"]
["Screening pap smear by phys","P3001","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},92.43,92.43,{"$nulls":361},92.43,{"$nulls":6},"fee schedule","P3001: RC 0310-0312|P3001: RC 0314|P3001: RC 0319"]
["Azithromycin dihydrate  oral","Q0144","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},50,61.1,{"$nulls":110},50,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",null,60.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":28},61.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file"]
["Graftjacket","Q4107","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},50,61.1,{"$nulls":110},50,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",null,60.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":28},61.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file"]
["Reguard  topical use per sq","Q4255","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},0.5,0.5,{"$nulls":109},0.5,{"$nulls":6},"fee schedule"]
["Nivestym","Q5110","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},0.27,0.99,null,0.31,{"$nulls":6},"fee schedule",null,0.28,{"$nulls":6},"fee schedule",null,0.3,{"$nulls":6},"fee schedule",{"$nulls":28},0.31,{"$nulls":6},"fee schedule",null,0.3,{"$nulls":6},"fee schedule",null,0.73,{"$nulls":6},"fee schedule",{"$nulls":10},0.3,{"$nulls":6},"fee schedule",{"$nulls":10},0.5,{"$nulls":6},"fee schedule",null,0.98,{"$nulls":6},"fee schedule",null,0.27,{"$nulls":6},"fee schedule",{"$nulls":10},0.3,{"$nulls":6},"fee schedule",null,0.99,{"$nulls":6},"fee schedule",{"$nulls":46},0.29,{"$nulls":6},"fee schedule",null,0.3,{"$nulls":6},"fee schedule",{"$nulls":10},0.28,{"$nulls":6},"fee schedule",{"$nulls":28},0.3,{"$nulls":6},"fee schedule",{"$nulls":19},0.3,{"$nulls":6},"fee schedule",{"$nulls":10},0.28,{"$nulls":6},"fee schedule",null,0.28,{"$nulls":6},"fee schedule",null,0.3,{"$nulls":6},"fee schedule",{"$nulls":10},0.29,{"$nulls":6},"fee schedule",{"$nulls":10},0.3,{"$nulls":6},"fee schedule",null,0.3,{"$nulls":6},"fee schedule",{"$nulls":28},0.3,{"$nulls":6},"fee schedule"]
["Lens sphcyl bifo 7.25-12/4.2","V2213","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},102.31,247.59,null,104.36,{"$nulls":6},"fee schedule",{"$nulls":10},102.31,{"$nulls":6},"fee schedule",{"$nulls":28},105.38,{"$nulls":6},"fee schedule",null,102.31,{"$nulls":6},"fee schedule",null,247.59,{"$nulls":6},"fee schedule",{"$nulls":10},102.31,{"$nulls":6},"fee schedule",{"$nulls":11},50,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",null,60.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":18},102.31,{"$nulls":6},"fee schedule",null,null,61.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":45},102.31,{"$nulls":6},"fee schedule",null,102.31,{"$nulls":6},"fee schedule",{"$nulls":46},102.31,{"$nulls":6},"fee schedule",{"$nulls":19},102.31,{"$nulls":6},"fee schedule",{"$nulls":28},102.31,{"$nulls":6},"fee schedule",{"$nulls":10},102.31,{"$nulls":6},"fee schedule",{"$nulls":10},102.31,{"$nulls":6},"fee schedule",null,102.31,{"$nulls":6},"fee schedule",{"$nulls":28},102.31,{"$nulls":6},"fee schedule"]
["Scratch resistant coating","V2760","CPT",{"$nulls":6},"facility","outpatient",{"$nulls":5},50,61.1,{"$nulls":110},50,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",null,60.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file",{"$nulls":28},61.1,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file"]
["Medical/Surgical Supplies: Other supplies/devices",279,"RC",{"$nulls":6},"facility","outpatient",{"$nulls":5},82.2,82.2,{"$nulls":362},82.2,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file"]
["Med - Surg Supplies Ext. of 270: Incident to radiology",621,"RC",{"$nulls":6},"facility","outpatient",{"$nulls":5},82.2,82.2,{"$nulls":362},82.2,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file"]
["Home supplies",852,"RC",{"$nulls":6},"facility","outpatient",{"$nulls":5},82.2,82.2,{"$nulls":362},82.2,{"$nulls":4},0,"percent of total billed charges","Zero remittances of the item or service received in the 12 months prior to posting the file"]
["EXCISION BENIGN LESION, TRUNK/ARM/LEG 1.1-2.0",11402,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},100,155,{"$nulls":29},35,null,116.302399999999,29.86,191.98,"1 through 10","percent of total billed charges","fee schedule rate applies to non-facility place of service",null,42,null,116.302399999999,29.86,191.98,"1 through 10","percent of total billed charges","fee schedule rate applies to non-facility place of service",null,42,null,116.302399999999,29.86,191.98,"1 through 10","percent of total billed charges","fee schedule rate applies to non-facility place of service",{"$nulls":108},100,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service",{"$nulls":9},155,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service",{"$nulls":10},43,null,116.302399999999,29.86,191.98,"1 through 10","percent of total billed charges","fee schedule rate applies to non-facility place of service",{"$nulls":72},154.6,{"$nulls":6},"other","fee schedule rate applies to non-facility place of service",{"$nulls":19},34,null,116.302399999999,29.86,191.98,"1 through 10","percent of total billed charges","fee schedule rate applies to non-facility place of service",{"$nulls":73},34,null,116.302399999999,29.86,191.98,"1 through 10","percent of total billed charges","fee schedule rate applies to non-facility place of service"]
["SIMPLE REPAIR FACE/EYELID/NOSE/LIP, 5.1-7.5 C",12014,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},26,44,{"$nulls":29},36,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,43,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,43,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":28},35,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":82},34,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},44,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},26,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},35,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},35,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["TISSUE TRANSFER SCALP/ARMS/LEGS 10 SQ CM",14020,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},24,42,{"$nulls":29},34,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,41,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,41,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":28},34,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":82},33,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},42,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},24,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},33,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},33,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["DRESS/DEBRIDE BURN, W/O ANESTH, LARGE",16030,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},25,45,{"$nulls":29},36,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,43,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,43,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":28},35,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":82},34,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},45,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},25,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},35,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},35,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["MONITOR INTERSTITIAL FLUID PRESSURE, MUSCLE",20950,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},25,43,{"$nulls":29},34,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,41,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,41,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":28},34,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":82},33,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},43,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},25,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},34,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},34,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["EXC TUMOR SOFT TISSUE SHOULDER >3CM",23071,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},387.4,561.24,{"$nulls":181},561.24,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service",{"$nulls":90},387.4,{"$nulls":6},"other","fee schedule rate applies to non-facility place of service"]
["REMOVAL OF COLLAR BONE",23125,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},23,43,{"$nulls":29},35,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,42,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,42,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":28},34,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":82},33,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},43,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},23,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},34,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},34,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["CLOSED TREATMENT HUMERAL SHAFT FX W/MANIP",24505,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},473.19,620.77,{"$nulls":181},620.77,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service",{"$nulls":90},473.19,{"$nulls":6},"other","fee schedule rate applies to non-facility place of service"]
["FOREARM/WRIST SEQUESTRECTOMY",25145,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},25,43,{"$nulls":29},35,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,41,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,41,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":28},34,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":82},33,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},43,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},25,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},34,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},34,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["ARTHROPLASTY W/REPLACEMENT DISTAL RADIUS",25441,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},24,42,{"$nulls":29},34,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,40,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,40,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":28},33,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":82},32,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},42,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},24,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},33,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},33,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["RAD RESECTION,HAND/FINGER SOFT TISSUE TUMOR",26117,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},24,42,{"$nulls":29},34,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,41,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,41,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":28},34,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":82},33,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},42,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},24,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},33,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},33,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["OSTEOTOMY FOR DEFORMITY OF PHALANX/FINGER",26567,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},26,45,{"$nulls":29},36,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,43,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,43,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":28},36,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":82},35,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},45,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},26,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},35,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},35,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["ARTHROD IP JOINT W/WO FIXATION",26860,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},27,46,{"$nulls":29},37,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,44,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,44,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":28},37,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":82},36,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},46,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},27,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},36,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},36,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["OPEN TREAT ACETABULAR FX W/COMP DETACH W/FIX",27228,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},1712.74,2305.53,{"$nulls":181},2305.53,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service",{"$nulls":90},1712.74,{"$nulls":6},"other","fee schedule rate applies to non-facility place of service"]
["RECONSTRUCT RECURRENT DISLOCATING PATELLA",27420,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},689.51,961.96,{"$nulls":181},961.96,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service",{"$nulls":90},689.51,{"$nulls":6},"other","fee schedule rate applies to non-facility place of service"]
["OPEN TREAT FEMORAL SUPRA/TRANSCONDYLAR FX",27511,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},910.36,1691.33,{"$nulls":163},1513,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service",{"$nulls":9},1691.33,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service",{"$nulls":90},910.36,{"$nulls":6},"other","fee schedule rate applies to non-facility place of service"]
["SECONDARY REPAIR/SUTURE TORN ANKLE LIGAMENTS",27698,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},589.07,1025.75,{"$nulls":181},1025.75,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service",{"$nulls":90},589.07,{"$nulls":6},"other","fee schedule rate applies to non-facility place of service"]
["OPEN TREAT ARTICULAR DISTAL TIBIA, FIBULA",27826,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},781.07,1372.03,{"$nulls":181},1372.03,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service",{"$nulls":90},781.07,{"$nulls":6},"other","fee schedule rate applies to non-facility place of service"]
["REPAIR/SUTURE,FOOT FLEXOR TENDON, SINGLE",28200,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},444.45,554.85,{"$nulls":181},554.85,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service",{"$nulls":90},444.45,{"$nulls":6},"other","fee schedule rate applies to non-facility place of service"]
["CLOSED TREATMENT FX OF SESAMOID BONE",28530,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},110.98,159.44,{"$nulls":181},159.44,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service",{"$nulls":90},110.98,{"$nulls":6},"other","fee schedule rate applies to non-facility place of service"]
["STRAPPING OF SHOULDER",29240,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},25,42,{"$nulls":29},34,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,41,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,41,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":28},34,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":82},33,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},42,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},25,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},33,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},33,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["KNEE ARTHROSCOPY/ABRASION ARTHROPLASTY",29879,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},24,42,{"$nulls":29},34,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,41,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,41,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":28},34,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":82},33,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},42,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},24,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},33,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},33,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["INSERT/REPLACE PULSE GENERATOR,ONLY,DUAL",33213,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},24,41,{"$nulls":29},33,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,40,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,40,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":28},33,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":82},32,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},41,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},24,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},32,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},32,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["ARTERY BYPASS GRAFT",35531,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},1733.07,2076.71,{"$nulls":181},2076.71,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service",{"$nulls":90},1733.07,{"$nulls":6},"other","fee schedule rate applies to non-facility place of service"]
["ARTERY BYPASS GRAFT",35606,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},23,40,{"$nulls":29},32,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,38,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,38,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":28},32,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":82},31,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},40,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},23,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},31,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},31,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["CESSJ THERAPY CATH REMOVAL",37214,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},23,39,{"$nulls":29},32,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,38,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,38,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":28},31,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":82},30,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},39,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},23,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},31,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},31,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["INCISION OF LINGUAL FRENUM FRENOTOMY",41010,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},25,42,{"$nulls":29},34,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,41,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,41,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":28},34,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":82},33,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},42,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},25,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},33,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},33,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["NASO OR ORO-GASTRIC TUBE PLACEMENT",43752,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},23,39,{"$nulls":29},32,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,38,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,38,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":28},31,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":82},30,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},39,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},23,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},31,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},31,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["PARTIAL REMOVAL OF COLON",44146,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},36,63,{"$nulls":29},51,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,60,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,60,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":28},50,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":82},48,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},63,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},36,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},49,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},49,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["APPENDECTOMY ADD-ON",44955,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},23,41,{"$nulls":29},33,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,39,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,39,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":28},32,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":82},31,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},41,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},23,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},32,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},32,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["COLONOSCOPY W BAND LIGATION",45398,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},29,49,{"$nulls":29},40,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,47,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,47,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":28},39,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":82},38,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},49,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},29,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},39,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["LAPARO DRAIN LYMPHOCELE",49323,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},24,42,{"$nulls":29},34,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,40,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,40,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":28},33,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":82},32,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},42,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},24,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},33,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},33,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["URETERONEOCYSTOSTOMY; WITH VESICO-PSOAS HITCH OR BLADDER FLAP",50785,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},1107.85,1581.67,{"$nulls":181},1581.67,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service",{"$nulls":90},1107.85,{"$nulls":6},"other","fee schedule rate applies to non-facility place of service"]
["CYSTOURETHROSCOPY, WITH BIOPSY(S)",52204,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},317.35,622.89,{"$nulls":38},36,null,210.526377777777,162,129,"1 through 10","percent of total billed charges","fee schedule rate applies to non-facility place of service",null,36,null,210.526377777777,162,129,"1 through 10","percent of total billed charges","fee schedule rate applies to non-facility place of service",{"$nulls":118},29,null,210.526377777777,162,129,"1 through 10","percent of total billed charges","fee schedule rate applies to non-facility place of service",622.89,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service",{"$nulls":10},38,null,210.526377777777,162,129,"1 through 10","percent of total billed charges","fee schedule rate applies to non-facility place of service",{"$nulls":72},317.35,{"$nulls":6},"other","fee schedule rate applies to non-facility place of service",{"$nulls":100},30,null,210.526377777777,162,129,"1 through 10","percent of total billed charges","fee schedule rate applies to non-facility place of service"]
["I&D SCROTAL ABSCESS",54700,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},196.47,296.57,{"$nulls":163},228,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service",{"$nulls":9},296.57,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service",{"$nulls":90},196.47,{"$nulls":6},"other","fee schedule rate applies to non-facility place of service"]
["REVISE VAG GRAFT VIA VAGINA",57295,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},458.29,565.48,{"$nulls":181},565.48,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service",{"$nulls":90},458.29,{"$nulls":6},"other","fee schedule rate applies to non-facility place of service"]
["VAG HYST W/URINARY REPAIR",58267,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},975.24,1494.5,{"$nulls":181},1494.5,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service",{"$nulls":90},975.24,{"$nulls":6},"other","fee schedule rate applies to non-facility place of service"]
["TREAT ECTOPIC PREGNANCY",59120,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},741.11,1340.37,{"$nulls":181},1340.37,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service",{"$nulls":90},741.11,{"$nulls":6},"other","fee schedule rate applies to non-facility place of service"]
["REPAIR HAND/FOOT NERVE, MEDIAN MOTOR",64835,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},24,42,{"$nulls":29},34,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,41,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,41,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":28},34,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":82},33,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},42,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},24,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},33,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},33,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["REMOVE OBJECT FROM EXT EYE, SUPERFIC CONJUNCT",65205,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},25.94,65.72,{"$nulls":181},65.72,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service",{"$nulls":90},25.94,{"$nulls":6},"other","fee schedule rate applies to non-facility place of service"]
["THORACIC SPINE 1 VIEW",72020,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},18,40,{"$nulls":29},34,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,40,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,40,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":28},33,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":82},32,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},35,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},18,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},33,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},33,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["XRAY HIPS BILATERAL W PELVIS 2 VIEWS",73521,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},36.98,69,{"$nulls":47},45,null,31.3088444444444,13.75,7.65,"1 through 10","percent of total billed charges","fee schedule rate applies to non-facility place of service",{"$nulls":126},69,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service",{"$nulls":90},36.98,{"$nulls":6},"other","fee schedule rate applies to non-facility place of service",{"$nulls":100},36,null,31.3088444444444,13.75,7.65,"1 through 10","percent of total billed charges","fee schedule rate applies to non-facility place of service"]
["XRAY FEMUR 1 VIEW",73551,"CPT",{"$nulls":6},"professional","both",null,null,26,null,null,19,26.53,{"$nulls":181},19,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service",{"$nulls":90},26.53,{"$nulls":6},"other","fee schedule rate applies to non-facility place of service"]
["FETAL MIDL CEREBRAL ARTERY ECHO",76821,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},78.91,120.87,{"$nulls":181},120.87,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service",{"$nulls":90},78.91,{"$nulls":6},"other","fee schedule rate applies to non-facility place of service"]
["RADIATION TREATMENT AID(S)",77332,"CPT",{"$nulls":6},"professional","both",null,null,26,null,null,17,40,{"$nulls":38},40,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,40,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":28},33,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":109},36,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},17,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},33,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["FLU SWAB",87804,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},16.5,30,{"$nulls":163},16.5,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service",{"$nulls":9},30,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["VARICELLA, CHICKEN POX VACCINE",90716,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},230.39,230.39,{"$nulls":181},230.39,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["ELECTROCARDIOGRAM (ROUTINE ECG), REPORT ONLY",93010,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},7.38,17.01,{"$nulls":29},31,null,5.55126666666666,5.89,7.71,624,"percent of total billed charges","fee schedule rate applies to non-facility place of service",null,37,null,5.55126666666666,5.89,7.71,328,"percent of total billed charges","fee schedule rate applies to non-facility place of service",null,37,null,5.55126666666666,5.89,7.71,747,"percent of total billed charges","fee schedule rate applies to non-facility place of service",{"$nulls":28},31,null,5.55126666666666,5.89,7.71,44,"percent of total billed charges","fee schedule rate applies to non-facility place of service",{"$nulls":72},15,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service",null,30,null,5.55126666666666,5.89,7.71,787,"percent of total billed charges","fee schedule rate applies to non-facility place of service",17.01,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service",{"$nulls":10},33,null,5.55126666666666,5.89,7.71,412,"percent of total billed charges","fee schedule rate applies to non-facility place of service",{"$nulls":19},23,null,5.55126666666666,5.89,7.71,44,"percent of total billed charges","fee schedule rate applies to non-facility place of service",{"$nulls":45},7.38,{"$nulls":6},"other","fee schedule rate applies to non-facility place of service",{"$nulls":19},31,null,5.55126666666666,5.89,7.71,467,"percent of total billed charges","fee schedule rate applies to non-facility place of service",{"$nulls":73},31,null,5.55126666666666,5.89,7.71,2678,"percent of total billed charges","fee schedule rate applies to non-facility place of service"]
["DOPPLER COLOR FLOW ADD-ON",93325,"CPT",{"$nulls":6},"professional","both",null,null,26,null,null,32,170,{"$nulls":83},32,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":136},170,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["ELECTROPHYSIOLOGY EVALUATION",93641,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},501.51,674.97,{"$nulls":181},674.97,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service",{"$nulls":90},501.51,{"$nulls":6},"other","fee schedule rate applies to non-facility place of service"]
["ALLERGY",95115,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},9.42,14.89,{"$nulls":181},14.89,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service",{"$nulls":90},9.42,{"$nulls":6},"other","fee schedule rate applies to non-facility place of service"]
["IV INFUSION CHEMO UP TO ONE HOUR INITIAL DOSE",96413,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},29,36,{"$nulls":29},30,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,36,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,36,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":28},30,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":82},29,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},32,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},29,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},30,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},30,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["CRITICAL CARE, EACH ADDITIONAL 1/2 HOUR",99292,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},26,39,{"$nulls":38},39,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,39,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":28},32,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":109},34,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},26,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},32,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["TRANSITIONAL CARE MANAGEMENT HIGH COMPLEXITY",99496,"CPT",{"$nulls":6},"professional","both",{"$nulls":5},39,49,{"$nulls":29},41,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,49,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,49,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":28},40,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":136},39,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},40,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["CRITICAL CARE TELEHEALTH CONSULT 50M","G0509","CPT",{"$nulls":6},"professional","both",{"$nulls":5},31,39,{"$nulls":29},32,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,39,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",null,39,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":28},32,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":82},31,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},32,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},31,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},32,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":73},32,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["OCTREOTIDE INJ, NON-DEPOT","J2354","CPT",{"$nulls":6},"professional","both",{"$nulls":5},6,6,{"$nulls":227},6,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["BENDEKA 1MG","J9034","CPT",{"$nulls":6},"professional","both",{"$nulls":5},18,18,{"$nulls":227},18,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["AVASTIN 10MG","J9035","CPT",{"$nulls":6},"professional","both",{"$nulls":5},90.85,90.85,{"$nulls":181},90.85,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["AVASTIN 10MG","J9035","CPT",{"$nulls":6},"professional","both",{"$nulls":5},33,33,{"$nulls":227},33,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["BEOMYCIN 15 UNITS","J9040","CPT",{"$nulls":6},"professional","both",{"$nulls":5},29.34,29.34,{"$nulls":181},29.34,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["BEOMYCIN 15 UNITS","J9040","CPT",{"$nulls":6},"professional","both",{"$nulls":5},5,5,{"$nulls":227},5,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["VELCADE BORTEZOMIB INJECTION 0.1MG","J9041","CPT",{"$nulls":6},"professional","both",{"$nulls":5},1.14,1.14,{"$nulls":181},1.14,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["VELCADE BORTEZOMIB INJECTION 0.1MG","J9041","CPT",{"$nulls":6},"professional","both",{"$nulls":5},2,2,{"$nulls":227},2,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["JAVTANA1 MG","J9043","CPT",{"$nulls":6},"professional","both",{"$nulls":5},276.91,276.91,{"$nulls":181},276.91,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["JAVTANA1 MG","J9043","CPT",{"$nulls":6},"professional","both",{"$nulls":5},47,47,{"$nulls":227},47,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["CARBOPLAT 50MG","J9045","CPT",{"$nulls":6},"professional","both",{"$nulls":5},3.91,3.91,{"$nulls":181},3.91,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["CARBOPLAT 50MG","J9045","CPT",{"$nulls":6},"professional","both",{"$nulls":5},2,2,{"$nulls":227},2,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["ERBITUX 10MG","J9055","CPT",{"$nulls":6},"professional","both",{"$nulls":5},95.36,95.36,{"$nulls":181},95.36,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["ERBITUX 10MG","J9055","CPT",{"$nulls":6},"professional","both",{"$nulls":5},45,45,{"$nulls":227},45,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["CISPLATIN 10 MG INJECTION","J9060","CPT",{"$nulls":6},"professional","both",{"$nulls":5},3.05,3.05,{"$nulls":181},3.05,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["CISPLATIN 10 MG INJECTION","J9060","CPT",{"$nulls":6},"professional","both",{"$nulls":5},29,29,{"$nulls":227},29,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["INJ CLADRIBINE PER 1 MG","J9065","CPT",{"$nulls":6},"professional","both",{"$nulls":5},26.68,26.68,{"$nulls":181},26.68,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["INJ CLADRIBINE PER 1 MG","J9065","CPT",{"$nulls":6},"professional","both",{"$nulls":5},19,19,{"$nulls":227},19,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["DACARBAZINE (DTIC)100MG","J9130","CPT",{"$nulls":6},"professional","both",{"$nulls":5},6.11,6.11,{"$nulls":181},6.11,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["DACARBAZINE (DTIC)100MG","J9130","CPT",{"$nulls":6},"professional","both",{"$nulls":5},15,15,{"$nulls":227},15,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["FIRMAGON 1MG DEGARELIX","J9155","CPT",{"$nulls":6},"professional","both",{"$nulls":5},6.35,6.35,{"$nulls":181},6.35,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["FIRMAGON 1MG DEGARELIX","J9155","CPT",{"$nulls":6},"professional","both",{"$nulls":5},37,37,{"$nulls":227},37,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["TAXOTERE 1MG    DOCETAXEL","J9171","CPT",{"$nulls":6},"professional","both",{"$nulls":5},0.86,0.86,{"$nulls":181},0.86,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["TAXOTERE 1MG    DOCETAXEL","J9171","CPT",{"$nulls":6},"professional","both",{"$nulls":5},13,13,{"$nulls":227},13,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["INJ, EPIRUBICIN HCL, 2 MG","J9178","CPT",{"$nulls":6},"professional","both",{"$nulls":5},2.19,2.19,{"$nulls":181},2.19,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["INJ, EPIRUBICIN HCL, 2 MG","J9178","CPT",{"$nulls":6},"professional","both",{"$nulls":5},6,6,{"$nulls":227},6,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["ERIBULIN MESYLATE INJ 0.1MG","J9179","CPT",{"$nulls":6},"professional","both",{"$nulls":5},92.86,92.86,{"$nulls":181},92.86,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["ERIBULIN MESYLATE INJ 0.1MG","J9179","CPT",{"$nulls":6},"professional","both",{"$nulls":5},41,41,{"$nulls":227},41,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["FLUDARA 50MG","J9185","CPT",{"$nulls":6},"professional","both",{"$nulls":5},98.03,98.03,{"$nulls":181},98.03,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["FLUDARA 50MG","J9185","CPT",{"$nulls":6},"professional","both",{"$nulls":5},70,70,{"$nulls":227},70,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["FLUOROURACIL","J9190","CPT",{"$nulls":6},"professional","both",{"$nulls":5},2.1,2.1,{"$nulls":181},2.1,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["FLUOROURACIL","J9190","CPT",{"$nulls":6},"professional","both",{"$nulls":5},22,22,{"$nulls":227},22,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["FLOXURIDINE","J9200","CPT",{"$nulls":6},"professional","both",{"$nulls":5},123.45,123.45,{"$nulls":181},123.45,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["FLOXURIDINE","J9200","CPT",{"$nulls":6},"professional","both",{"$nulls":5},2035,2035,{"$nulls":227},2035,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["GEMZAR 200 MG","J9201","CPT",{"$nulls":6},"professional","both",{"$nulls":5},1.37,1.37,{"$nulls":181},1.37,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["GEMZAR 200 MG","J9201","CPT",{"$nulls":6},"professional","both",{"$nulls":5},2,2,{"$nulls":227},2,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["GOSERELIN ACETATE IMPLANT","J9202","CPT",{"$nulls":6},"professional","both",{"$nulls":5},795.88,795.88,{"$nulls":181},795.88,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["GOSERELIN ACETATE IMPLANT","J9202","CPT",{"$nulls":6},"professional","both",{"$nulls":5},64,64,{"$nulls":227},64,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["ONIVYDE 1MG INJ IRINOTECAN LIPOSOME","J9205","CPT",{"$nulls":6},"professional","both",{"$nulls":5},78.97,78.97,{"$nulls":181},78.97,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["ONIVYDE 1MG INJ IRINOTECAN LIPOSOME","J9205","CPT",{"$nulls":6},"professional","both",{"$nulls":5},51,51,{"$nulls":227},51,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["CAMPTOSAR 20MG","J9206","CPT",{"$nulls":6},"professional","both",{"$nulls":5},2.05,2.05,{"$nulls":181},2.05,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["CAMPTOSAR 20MG","J9206","CPT",{"$nulls":6},"professional","both",{"$nulls":5},17,17,{"$nulls":227},17,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["IXEMPRA 1MG","J9207","CPT",{"$nulls":6},"professional","both",{"$nulls":5},153.1,153.1,{"$nulls":181},153.1,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["IXEMPRA 1MG","J9207","CPT",{"$nulls":6},"professional","both",{"$nulls":5},64,64,{"$nulls":227},64,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["IFOSFOMIDE","J9208","CPT",{"$nulls":6},"professional","both",{"$nulls":5},37.41,37.41,{"$nulls":181},37.41,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["IFOSFOMIDE","J9208","CPT",{"$nulls":6},"professional","both",{"$nulls":5},12,12,{"$nulls":227},12,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["MESNA","J9209","CPT",{"$nulls":6},"professional","both",{"$nulls":5},2.98,2.98,{"$nulls":181},2.98,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["MESNA","J9209","CPT",{"$nulls":6},"professional","both",{"$nulls":5},4,4,{"$nulls":227},4,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["INTRON-A (INTERFERON) 1MU","J9214","CPT",{"$nulls":6},"professional","both",{"$nulls":5},35.04,35.04,{"$nulls":181},35.04,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["INTRON-A (INTERFERON) 1MU","J9214","CPT",{"$nulls":6},"professional","both",{"$nulls":5},33,33,{"$nulls":227},33,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), 7.5MG","J9217","CPT",{"$nulls":6},"professional","both",{"$nulls":5},321.34,321.34,{"$nulls":181},321.34,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), 7.5MG","J9217","CPT",{"$nulls":6},"professional","both",{"$nulls":5},30,30,{"$nulls":227},30,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["IPILIMUMAB 1MG YERVOY","J9228","CPT",{"$nulls":6},"professional","both",{"$nulls":5},206.44,206.44,{"$nulls":181},206.44,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["IPILIMUMAB 1MG YERVOY","J9228","CPT",{"$nulls":6},"professional","both",{"$nulls":5},41,41,{"$nulls":227},41,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["MECHLORETHAMINE HCL INJ","J9230","CPT",{"$nulls":6},"professional","both",{"$nulls":5},353.07,353.07,{"$nulls":181},353.07,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["MECHLORETHAMINE HCL INJ","J9230","CPT",{"$nulls":6},"professional","both",{"$nulls":5},36,36,{"$nulls":227},36,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["METHOTREXATE 50MG","J9260","CPT",{"$nulls":6},"professional","both",{"$nulls":5},0.68,0.68,{"$nulls":181},0.68,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["METHOTREXATE 50MG","J9260","CPT",{"$nulls":6},"professional","both",{"$nulls":5},6,6,{"$nulls":227},6,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["OXALIPLATIN 0.5MG (ELOXATIN)","J9263","CPT",{"$nulls":6},"professional","both",{"$nulls":5},0.18,0.18,{"$nulls":181},0.18,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["OXALIPLATIN 0.5MG (ELOXATIN)","J9263","CPT",{"$nulls":6},"professional","both",{"$nulls":5},1,1,{"$nulls":227},1,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["PACLITAXEL INJECTION","J9264","CPT",{"$nulls":6},"professional","both",{"$nulls":5},16.21,16.21,{"$nulls":181},16.21,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["PACLITAXEL INJECTION","J9264","CPT",{"$nulls":6},"professional","both",{"$nulls":5},42,42,{"$nulls":227},42,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["TAXOL PACLITAXEL 1MG","J9267","CPT",{"$nulls":6},"professional","both",{"$nulls":5},0.14,0.14,{"$nulls":181},0.14,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["TAXOL PACLITAXEL 1MG","J9267","CPT",{"$nulls":6},"professional","both",{"$nulls":5},2,2,{"$nulls":227},2,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["KEYTRUDA 1MG  INJ PEMBROLIZUMAB","J9271","CPT",{"$nulls":6},"professional","both",{"$nulls":5},67.23,67.23,{"$nulls":181},67.23,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["KEYTRUDA 1MG  INJ PEMBROLIZUMAB","J9271","CPT",{"$nulls":6},"professional","both",{"$nulls":5},39,39,{"$nulls":227},39,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["MITOMYCIN 5 MG INJ","J9280","CPT",{"$nulls":6},"professional","both",{"$nulls":5},102.3,102.3,{"$nulls":181},102.3,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["MITOMYCIN 5 MG INJ","J9280","CPT",{"$nulls":6},"professional","both",{"$nulls":5},12,12,{"$nulls":227},12,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["MITOXANTRONE HYDROCHL / 5 MG","J9293","CPT",{"$nulls":6},"professional","both",{"$nulls":5},45.59,45.59,{"$nulls":181},45.59,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["MITOXANTRONE HYDROCHL / 5 MG","J9293","CPT",{"$nulls":6},"professional","both",{"$nulls":5},68,68,{"$nulls":227},68,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["INJ NOVOLUMAB 1MG  OPDIVO","J9299","CPT",{"$nulls":6},"professional","both",{"$nulls":5},37.73,37.73,{"$nulls":181},37.73,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["INJ NOVOLUMAB 1MG  OPDIVO","J9299","CPT",{"$nulls":6},"professional","both",{"$nulls":5},45,45,{"$nulls":227},45,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["ARZERRA OFATUMUMAB 10MG","J9302","CPT",{"$nulls":6},"professional","both",{"$nulls":5},68.78,68.78,{"$nulls":181},68.78,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["ARZERRA OFATUMUMAB 10MG","J9302","CPT",{"$nulls":6},"professional","both",{"$nulls":5},36,36,{"$nulls":227},36,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["VECTIBIX 10MG","J9303","CPT",{"$nulls":6},"professional","both",{"$nulls":5},206.53,206.53,{"$nulls":181},206.53,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["VECTIBIX 10MG","J9303","CPT",{"$nulls":6},"professional","both",{"$nulls":5},51,51,{"$nulls":227},51,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["ALIMTA 10MG","J9305","CPT",{"$nulls":6},"professional","both",{"$nulls":5},1.14,1.14,{"$nulls":181},1.14,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["ALIMTA 10MG","J9305","CPT",{"$nulls":6},"professional","both",{"$nulls":5},3,3,{"$nulls":227},3,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["PERJETA 1MG PERTUZUMAB","J9306","CPT",{"$nulls":6},"professional","both",{"$nulls":5},18.52,18.52,{"$nulls":181},18.52,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["PERJETA 1MG PERTUZUMAB","J9306","CPT",{"$nulls":6},"professional","both",{"$nulls":5},51,51,{"$nulls":227},51,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["INJ RAMUCIRUMAB 5MG","J9308","CPT",{"$nulls":6},"professional","both",{"$nulls":5},85.55,85.55,{"$nulls":181},85.55,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["INJ RAMUCIRUMAB 5MG","J9308","CPT",{"$nulls":6},"professional","both",{"$nulls":5},44,44,{"$nulls":227},44,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["STREPTOZOCIN INJECTION 1GM","J9320","CPT",{"$nulls":6},"professional","both",{"$nulls":5},1482,1482,{"$nulls":181},1482,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["STREPTOZOCIN INJECTION 1GM","J9320","CPT",{"$nulls":6},"professional","both",{"$nulls":5},35,35,{"$nulls":227},35,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["TEMOZOLOMIDE 1MG","J9328","CPT",{"$nulls":6},"professional","both",{"$nulls":5},11.44,11.44,{"$nulls":181},11.44,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["TORISEL 1MG","J9330","CPT",{"$nulls":6},"professional","both",{"$nulls":5},49.11,49.11,{"$nulls":181},49.11,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["TORISEL 1MG","J9330","CPT",{"$nulls":6},"professional","both",{"$nulls":5},14,14,{"$nulls":227},14,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["TOPOTECAN 0.1 MG HYCAMTIN","J9351","CPT",{"$nulls":6},"professional","both",{"$nulls":5},2.03,2.03,{"$nulls":181},2.03,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["TOPOTECAN 0.1 MG HYCAMTIN","J9351","CPT",{"$nulls":6},"professional","both",{"$nulls":5},3,3,{"$nulls":227},3,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["INJ ADO TRASTUZUMAB EMT 1MG","J9354","CPT",{"$nulls":6},"professional","both",{"$nulls":5},45.49,45.49,{"$nulls":181},45.49,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["INJ ADO TRASTUZUMAB EMT 1MG","J9354","CPT",{"$nulls":6},"professional","both",{"$nulls":5},47,47,{"$nulls":227},47,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["HERCEPTIN (TRASTUZUMAB) 10MG","J9355","CPT",{"$nulls":6},"professional","both",{"$nulls":5},111.44,111.44,{"$nulls":181},111.44,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["HERCEPTIN (TRASTUZUMAB) 10MG","J9355","CPT",{"$nulls":6},"professional","both",{"$nulls":5},26,26,{"$nulls":227},26,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["VELBAN 1MG (VINBLASTINE)","J9360","CPT",{"$nulls":6},"professional","both",{"$nulls":5},5.95,5.95,{"$nulls":181},5.95,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["VELBAN 1MG (VINBLASTINE)","J9360","CPT",{"$nulls":6},"professional","both",{"$nulls":5},40,40,{"$nulls":227},40,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["VINCRISTINE SULFATE 1 MG INJ","J9370","CPT",{"$nulls":6},"professional","both",{"$nulls":5},6.29,6.29,{"$nulls":181},6.29,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["VINCRISTINE SULFATE 1 MG INJ","J9370","CPT",{"$nulls":6},"professional","both",{"$nulls":5},11,11,{"$nulls":227},11,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["NAVELBINE 10MG","J9390","CPT",{"$nulls":6},"professional","both",{"$nulls":5},12.95,12.95,{"$nulls":181},12.95,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["NAVELBINE 10MG","J9390","CPT",{"$nulls":6},"professional","both",{"$nulls":5},4,4,{"$nulls":227},4,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["FULVESTRANT PER 25MG","J9395","CPT",{"$nulls":6},"professional","both",{"$nulls":5},5.7,5.7,{"$nulls":181},5.7,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["FULVESTRANT PER 25MG","J9395","CPT",{"$nulls":6},"professional","both",{"$nulls":5},3,3,{"$nulls":227},3,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["PAP SMEAR SCREENING","Q0091","CPT",{"$nulls":6},"professional","both",{"$nulls":5},40.22,41,{"$nulls":29},33,null,44.7925111111111,44.86,39.93,"1 through 10","percent of total billed charges","fee schedule rate applies to non-facility place of service",null,40,null,44.7925111111111,44.86,39.93,"1 through 10","percent of total billed charges","fee schedule rate applies to non-facility place of service",null,40,null,44.7925111111111,44.86,39.93,21,"percent of total billed charges","fee schedule rate applies to non-facility place of service",{"$nulls":118},32,null,44.7925111111111,44.86,39.93,"1 through 10","percent of total billed charges","fee schedule rate applies to non-facility place of service",41,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service",{"$nulls":90},40.22,{"$nulls":6},"other","fee schedule rate applies to non-facility place of service",{"$nulls":19},33,null,44.7925111111111,44.86,39.93,"1 through 10","percent of total billed charges","fee schedule rate applies to non-facility place of service",{"$nulls":73},33,null,44.7925111111111,44.86,39.93,63,"percent of total billed charges","fee schedule rate applies to non-facility place of service"]
["PAP SMEAR SCREENING","Q0091","CPT",{"$nulls":6},"professional","both",{"$nulls":5},32,33,{"$nulls":83},33,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":109},33,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service ",{"$nulls":19},32,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["WET MOUNTS/ W PREPARATIONS","Q0111","CPT",{"$nulls":6},"professional","both",{"$nulls":5},10.2,10.2,{"$nulls":181},10.2,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["WET MOUNTS/ W PREPARATIONS","Q0111","CPT",{"$nulls":6},"professional","both",{"$nulls":5},65,65,{"$nulls":227},65,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["FERUMOXYTOL FERAHEME 1MG NON ESRD","Q0138","CPT",{"$nulls":6},"professional","both",{"$nulls":5},1.59,1.59,{"$nulls":181},1.59,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["FERUMOXYTOL FERAHEME 1MG NON ESRD","Q0138","CPT",{"$nulls":6},"professional","both",{"$nulls":5},13,13,{"$nulls":227},13,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["AFLURIA VACCINE IM 3 YEARS <","Q2035","CPT",{"$nulls":6},"professional","both",{"$nulls":5},19.2,19.2,{"$nulls":181},19.2,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["AFLURIA VACCINE IM 3 YEARS <","Q2035","CPT",{"$nulls":6},"professional","both",{"$nulls":5},133,133,{"$nulls":227},133,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["FLULAVAL VACC IM 3 YRS <","Q2036","CPT",{"$nulls":6},"professional","both",{"$nulls":5},9.03,9.03,{"$nulls":181},9.03,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["FLULAVAL VACC IM 3 YRS <","Q2036","CPT",{"$nulls":6},"professional","both",{"$nulls":5},51,51,{"$nulls":227},51,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["FLUVIRIN VACC, 3 YRS & >,IM","Q2037","CPT",{"$nulls":6},"professional","both",{"$nulls":5},18.62,18.62,{"$nulls":181},18.62,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["FLUVIRIN VACC, 3 YRS & >,IM","Q2037","CPT",{"$nulls":6},"professional","both",{"$nulls":5},104,104,{"$nulls":227},104,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["FLUZONE VACCINE","Q2038","CPT",{"$nulls":6},"professional","both",{"$nulls":5},12.68,12.68,{"$nulls":181},12.68,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["FLUZONE VACCINE","Q2038","CPT",{"$nulls":6},"professional","both",{"$nulls":5},121,121,{"$nulls":227},121,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["NOS VACC IM 3 YRS <","Q2039","CPT",{"$nulls":6},"professional","both",{"$nulls":5},73,73,{"$nulls":227},73,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["DOXIL10MG","Q2050","CPT",{"$nulls":6},"professional","both",{"$nulls":5},245.52,245.52,{"$nulls":181},245.52,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["DOXIL10MG","Q2050","CPT",{"$nulls":6},"professional","both",{"$nulls":5},12,12,{"$nulls":227},12,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["INJ FILGRASTIM BIOSIMILAR 1MCG","Q5101","CPT",{"$nulls":6},"professional","both",{"$nulls":5},0.69,0.69,{"$nulls":181},0.69,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["INJ FILGRASTIM BIOSIMILAR 1MCG","Q5101","CPT",{"$nulls":6},"professional","both",{"$nulls":5},12,12,{"$nulls":227},12,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["CONSULT SCREENING COLONOSCOPY","S0285","CPT",{"$nulls":6},"professional","both",{"$nulls":5},17.54,17.54,{"$nulls":181},17.54,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["NUTRITION COUNSELING DIETICIAN","S9470","CPT",{"$nulls":6},"professional","both",{"$nulls":5},17,17,{"$nulls":181},17,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["COVID19 PCR TEST","U0001","CPT",{"$nulls":6},"professional","both",{"$nulls":5},35.91,35.91,{"$nulls":181},35.91,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["COVID19 PCR TEST","U0001","CPT",{"$nulls":6},"professional","both",{"$nulls":5},20,20,{"$nulls":227},20,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]
["COVID19 PCR TEST","U0002","CPT",{"$nulls":6},"professional","both",{"$nulls":5},51.31,51.31,{"$nulls":181},51.31,{"$nulls":6},"fee schedule","fee schedule rate applies to non-facility place of service"]
["COVID19 PCR TEST","U0002","CPT",{"$nulls":6},"professional","both",{"$nulls":5},28,28,{"$nulls":227},28,{"$nulls":4},0,"percent of total billed charges"," Zero remittances of the item or service received in the 12 months prior to posting the file|fee schedule rate applies to non-facility place of service "]